bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of event‐based centralized excitation control method of synchronous generators for improving the transient stability
Authors: Yamaoka Fumichika , Kawabe Kenichi
Published: February 2024

Maintenance of transient stability is important for the stable operation of power systems. However, as a large amount of renewable energy sources are concerned that the transient stability deteriorates. Excitation control systems have been widely used to improve the transient stability. The defect is that only the synchronous generator (SG) near the fault location changes the excitation voltage so much immediately after the fault. In this study, we propose a novel excitation control method based on an event‐based wide‐area emergency control system. In this method, the SGs that are distant from the fault location play a role to mitigate the first swing as well as the SGs near the fault. The effectiveness of the proposed method is verified demonstrated by numerical simulation for a multi‐machine test system
Habitual carbohydrate ingestion reduces the efficacy of oral carbohydrate rinsing during repetitions to failure
Authors: Clarke Neil D. , Richardson Darren L.
Published: February 2024

Carbohydrate mouth rinsing has been reported to enhance exercise performance although individual variation exists. The present study aimed to investigate the effect of habitual dietary carbohydrate intake on the efficacy of rinsing a 6% carbohydrate solution on the number of bench press repetitions to failure at 60% of 1‐RM. Twenty‐one recreationally active male participants (Mean ± SD) (age: 24 ± 4 years, height: 177.8 ± 7.8 cm, body mass: 78.6 ± 8.1 kg; bench press 1‐RM: 73.3 ± 20.5 kg) performed bench press repetitions to failure at 60% 1‐RM following rinsing with 25 mL of a 6% carbohydrate (CHO), an artificially sweetened solution (PLA) and a non‐rising control condition (CON) in a randomised cross‐over design. A 7‐day dietary record was completed prior to the first session and subsequently analysed for daily carbohydrate consumption. The number of repetitions performed during CHO (24 ± 4) was higher than CON [21 ± 4; p < 0.001; 95% CI: 1, 4; d = 0.64], as was PLA [23 ± 4; p = 0.002; 95% CI: 1, 3; d = 0.48]. However, there was a large, negative relationship [r = −0.68 (95% CI: −0.86, −0.36), p < 0.001] between daily relative carbohydrate intake (g kg−1) and the difference in the number of repetitions between CHO and PLA. The present study suggests the existence of an inverse relationship between daily carbohydrate ingestion and the efficacy of carbohydrate mouth rinsing; participants who consumed the most daily carbohydrate were generally less likely to see an increase in performance with carbohydrate rinsing.
ILAE neuroimaging task force highlight: Subcortical laminar heterotopia
Authors: Kasper Burkhard S. , Archer John , Bernhardt Boris C. , Caciagli Lorenzo , Cendes Fernando , Chinvarun Yotin , Concha Luis , Federico Paolo , Gaillard William , Kobayashi Eliane , Ogbole Godwin , Vaudano Anna Elisabetta , Wang Irene , Wang Shuang , Winston Gavin P. , Rampp Stefan
Published: February 2024

The ILAE Neuroimaging Task Force publishes educational case reports that highlight basic aspects of neuroimaging in epilepsy consistent with the ILAE's educational mission. Subcortical laminar heterotopia, also known as subcortical band heterotopia (SBH) or “double cortex,” is an intriguing and rare congenital malformation of cortical development. SBH lesions are part of a continuum best designated as agyria‐pachygyria‐band‐spectrum. The malformation is associated with epilepsy that is often refractory, as well as variable degrees of developmental delay. Moreover, in an increasing proportion of cases, a distinct molecular‐genetic background can be found. Diagnosing SBH can be a major challenge for many reasons, including more subtle lesions, and “non‐classic” or unusual MRI‐appearances. By presenting an illustrative case, we address the challenges and needs of diagnosing and treating SBH patients in epilepsy, especially the value of high‐resolution imaging and specialized MRI‐protocols.
Numerical investigation of the temperature characteristics beneath the ceiling driven by a strong plume in a longitudinal ventilated tunnel
Authors: Chen Longfei , Li Xiaosong , Yang Yunping , Li Zhisheng , Li Tao , Lan Yujie , Chen Yanqiu
Published: February 2024

Previous studies have mainly focused on the situation that the tunnel's continuous flame region was lower than the ceiling height. For tunnels with longitudinal ventilation, the temperature characteristics of strong fire plumes are still unclear. In this paper, the maximum temperature rise beneath the ceiling for strong fire plume conditions in a small‐scale tunnel is studied using fire dynamics simulator. Results show that when the effective height (the distance from the burner surface to the ceiling of the tunnel) is 0.65 m, the maximum temperature rise beneath the ceiling in this work shows a good correlation with Li's model and Kurioka's model. However, as the effective height decreases to 0.55 and 0.50 m, the maximum temperature rise would be significantly lower than the previous model. Therefore, a dimensionless coefficient is introduced to modify the maximum temperature rise model for a strong fire plume, which involves the effective height coefficient, heat release rate, and longitudinal ventilation. A calculation model for the maximum temperature rise beneath the tunnel ceiling in the condition of strong fire plumes is established. The temperature attenuation data along the tunnel are given by statistics. The relationship between the dimensionless temperature rise and the dimensionless position parameter is established, and a unified model under various heat release rates is obtained.
A deep learning hierarchical approach to road traffic forecasting
Authors: Benabdallah Benarmas Redouane , Beghdad Bey Kadda
Published: February 2024

Traffic forecasting is a crucial task of an Intelligent Transportation System (ITS), which remains very challenging as it is affected by the complexity and depth of the road network. Although the decision‐makers focus on the accuracy of the top‐level roads, the forecasts on the lower levels also improve the overall performance of ITS. In such a situation, a hierarchical forecasting strategy is more appropriate as well as a more accurate prediction methods to reach an efficient forecast. In this paper, we present a deep learning (DL) approach for hierarchical forecasting of traffic flow by exploring the hierarchical structure of the road network. The proposed approach is considered an improved variation on the top‐down strategy for the reconciliation process. We propose a model based on two deep neural network components to generate a coherent forecast for the total number of road segments. We use N‐BEATS, a pure deep learning forecasting method, at the highest levels for traffic time series, then disaggregate these downwards to get coherent forecasts for each series of the hierarchy using a combination of CNN and LSTM. Experiments were carried out using Beijing road traffic dataset to demonstrate the effectiveness of the approach.
Sarcopenia predicts short‐term treatment‐related toxicity in patients undergoing curative‐intent therapy for head and neck cancer: A systematic review and meta‐analysis
Authors: Mascarella Marco A. , Ferdus Jannatul , Vendra Varun , Sridharan Shaum , Sultanem Khalil , Tsien Christina , Shenouda George , Bouganim Nathaniel , Esfahani Khashayar , Richardson Keith , Mlynarek Alex , Sadeghi Nader , Hier Michael , Kergoat Marie‐Jeanne
Published: February 2024

Sarcopenia is an increasingly recognized biomarker associated with poorer outcomes. The objective of this study was to ascertain the effect of sarcopenia on treatment tolerance and short‐term toxicity in head and neck cancer (HNC). A systematic review was performed using multiple databases. An inverse‐variation, random‐effects model was used to perform the meta‐analysis to evaluate the effect of sarcopenia on severe treatment toxicity and poor treatment tolerance. Sixteen observational studies, including 3187 patients with HNC, were analyzed. The combined odds ratio (OR) for severe treatment toxicity and tolerance was 2.22 (95%CI 1.50–3.29) and 1.40 (95%CI 0.84–2.32), respectively. The effect of sarcopenia on short‐term severe treatment toxicity was similar with upfront surgery (OR 2.03, 95%CI 1.22–3.37) and definitive radiotherapy (OR 2.24, 95%CI 1.18–4.27) Patients with sarcopenia are more than twice as likely to suffer a short‐term treatment‐related toxicity when undergoing curative‐intent HNC treatment.
Human factors analysis of coal mine gas accidents based on improved HFACS model
Authors: Zhang Mengjiao , Li Hongxia , Xia Heqiong , Zhang Qian , Chen Yanlin , Liu Yuchen , Xu Haoran
Published: February 2024

Gas accidents represent a crucial domain of coal mine safety research, as they result in substantial property damage, environmental pollution, and even loss of life compared to other types of accidents. Particularly, human factors play a significant role in the majority of mining accidents. The objective of this paper is to enhance the quality of coal mine safety management, minimize the occurrence of adverse human factors in gas accidents, and analyze the factors influencing coal mine gas accidents using the Human Factors Analysis and Classification System (HFACS). To commence, this paper has devised a human factor influence index system based on the enhanced HFACS for coal mine gas accidents. Subsequently, the Decision‐making Trial and Evaluation Laboratory (DEMATEL) method has been employed to quantitatively delineate the causal relationships among these factors. Lastly, this paper utilized the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) comprehensive evaluation method to evaluate the importance of factors influencing coal mine gas accidents. The research findings indicate that through the utilization of the DEMATEL methodology for centrality and causal relationship calculations, the centrality and causality values associated with poor organizational management emerge as the foremost among all factors. This underscores the pivotal role that poor organizational management plays in the human factors influencing coal mine gas accidents. Furthermore, a meticulous examination using TOPSIS identified the top five indicators of influence capability: cognitive errors > habitual violations > operational management > management process > resource management. The analysis of human factors in coal mine gas accidents can provide enhanced theoretical support for the management of production safety in coal mines, as well as the prevention of gas accidents.
Short‐term effect of dressing with Dermaheal ointment in the treatment of diabetic foot ulcer: A double‐blinded randomized controlled clinical trial
Authors: Salahi Pouya , Nasiri Morteza , Yazdanpanah Leila , Khosravi Sepehr , Amini Mohammad Reza
Published: February 2024

Background and Aims

Diabetic foot ulcers, a major cause of amputations in diabetics, could benefit from natural products as adjuncts to standard care, given the costs and adverse effects of typical therapies. This study aims to evaluate the short‐term effects of dressing with Dermaheal ointment in the treatment of DFUs through a double‐blinded randomized controlled clinical trial.

Methods

This double‐blinded, placebo‐controlled trial included 50 patients with Wagner's ulcer grade I or II, randomly assigned to Dermaheal and placebo groups (received standard treatment and placebo ointment). The ulcer site was dressed daily for four consecutive weeks with either Dermaheal or placebo ointment. Ulcer healing score (using DFU healing checklist), ulcer size with transparent ruler and largest dimension of ulcer, and pain severity using numerical pain rating score (were recorded at five‐time points, including baseline, and on weeks 1, 2, 3, and 4). Also, ulcer healing status was investigated at the trial ended in November 2021.

Results

Both groups showed significant improvement in ulcer healing over 4 weeks (ptime < 0.001), with more remarkable progress in the Dermaheal group (pgroup = 0.03). At the trial end, complete ulcer healing was also significantly higher in the Dermaheal group compared to the placebo group (56% vs. 12%, p = 0.002). Both groups exhibited a decrease in ulcer size (ptime < 0.001). Considering the baseline ulcer size as a covariate, substantial changes in mean ulcer size were noted in the initial (p = 0.01), second (p = 0.001), third (p = 0.002), and fourth (p = 0.002) weeks of the intervention, showing a preference for the Dermaheal group. However, no significant between‐group difference was observed in pain severity levels.

Conclusion

Dressing with Dermaheal as a topical treatment shows promise in improving healing and reducing the size of diabetic foot ulcers. Further research is needed to confirm these findings' long‐term efficacy.
Galectin‐9 alleviates acute graft‐versus‐host disease after haplo‐hematopoietic stem cell transplantation by regulating regulatory T cell/effector T cell imbalance
Authors: Pang Nannan , Tudahong Shabaaiti , Zhu Yuejie , He Jiang , Han Chunxia , Chen Gang , Wang Weiguo , Wang Jing , Ding Jianbing
Published: February 2024

Background

Acute graft‐versus‐host disease (aGVHD) arises from the imbalance of host T cells. Galectin‐9 negatively regulates CD4 effector T cell (Th1 and Th17) function by binding to Tim‐3. However, the relationship between Galectin‐9/Tim‐3 and CD4+ T subsets in patients with aGVHD after Haplo‐HSCT (haploidentical peripheral blood hematopoietic stem cell transplantation) has not been fully elucidated. Here, we investigated the role of Galectin‐9 and CD4+T subsets in aGVHD after haplo‐HSCT.

Methods

Forty‐two patients underwent Haplo‐HSCT (26 without aGVHD and 16 with aGVHD), and 20 healthy controls were included. The concentrations of Galectin‐9, interferon‐gamma (IFN‐γ), interleukin (IL)‐4, transforming growth factor (TGF)‐β, and IL‐17 in the serum and culture supernatant were measured using enzyme‐linked immunosorbent assay or cytometric bead array. The expression levels of Galectin‐9, PI3K, p‐PI3K, and p‐mTOR protein were detected by western blot analysis. Flow cytometry was used to analyze the proportions of CD4+ T cell subsets. Bioinformatics analysis was performed.

Results

In patients with aGVHD, regulatory T (Treg) cells and Galectin‐9 decreased, and the Th1, Th17, and Treg cells were significantly imbalanced. Moreover, Treg and Galectin‐9 were rapidly reconstituted in the early stage of patients without aGVHD after Haplo‐HSCT, but Th17 cells were reconstituted slowly. Furthermore, Tim‐3 upregulation on Th17 and Th1 cells was associated with excessive activation of the PI3K/AKT pathway in patients with aGVHD. Specifically, in vitro treatment with Galectin‐9 reduced IFN‐γ and IL‐17 production while augmenting TGF‐β secretion. Bioinformatics analysis suggested the potential involvement of the PI3K/AKT/mTOR pathway in aGVHD. Mechanistically, exogenous Galectin‐9 was found to mitigate aGVHD by restoring the Treg/Teffs (effector T cells) balance and suppressing PI3K.

Conclusion

Galectin‐9 may ameliorate aGVHD after haplo‐HSCT by modulating Treg/Teffs balance and regulating the PI3K/AKT/mTOR pathway. Targeting Galectin‐9 may hold potential value for the treatment of aGVHD.
Real‐world evidence of heparin and citrate use in extracorporeal photopheresis: A hypothesis‐generating data review of device settings and performance
Authors: Connelly‐Smith Laura S. , Griffin James , Leung Albert T. , Gennari Francesca
Published: February 2024

Extracorporeal photopheresis (ECP) is widely used for the treatment of cutaneous T‐cell lymphoma, graft‐vs‐host disease, and other immune‐related conditions. To avoid clotting during treatment, the ECP system used must be effectively primed with an anticoagulant. Heparin is the recommended anticoagulant for the THERAKOS CELLEX System, but acid citrate dextrose‐A (ACDA) is often used. We compared system performance between these two anticoagulants for this ECP system. Deidentified data for ECP device performance were obtained at each treatment session, from automatically logged Smart Cards or labels completed by device operators. We compared the effects of ACDA or heparin on overall treatment duration, buffy coat (leukocyte) collection time, photoactivation time and the number of alarms and warnings. The variability in these parameters was also assessed. Data from 23 334 treat sessions were analyzed; ACDA was used in 34.4% and heparin in 65.6%. Overall, the ECP procedure duration, buffy coat collection time and photoactivation time were numerically similar regardless of whether ACDA or heparin was used, and regardless of needle mode. Photoactivation time variability was lower with ACDA compared with heparin in all needle modes. Among treatments that were completed automatically without any operator intervention, total treatment duration and photoactivation time were significantly reduced with ACDA use in both the double‐ and single‐needle modes. The data presented indicate that, in both double‐ and single‐needle modes, the THERAKOS® CELLEX® integrated ECP system performed similarly with ACDA compared to heparin, although ACDA demonstrated potential benefits in reducing variability in photoactivation time.
Quantum cluster equilibrium theory applied to liquid ammonia
Authors: Maya Josué , Malloum Alhadji , Fifen Jean Jules , Dhaouadi Zoubeida , Fouda Henri Paul Ekobena , Conradie Jeanet
Published: February 2024

Through this paper, the authors propose using the quantum cluster equilibrium (QCE) theory to reinvestigate ammonia clusters in the liquid phase. The ammonia clusters from size monomer to hexadecamer were considered to simulate the liquid ammonia in this approach. The clusterset used to model the liquid ammonia is an ensemble of different structures of ammonia clusters. After studious research of the representative configurations of ammonia clusters through the cluster research program ABCluster, the configurations have been optimized at the MN15/6‐31++G(d,p) level of theory. These optimizations lead to geometries and frequencies as inputs for the Peacemaker code. The QCE study of this molecular system permits us to get the liquid phase populations in a temperature range of 190–260 K, covering the temperatures from the melting point to the boiling point. The results show that the population of liquid ammonia comprises mainly the ammonia hexadecamer followed by pentadecamer, tetradecamer, and tridecamer. We noted that the small‐sized ammonia clusters do not contribute to the population of liquid ammonia. In addition, the thermodynamic properties, such as heat of vaporization, heat capacity, entropy, enthalpy, and free energies, obtained by the QCE theory have been compared to the experiment given some relatively good agreements in the gas phase and show considerable discrepancies in liquid phase except the density. Finally, based on the predicted population, we calculated the infrared spectrum of liquid ammonia at 215 K temperature. It comes out that the calculated infrared spectrum qualitatively agrees with the experiment.
Taxonomic significance of morphological and elemental characteristics of achenes of Artemisia genus from Turkey
Authors: Karaismailoğlu Mehmet Cengiz , Polat Alkan Nagihan , Kürşat Murat , Civelek Şemsettin
Published: February 2024

In the study, the achene macromorphological and micromorphological characters of the genus Artemisia distributed in Turkey have been researched with the target of knowing systematically important carpological structures for the examined species. Macro‐morphological structures of the achenes including color, shape, dimension, and carpopodium diameter were studied with 100 achenes of 10 specimens per taxa with a Light Microscope. Micro‐morphological features of the achenes containing surface ornamentation, anticlinal and periclinal cell walls, epidermal cells, and the presence of secondary structures were examined with a Scanning Electron Microscope. EDS analyses were performed with a SEM. EDS analyses were carried out by selecting the same spot on the sample surface at 80 sec under 30 μm aperture size, with 20 kV acceleration voltage, 8 mm operating distance, high current, and processing time conditions. The color, shape, and dimension of achene have macro‐morphologically shown variations. The examined achenes are separated into four shapes; fusiform‐oblong, oblong, oblong‐ovate, and ovate. Oblong‐ovate is the most common type. Achene dimensions range from 0.62 to 2.48 mm in length, and from 0.30 to 1.21 mm in width. Also, carpopodium diameter varies between 0.10 and 0.19 mm. Achene surfaces of the examined taxa are micro‐morphologically assessed, and substantial differences are noticeably detected on behalf of the surface structures for instance, surface ornamentation, anticlinal and periclinal cell walls, epidermal cells, and the presence of secondary structures of the achenes. Surface ornamentation is separated into 10 types: irregularly sulcate, regularly sulcate, ruminate, sulcate‐scalariform, rugose, favulariate, slightly sulcate, alveolate, tuberculate, and reticulate. A percentage comparison of the elements in the achene pericarp of the studied taxa has been performed with SEM‐EDS. Accordingly, pericarps in taxa include C, Ca, K, Mg, Cl, Si, Na, and S elements. In the taxonomy of the genus Artemisia, the achene morphological characters are very significant characteristics that disclose inter‐specific relations among the examined taxa. Moreover, a dichotomous key is offered for the identification of the studied taxa based on achene characters.

Research Highlights

The achenes of Turkish Artemisia taxa have been examined in depth.

The morphological characteristics of achenes of Turkish Artemisia taxa have been studied using SEM and LM for the first time and debated the systematic practice of these characters.

The elemental content of the achene pericarp has been systematically evaluated for the first time.
Association of Pulmonary Transit Time and Pulmonary Blood Volume From First‐Pass Perfusion Cardiac MRI With Diastolic Dysfunction and Left Ventricle Deformation in Restrictive Cardiomyopathy
Authors: Gao Yue , Min Chen‐Yan , Jiang Yi‐Ning , Shi Rui , Guo Ying‐Kun , Xu Hua‐Yan , Yang Zhi‐Gang , Li Yuan
Published: February 2024

Background

Patients with restrictive cardiomyopathy (RCM) have impaired diastolic filling and hemodynamic congestion. Pulmonary transit time (PTT) and pulmonary blood volume index (PBVi) reflect the hemodynamic status, but the relationship with left ventricle (LV) dysfunction remains unclear.

Purpose

To evaluate the PTT and PBVi in RCM patients, the association with diastolic dysfunction and LV deformation, and the effects on the occurrence of major adverse cardiac events (MACE) in RCM patients.

Study Type

Retrospective.

Population

137 RCM patients (88 men, age 58.80 ± 10.83 years) and 68 age‐ and sex‐matched controls (46 men, age 57.00 ± 8.59 years).

Field Strength/Sequence

3.0T/Balanced steady‐state free precession sequence, recovery prepared echo‐planar imaging sequence, and phase‐sensitive inversion recovery sequence.

Assessment

The LV function and peak strain (PS) parameters were measured. The PTT was calculated and corrected by heart rate (PTTc). The PBVi was calculated as the product of PTTc and RV stroke volume index.

Statistical Tests

Chi‐squared test, student's t‐test, Mann–Whitney U test, Pearson's or Spearman's correlation, multivariate linear regression, Kaplan–Meier survival analysis, and Cox regression models analysis. A P‐value <0.05 was considered statistically significant.

Results

The PTTc showed a significant correlation with the E/A ratio (r = 0.282), and PBVi showed a significant correlation with the E/e′ ratio, E/A ratio, and diastolic dysfunction stage (r = 0.222, 0.320, and 0.270). PTTc showed an independent association with LVEF, LV circumferential PS, and LV longitudinal PS (β = 0.472, 0.299, and 0.328). In Kaplan–Meier analysis, higher PTTc and PBVi were significantly associated with MACE. In multivariable Cox regression analysis, PTTc was a significantly independent predictor of the MACE in combination with both cardiac MRI functional and tissue parameters (hazard ratio: 1.23/1.32, 95% confidence interval: 1.10–1.42/1.20–1.46).

Data Conclusion

PTTc and PBVi are associated with diastolic dysfunction and deteriorated LV deformation, and PTTc independently predicts MACE in patients with RCM.

Level of Evidence

3

Technical Efficacy

Stage 2
Mottled ducks, feral mallards, and their hybrids in Florida
Authors: Bielefeld Ronald R. , Sylvia Andrea L. , Bankovich Brittany A. , McBride K. Mark , Orange Jeremy P.
Published: February 2024

The nonmigratory and endemic Florida mottled duck (Anas fulvigula fulvigula) is facing conservation threats from the combined effects of urbanization and introgressive hybridization with feral mallards (Anas platyrhynchos) and mallard x mottled duck hybrids. In the past, the status of the Florida mottled duck population was assessed during annual aerial surveys and most brown ducks (mottled ducks, mallards, and hybrids of them) detected during the survey would have been mottled ducks. But the release of domesticated mallards for aesthetic purposes has led to increases in the prevalence of mallards‐hybrids (mallards or mallard x mottled duck hybrids) throughout peninsular Florida, USA, and because it is impossible to differentiate among mottled ducks, female mallards, and hybrids during aerial surveys, helicopter surveys were halted in 2009 until state researchers could conduct a range‐wide study to determine what proportion of brown ducks are mottled ducks versus mallards‐hybrids. We used plumage keys and high‐resolution photography to categorize brown ducks from 557 wetland grid points as either mottled ducks or mallards‐hybrids. Of the 5,179 brown ducks categorized, 40.1% were mottled ducks and 59.9% were mallards‐hybrids. We used logistic regression analysis to model the interactive effect of a site's latitude and level of urbanization (urban gradient value within a 2‐km buffer) to generate a predictive raster surface (1‐km resolution) of the study area with values corresponding to the probability that a brown duck observed within a cell is a pure mottled duck. Predicted values will be used as correction factors when estimating final mottled duck population abundance from brown‐duck survey data. Additionally, the predictive raster surface will be used to identify wetlands where mottled ducks remain predominant so that these sites can be targeted for preservation. Overall, mallards‐hybrids outnumbered mottled ducks throughout most of peninsular Florida, especially in more urbanized regions, and their current prevalence rate presents a serious conservation threat, via hybridization, to extant mottled duck populations.
Full‐face and neck resurfacing with a novel ablative fractional 2910 nm erbium‐doped fluoride glass fiber laser for advanced photoaging
Authors: Murray Taryn N. , Hu Jamie K. , Friedman Paul M.
Published: February 2024

Objectives

Ablative fractional lasers have long been considered the gold standard for facial resurfacing for advanced photoaging. These lasers offer an improved safety profile compared to traditional ablative lasers but typically require more treatment sessions given their fractional approach. In this study, we evaluate a new novel 2910 nm erbium‐doped fluoride glass fiber laser (2910 nm fiber laser) (UltraClear; Acclaro Medical) for full‐face and neck resurfacing for the treatment of advanced photoaging.

Methods

Twenty‐two healthy subjects aged 44–80 years presenting for advanced facial photoaging and rhytides were enrolled in the study. All subjects received three full‐face and neck, multipass treatments utilizing the 2910 nm fiber laser spaced 6–8 weeks apart. Subjects were asked to rate the average level of pain during the treatment. At 90 days following subjects' third treatment subjects evaluated their improvement using a Global Aesthetic Improvement Scale (GAIS) and rated their satisfaction with the treatment. Evaluation of pretreatment and posttreatment photos was completed by two blinded physician reviewers. Reviewers were asked to identify the pretreatment and posttreatment photographs and to rate the degree of improvement utilizing a GAIS.

Results

Fifteen participants completed the study; six were exited from the study (withdrew or lost to follow‐up). The average subject GAIS score for overall appearance was 3.8. The average subject satisfaction level at follow‐up was 4.8. The average subject pain score was 4.9. One blinded physician reviewer correctly identified 100% of subjects' posttreatment photographs, while the second blinded reviewer correctly identified 93%. Blinded evaluation of digital photographs revealed an average GAIS score of 3.2. Posttreatment skin responses included pin‐point hemorrhage, erythema, edema, and soft tissue crusting lasting 5–7 days. There were no instances of infection, scarring or hypopigmentation. There were two instances of temporary hyperpigmentation.

Conclusions

Treatment with the novel 2910 nm fiber laser is safe and effective in treating advanced photoaging and rhytides. Three treatments produced moderate to marked improvement with high patient satisfaction and treatment was associated with less discomfort and downtime compared to conventional fractional ablative lasers.
Neuronal CFL1 upregulation in head and neck squamous cell carcinoma enhances tumor‐nerve crosstalk and promotes tumor growth
Authors: Liu Ruoyan , Wang Chunli , Sun Zhonghao , Shi Xiaotian , Zhang Ze , Luo Jingtao
Published: February 2024

Head and neck squamous cell carcinoma (HNSCC) is a prevalent cancer type, marked by a pronounced nerve density within the tumor microenvironment and a high rate of perineural invasion (PNI). Growing evidence suggests that the nervous system plays a vital role in HNSCC progression. Yet, the mechanisms governing cancer‐nerve interactions remain largely elusive. Our research revealed that cofilin‐1 (CFL1) is significantly overexpressed in HNSCC and correlates with both PNI and unfavorable prognosis. Utilizing multiplex fluorescent immunohistochemistry, we have localized CFL1 chiefly to the nerves adjacent to tumor sites. Significantly, it is the elevated expression of CFL1 in neuronal structures, rather than in the tumor cells, that aligns with diminished patient survival rates. We observed that HNSCC cells induced the expression of neuronal CFL1 and that the conditional knockout of neuronal CFL1 impedes tumor‐nerve interactions. Both Gene Ontology functional enrichment analyses and Gene Set Enrichment Analysis demonstrate that CFL1 expression in HNSCC is associated with specific biological processes, including “RIBOSOME,” “PROTEASOME,” and “cadherin binding.” In summary, HNSCC promotes the expression of CFL1 in nerves, which is essential for cancer‐nerve interactions. The neuronal CFL1 is associated with PNI and may be a potential molecular prognostic marker of poor survival in HNSCC.
Glutaminase potentiates the glycolysis in esophageal squamous cell carcinoma by interacting with PDK1
Authors: Zhu Guangzhao , Guan Fangxia , Li Shenglei , Zhang Qing , Zhang Xueying , Qin Yue , Sun Zhangzhan , Peng Shaohua , Cheng Jiexing , Li Yiyang , Ren Ruili , Fan Tianli , Liu Hongtao
Published: February 2024

Increasing evidence has demonstrated that glutaminase (GLS) as a key mitochondrial enzyme plays a pivotal role in glutaminolysis, which widely participates in glutamine metabolism serving as main energy sources and building blocks for tumor growth. However, the roles and molecular mechanisms of GLS in esophageal squamous cell carcinoma (ESCC) remains unknown. Here, we found that GLS was highly expressed in ESCC tissues and cells. GLS inhibitor CB‐839 significantly suppressed cell proliferation, colony formation, migration and invasion of ESCC cells, whereas GLS overexpression displayed the opposite effects. In addition, CB‐839 markedly suppressed glucose consumption and lactate production, coupled with the downregulation of glycolysis‐related proteins HK2, PFKM, PKM2 and LDHA, whereas GLS overexpression exhibited the adverse results. In vivo animal experiment revealed that CB‐839 dramatically suppressed tumor growth, whereas GLS overexpression promoted tumor growth in ESCC cells xenografted nude mice. Mechanistically, GLS was localized in mitochondria of ESCC cells, which interacted with PDK1 protein. CB‐839 attenuated the interaction of GLS and PDK1 in ESCC cells by suppressing PDK1 expression, which further evoked the downregulation of p‐PDHA1 (s293), however, GLS overexpression markedly enhanced the level of p‐PDHA1 (s293). These findings suggest that interaction of GLS with PDK1 accelerates the glycolysis of ESCC cells by inactivating PDH enzyme, and thus targeting GLS may be a novel therapeutic approach for ESCC patients.
Design a wideband high‐efficiency continuous class‐GF power amplifier based on a source second harmonic manipulation architecture
Authors: Xuan Xuefei , Cheng Zhiqun , Zhang Zhiwei , Zhang Ruizhe , Gong Tingwei , Le Chao
Published: February 2024

In this paper, a novel source second harmonic manipulation architecture achieving second harmonic control at device input is proposed to solve the issue of reduced operating efficiency of power amplifiers (PAs) caused by the input nonlinearity in continuous Class‐GF mode. The key to the proposed architecture lies in the use of a compact multibranch network to match the source second harmonics of the three design frequency points to the short‐circuit state, which can expand bandwidth while avoiding unexpected efficiency degradation. Considering the necessity of theoretical verification, a broadband continuous Class‐GF PA is designed, implemented, and assembled employing a commercially available 10‐W gallium nitride device. The measured results show that a fractional bandwidth of 100% across 1.1–3.3 GHz with a drain efficiency of 62.4%–72.5%, an output power of 40.1–42.2 dBm, and a gain of 10.1–12.2 dBm are achieved under saturated output power.
Equivalent uniform RBE‐weighted dose in eye plaque brachytherapy
Authors: Chvetsov Alexei V.
Published: February 2024

Background

Brachytherapy for ocular melanoma is based on the application of eye plaques with different spatial dose nonuniformity, time‐dependent dose rates and relative biological effectiveness (RBE).

Purpose

We propose a parameter called the equivalent uniform RBE‐weighted dose (EUDRBE) that can be used for quantitative characterization of integrated cell survival in radiotherapy modalities with the variable RBE, dose nonuniformity and dose rate. The EUDRBE is applied to brachytherapy with 125I eye plaques designed by the Collaborative Ocular Melanoma Study (COMS).

Methods

The EUDRBE is defined as the uniform dose distribution with RBE = 1 that causes equal cell survival for a given nonuniform dose distribution with the variable RBE > 1. The EUDRBE can be used for comparison of cell survival for nonuniform dose distributions with different RBE, because they are compared to the reference dose with RBE = 1. The EUDRBE is applied to brachytherapy with 125I COMS eye plaques that are characterized by a steep dose gradient in tumor base‐apex direction, protracted irradiation during time intervals of 3–8 days, and variable dose‐rate dependent RBE with a maximum of about 1.4. The simulations are based on dose of 85 Gy prescribed to the farthest intraocular extent of the tumor (tumor apex). To compute the EUDRBE in eye plaque brachytherapy and correct for protracted irradiation, the distributions of physical dose have been converted to non‐uniform distributions of biologically effective dose (BED) to include the biological effects of sublethal cellular repair, Our radiobiological analysis considers the combined effects of different time‐dependent dose rates, spatial dose non‐uniformity, dose fractionation and different RBE and can be used to derive optimized dose regimens brachytherapy.

Results

Our simulations show that the EUDRBE increases with the prescription depths and the maximum increase may achieve 6% for the tumor height of 12 mm. This effect stems from a steep dose gradient within the tumor that increases with the prescription depth. The simulations also show that the EUDRBE increase may achieve 12% with increasing the dose rate when implant duration decreases. The combined effect of dose nonuniformity and dose rate may change the EUDRBE up to 18% for the same dose prescription of 85 Gy to tumor apex. The absolute dose range of 48–61 Gy (RBE) for the EUDRBE computed using 4 or 5 fractions is comparable to the dose prescriptions used in stereotactic body radiation therapy (SBRT) with megavoltage X‐rays (RBE = 1) for different cancers. The tumor control probabilities in SBRT and eye plaque brachytherapy are very similar at the level of 80% or higher that support the hypothesis that the selected approximations for the EUDRBE are valid.

Conclusions

The computed range of the EUDRBE in 125I COMS eye plaque brachytherapy suggests that the selected models and hypotheses are acceptable. The EUDRBE can be useful for analysis of treatment outcomes and comparison of different dose regimens in eye plaque brachytherapy.
UDRSNet: An unsupervised deformable registration module based on image structure similarity
Authors: Wang Yun , Huang Chongfei , Chang Wanru , Lu Wenliang , Hui Qinglei , Jiang Siyuan , Ouyang Xiaoping , Kong Dexing
Published: February 2024

Background

Image registration is a challenging problem in many clinical tasks, but deep learning has made significant progress in this area over the past few years. Real‐time and robust registration has been made possible by supervised transformation estimation. However, the quality of registrations using this framework depends on the quality of ground truth labels such as displacement field.

Purpose

To propose a simple and reliable method for registering medical images based on image structure similarity in a completely unsupervised manner.

Methods

We proposed a deep cascade unsupervised deformable registration approach to align images without reliable clinical data labels. Our basic network was composed of a displacement estimation module (ResUnet) and a deformation module (spatial transformer layers). We adopted ‐norm to regularize the deformation field instead of the traditional ‐norm regularization. Additionally, we utilized structural similarity (ssim) estimation during the training stage to enhance the structural consistency between the deformed images and the reference images.

Results

Experiments results indicated that by incorporating ssim loss, our cascaded methods not only achieved higher dice score of 0.9873, ssim score of 0.9559, normalized cross‐correlation (NCC) score of 0.9950, and lower relative sum of squared difference (SSD) error of 0.0313 on CT images, but also outperformed the comparative methods on ultrasound dataset. The statistical ‐test results also proved that these improvements of our method have statistical significance.

Conclusions

In this study, the promising results based on diverse evaluation metrics have demonstrated that our model is simple and effective in deformable image registration (DIR). The generalization ability of the model was also verified through experiments on liver CT images and cardiac ultrasound images.
Clinical prognostic factors predicting survival of motor neuron disease patients with gastrostomy: A retrospective analysis
Authors: Yang Jie , Zhao Yun , Soares Mario , Needham Merrilee , Begley Andrea , Calton Emily
Published: February 2024

Introduction/Aims

Enteral feeding via gastrostomy is a key intervention to prevent significant weight loss in Motor Neuron Disease (MND). The aim of this study was to explore demographic, clinical, and nutritional factors associated with survival time in MND patients with gastrostomy.

Methods

The retrospective study analyzed 94 MND patients (n = 58 bulbar‐onset and n = 36 limb‐onset) who underwent gastrostomy between 2015 and 2021. The primary outcome was the survival time from gastrostomy insertion to death. Independent variables of interest explored were: age at gastrostomy insertion, disease onset type, known genetic cause, use of riluzole, non‐invasive ventilation (NIV) use, forced vital capacity prior to gastrostomy, weight loss from diagnosis to gastrostomy insertion, and body mass index (BMI) at the time of gastrostomy insertion.

Results

The median survival time from gastrostomy to death was 357 days (± 29.3, 95%CI: 299.5, 414.5). Kaplan–Meier method and log‐rank test revealed patients with lower body mass index <18.5 kg/m2 at the time of gastrostomy insertion (p = .023) had shorter survival. Cox proportional hazards model with multivariable adjustment revealed that older age (p = .008), and greater weight loss from diagnosis to gastrostomy (p = .003) were associated with shorter survival time post gastrostomy. Limb onset (p = .023), NIV use not being required (p = .008) and daily NIV use when required and tolerated (p = .033) were associated with longer survival.

Discussion

Preventing or minimizing weight loss from MND diagnosis and encouraging NIV use when clinically indicated are modifiable factors that may prolong the survival of MND patients with gastrostomy.
Uncertainty‐oriented thermoelastic topology optimization with stress constraint
Authors: Cheng Changzheng , Yang Bo , Wang Xuan , Lee Ikjin
Published: February 2024

The material redistribution abilities of traditional deterministic topology optimization are effective in addressing stress‐related design issues in thermal elastic structures. However, uncertainties are inevitable in real‐world. The structural strength of a design, achieved through deterministic topology optimization, is highly susceptible to these uncertainties, which may result in failure. This article introduces a novel method for topology optimization in stress‐constrained thermoelastic structures, taking into account the uncertainties associated with heat sources and loads. We employ the Kieisselmeier–Steinhauser function to aggregate the stress constraint when constructing the performance function. In order to improve optimization efficiency, the sequential optimization and reliability assessment method is used to decouple the double‐layer loop reliability‐based topology optimization. Initially, we derive the derivative of stress‐based performance functions with respect to heat source and load uncertainty variables, thereby facilitating the use of modified chaos control for assessing structural reliability and imposing constraints. The adjoint method and chain rule are utilized to obtain the derivative information of the performance function with respect to density variables, guiding the topology updates. We present five design examples to demonstrate the effectiveness of the presented method. Monte Carlo simulations for the optimized results are performed to show that the presented method can obtain a structure that meets reliability requirements.
Building boards into better coxswains through sensemaking
Authors: Nesbit Rebecca
Published: February 2024

This response to von Schnurbein and Ahmad's article delves deeper into the authors' recommendation that foundation boards focus on developing their sensemaking skills. This article discusses five practical suggestions for incorporating sensemaking activities into the work of the board. These recommendations include hiring a coach, including training in board meetings, evaluating the board's performance, bringing a beneficiary to speak at board meetings, and acting as a convenor in the community.
Neuromodulation for Treatment of Tinnitus: A Systematic Review and Meta‐Analysis
Authors: Heiland Luke D. , Owen Johnny M. , Nguyen Shaun A. , Labadie Robert F. , Lambert Paul R. , Meyer Ted A.
Published: February 2024

Objective

To evaluate the treatment efficacy of neuromodulation versus sham for the treatment of tinnitus.

Data Sources

Cochrane Library, CINAHL, PubMed, Scopus.

Review Methods

The Cochrane Library, CINAHL, PubMed, and Scopus were searched from inception through May 2023 for English language articles documenting “neuromodulation” and “tinnitus” stratified by sham‐controlled randomized control trials with 40 or more patients. Data collected included Beck Anxiety Inventory, Beck Depression Inventory (BDI), Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire, and Visual Analog Scale. A Meta‐analysis of continuous measures (mean) and proportions (%) were conducted.

Results

A total of 19 randomized control trials (N = 1186) were included. The mean age was 48.4 ± 5.3 (range: 19‐74), mean duration of tinnitus was 3.8 ± 3.4 years, 61% [56.2‐65.7] male, and 55.7% [46‐65] with unilateral tinnitus. The short‐term effect of transcutaneous electrical nerve stimulation and transcranial direct current stimulation on THI score is −16.2 [−23.1 to −9.3] and −19 [−30.1 to −7.8], respectively. The long‐term effect of repetitive transcranial magnetic stimulation on THI score is −8.6 [−11.5 to −5.7]. Transcranial direct current stimulation decreases BDI score by −11.8 [−13.3 to −10.3].

Conclusion

As measured by the Tinnitus Handicap Index, our findings suggest the effects of transcutaneous electrical nerve stimulation and transcranial direct current stimulation reach significant benefit in the short term, whereas repetitive transcranial magnetic stimulation reaches significant benefit in the long term. Based on the BDI, transcranial direct current stimulation significantly reduces comorbid depression in patients with tinnitus.
Revisiting Feeding Tube Utilization in Oropharynx Cancer: 6‐Year Prospective Registry Analysis
Authors: Anderson Brady J. , Moreno Amy C. , Qing Yun , Lee J. Jack , Johnson Faye M. , Lango Miriam N. , Barbon Carly E. A. , Tripuraneni Lavanya , Sahli Ariana , Piper Vicki , Gross Neil , Fuller Clifton D. , Lai Stephen Y. , Myers Jeffrey N. , Hutcheson Katherine A.
Published: February 2024

Objective

Patients treated for oropharyngeal cancer (OPC) have historically demonstrated high feeding tube rates for decreased oral intake and malnutrition. We re‐examined feeding tube practices in these patients.

Study Design

Retrospective analysis of prospective cohort from 2015 to 2021.

Setting

Single‐institution NCI‐Designated Comprehensive Cancer Center.

Methods

With IRB approval, patients with new oropharyngeal squamous cell cancer or (unknown primary with neck metastasis) were enrolled. Baseline swallowing was assessed via videofluoroscopy and Performance Status Scale for Head and Neck Cancer (PSSHN). G‐tubes or nasogastric tubes (NGT) were placed for weight loss before, during, or after treatment. Prophylactic NGT were placed during transoral robotic surgery (TORS). Tube duration was censored at last disease‐free follow‐up. Multivariate regression was performed for G‐tube placement (odds ratio [OR] [95% confidence interval [CI]) and removal (Cox hazard ratio, hazard ratio [HR] [95% CI]).

Results

Of 924 patients, most had stage I to II (81%), p16+ (89%), node‐positive (88%) disease. Median follow‐up was 2.6 years (interquartile range 1.5‐3.9). Most (91%) received radiation/chemoradiation, and 16% received TORS. G‐tube rate was 27% (5% after TORS). G‐tube risk was increased with chemoradiation (OR 2.78 [1.87‐4.22]) and decreased with TORS (OR 0.31 [0.15‐0.57]) and PSSHN‐Diet score ≥60 (OR 0.26 [0.15‐0.45]). G‐tube removal probability over time was lower for T3 to T4 tumors (HR 0.52 [0.38‐0.71]) and higher for PSSHN‐Diet score ≥60 (HR 1.65 [1.03‐2.66]).

Conclusions

In this modern cohort of patients treated for OPC, 27% received G‐tubes—50% less than institutional rates 10 years ago. Patients with preserved baseline swallowing and/or those eligible for TORS may have lower G‐tube risk and duration.