bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of total dissolved solids and organic loadings on the chemical oxygen demand removal by yeast-activated sludge system.
Authors: Sinlapacheewa Peacharach , Sriariyanun Malinee , Pornwongthong Peerapong
Published: March 2023

Typically, the soybean oil processing industry generates complex wastewater containing high total dissolved solids (TDS), chemical oxygen demand (COD), and fat oil and grease (FOG) contents with low pH. Therefore, treating this industrial wastewater with the conventional activated sludge (AS) wastewater treatment system is challenging. Yeast can be co-cultured with the activated sludge (AS) called yeast-activated sludge (YAS) to degrade high COD and salinity in the wastewater. However, little is known about the effects of TDS and organic loading (OLRs) on the performance of YAS system with the presence of both Rhodotorula mucilaginosa and Candida xylanilytica. In this study, we evaluated the effects of TDS and organic loading rates (OLRs) on the performances of the YAS system for soybean oil wastewater treatment. Four sequencing batch reactors (SBRs) were operated under aerobic conditions at different TDS concentrations 25%, 50%, 75%, and 100% increasing rate. The results indicated that the TDS at the loading rate of 50% resulted in maximum biomass production. The overloading of the clarifier was observed and possibly caused by the accumulation of solids contained in the influent wastewater. At the OLR of 0.67 kg BOD5/m3-day and the TDS loading rate of 15.5 kg TDS/m3-day, the YAS system achieved the average COD removal efficiencies of 71±1%
Determination of GERR lifespan using RUSLE method and GIS integration
Authors: Shobary A S , Elsharkawy A S , El-Hanafy H E M , Moussa O M
Published: March 2023

Soil erosion is a grave and ongoing matter that poses an intimidation to the ecosystem all around the world. On basins with enormous surface areas, sedimentation has a significant impact. The Blue Nile basin is considered one of these basins that would be exposed to erosion and sedimentation after construction of the Grand Ethiopian Renaissance Dam (GERD), which will retain a large amount of sediments. The goal of this study is to calculate the lifespan of the Grand Ethiopian Renaissance Reservoir (GERR). In this research, the Revised Universal Soil Loss Equation (RUSLE) method, with the help of remote sensing and Geographic Information System (GIS), was utilized in order to determine soil erosion and sediment yield from the Blue Nile basin. Accordingly, lifespan of GERR could be estimated. The findings revealed that the total annual soil loss computed for Blue Nile basin is about 4.06*108 t. y−1, the total annual sediment yield equals about 1.21*108 t. y−1 and life span of GERR is estimated about 611 years. The approach presented in this study can be benefited from and applied in other basins that have the same conditions. Decision makers are able to use this approach to get reasonable results and control the problem of soil erosion and sedimentation.
Research on Scaling of Wastewater Transportation Pipes: A Review
Authors: Zhang L Z P , Yang C , Wang L , Wang X D
Published: March 2023

The pipes are prone to scaling and fouling during collection and transportation, mainly due to the complex and variable composition of industrial wastewater. It causes failure of the transmission system, shortens the life of the pipe, increases the operation cost, and poses potential risks to the ecological environment as well as human health. Therefore, the purpose of this paper is to sort out the research progress on the factors influencing the scaling of wastewater transport pipes and the mechanism of action. To suggest scientific scale inhibition for wastewater transport pipes. The purpose of this paper is to ensure the safety stability along with the effectiveness of the transport pipeline and treatment structures. In addition to provide a reference for future research directions.
Utilization of Rice Straw Wastes as Aggregate in Lightweight Concrete Block Production by Using Cold Press Technique
Authors: Thongchua G , Suwan T , Jitsangiam P , Wattanachai P , Kamthai S , Thongchua H , Prom-u-thai C , Yamuangmorn S
Published: March 2023

A massive rice straw waste was collected annually after the harvesting period. To reduce the air pollution/PM 2.5 during the burning season and to utilize those straw wastes, the development of rice straw based-lightweight cement block was studied. A Cold press method was selected for block manufacturing as it could gain terrific compressive strength with user-friendly operation. It was found that the saturated surface dry (SSD) condition of the straws achieved higher strength than that of the as-received (AR) condition. SSD of straw had softer and more flexibility to easily disperse in the cement matrix. Moreover, extra water in the wet SSD straws could also allow internal curing for more hydration reactions inside the specimens during their curing period. The optimal proportion for the production of rice straw based-lightweight cement block, achieving 6.43 MPa, is 0.30 of w/c ratio with 2% of straw addition in the SDD state. The outcomes could promote a value-added concept and achieve greener and cleaner production for the development of environmentally friendly alternative construction materials.
Development of Polymeric Binder from Expanded Polystyrene (EPS) Foam Waste as Construction Materials
Authors: Van Deursen C , Suwan T , Laosuwan S , Wongmatar P , Kaewmoracharoen M , Suwan P
Published: March 2023

Expanded Polystyrene (EPS) foam wastes become a huge environmental issue as most of them are non-biodegradable materials and are disposed of inappropriately. It was reported that the amount of plastic and foam wastes for food containers and other packagings was evidently increased during the past 5 years, especially since the COVID19 pandemic. This work studied the development of the polymeric foam binder from the EPS foam waste for the production of green construction blocks or pavement tiles. The types of solvent (acetone and toluene) and the amount of additional EPS foam binder were investigated. The results show that the appropriate mixtures contained EPS foam binder from 15% to 30% to achieve maximum compressive strength at approximately 10 to 12 MPa with the optimal unit weight of 1,600 to 1,900 kg/m3. Those outcomes have equally passed the strength class of Thai Industrial Standard (TIS 57 and 77) for construction brick and block. This eco-friendly technique could facilitate value-added production and reduce the environmental impact of EPS wastes disposal. Moreover, it is one of the alternative approaches to promote greener and cleaner production for environmentally friendly construction materials.
The Substitution of Natural Zeolite with Agriculture Waste as Carbon Dioxide Adsorbent in Biogas Purification
Authors: Pertiwiningrum A , Wuri M A , Tontowi A E , Harto A W , Wicaksono P A
Published: March 2023

Today, climate change is a global issue that must be resolved as soon as possible. Many governments take action to include renewable energy in energy mix policy. For Indonesia, biogas energy becomes one of many adopted alternative renewable energy sources. To increase the adoption of biogas in energy mix of Indonesia, biogas improvement should be enhanced. Biogas purification by adsorption is one of many methods of biogas improvement. To reduce the cost of biogas purification, we substitute natural zeolite with a local and waste-based adsorbent, the rice husk-based-biochar. In this study, we used five formulations with different ratios of zeolite and biochar: A1 (100% of natural zeolite), A2 (75%:25%), A3 (50%:50%), A4 (25%:75%), and A5 (100% of biochar) to decrease carbon dioxide composition and increase the calorific value of biogas. The substitution of 25% volume of zeolite with rice husk-based-biochar adsorbed 10.63% carbon dioxide. However, the substitution above 25% actually reduced the ability to adsorb carbon dioxide. The results showed that there is no correlation between carbon dioxide and the calorific value of biogas so further study needs to be developed to improve the biogas purification.
Theoretical prediction of novel two-dimensional MA2Z4 family for Li/Na battery anodes
Authors: Liu Yuyan , Ji Yujin , Ding Yi-Min , Li Youyong , Lee Shuit-Tong
Published: March 2023

The synthesized MoSi2N4 marks a new-born two-dimensional MA2Z4 family. In this work, we present a comprehensive study on the MA2Z4 family as anodes for Li- and Na-ion batteries (LIBs and SIBs) based on first-principle calculations. There exists a linear relationship between the ion adsorption energy

E

ads

and the energy level of the lowest unoccupied states

E

LUS

of MA2Z4, and a lower

E

LUS

leads to more energetically favorable electron occupation and hence stronger adsorption.

E

LUS

acts as a simple and useful descriptor, which allows for the straightforward prediction of ion adsorption based solely on the substrate electronic properties. Through evaluating the theoretical capacities and diffusion barriers, NbGe2N4 is predicted to be the most promising candidate for LIBs while VSi2P4 is better for SIBs, with maximum theoretical capacities of 547 mAh g−1 and 696 mAh g−1 and ion diffusion barriers of 0.34 eV and 0.10 eV, respectively. Moreover, NbGe2N4 and VSi2P4 show good phase stabilities by the analysis of their phase transformations. This study explores the application prospects of novel MA2Z4 in LIBs and SIBs and provides a deep understanding of intrinsic electronic mechanisms.
Combined estimation of B1 and T1 for dynamic contrast-enhanced MRI by accounting for incomplete spoiling of transverse magnetization
Authors: He J , Li Z F , Qi T F , Hou Z , Koh T S
Published: March 2023

Objective. The variable flip angle (VFA) method for longitudinal relaxation time (T
1) measurement is inherently sensitive to inaccuracies in the radiofRequency transmit field (B
1) and incomplete spoiling of transverse magnetization. The objective of this study is to devise a computational method that addresses the problems of incomplete spoiling and B
1 inhomogeneity in the estimation of T
1 using VFA method. Approach. Using an analytical expression of the gradient echo signal with account of incomplete spoiling, we first showed that ill-posedness in the simultaneous estimation of B
1 and T
1 can be lifted with the use of flip angles larger than the Ernst angle. We then devised a nonlinear optimization method based on this signal model of incomplete spoiling for simultaneous estimation of B
1 and T
1. Main results. We evaluated the proposed method on a graded-concentration phantom to show that the derived T
1 estimates offers an improvement over the regular VFA method and compares well with reference values measured by inversion recovery. Reduction of the number of flip angles from 17 to 5 yielded consistent results indicating that the proposed method is numerically stable. T
1 estimates derived from in-vivo brain imaging were consistent with literature values for gray and white matter tissues. Significance. Contrary to the common notion that B
1 correction in the VFA method for T
1 mapping should be performed separately, we show that combined estimation of B
1 and T
1 is feasible by the proposed method simply with the acquisition of 5 flip angles, as demonstrated on both phantom and in-vivo imaging data.
On the physics of ultrasound transmission for in-plane needle tracking in guided interventions
Authors: Malamal Gayathri , Panicker Mahesh Raveendranatha
Published: March 2023

Objective. In ultrasound (US) guided interventions, the accurate visualization and tracking of needles is a critical challenge, particularly during in-plane insertions. An inaccurate identification and localization of needles lead to severe inadvertent complications and increased procedure times. This is due to the inherent specular reflections from the needle with directivity depending on the angle of incidence of the US beam, and the needle inclination. Approach. Though several methods have been proposed for improved needle visualization, a detailed study emphasizing the physics of specular reflections resulting from the interaction of transmitted US beam with the needle remains to be explored. In this work, we discuss the properties of specular reflections from planar and spherical wave US transmissions respectively through multi-angle plane wave (PW) and synthetic transmit aperture (STA) techniques for in-plane needle insertion angles between 15°–50°. Main Results. The qualitative and quantitative results from simulations and experiments reveal that the spherical waves enable better visualization and characterization of needles than planar wavefronts. The needle visibility in PW transmissions is severely degraded by the receive aperture weighting during image reconstruction than STA due to greater deviation in reflection directivity. It is also observed that the spherical wave characteristics starts to alter to planar characteristics due to wave divergence at large needle insertion depths. Significance. The study highlights that synergistic transmit-receive imaging schemes addressing the physical properties of reflections from the transmit wavefronts are imperative for the precise imaging of needle interfaces and hence have strong potential in elevating the quality of outcomes from US guided interventional practices.
Explicit Upper Bound Of Impossible Differentials For AES-Like Ciphers: Application To uBlock And Midori
Authors: Zhang Li , Zhang Yu , Wu Wenling , Mao Yongxia , Zheng Yafei
Published: March 2023

Whether a block cipher can resist impossible differential attack is an important basis to evaluate the security of a block cipher. However, the length of impossible differentials is important for the security evaluation of block ciphers. Most of the previous studies are based on structural cryptanalysis to find the impossible differential, and the structural cryptanalysis covers a lot of specific cryptanalytic vectors which are independent of the nonlinear S-boxes. In this paper, we study the maximum length of the impossible differential of an Advanced Encryption Standard-like cipher in the setting with the details of S-boxes. Inspired by the ‘Divide-and-Conquer’ technique, we propose a new technique called Reduced Block, which combines the details of the S-box. With this tool, the maximum length of impossible differentials can be proven under reasonable assumptions. As applications, we use this tool on uBlock and Midori. Consequently, we prove that for uBlock-128, uBlock-256 and Midori-64, there are no impossible five-round, six-round and seven-round differentials with one active input nibble and one active output nibble, even when considering the details of S-boxes. Furthermore, we reveal some properties of the uBlock S-box and linear layer and demonstrate theoretically that there are no impossible differentials longer than four rounds for uBlock-128 under the assumption that the round keys are independent and uniformly random. This study might provide some insight into the bounds of the length of impossible differentials.
Linear schemes with several degrees of freedom for the transport equation and the long-time simulation accuracy
Authors: Bakhvalov Pavel , Surnachev Mikhail
Published: March 2023

We consider linear schemes with several degrees of freedom for the transport equation on uniform meshes. For these schemes, the solution error is $O(h^p + th^q)$, where $p$ is equal to or greater by one than the order of the truncation error and $q \geqslant p$. We prove the existence of a mapping of smooth functions on the mesh space providing the $q$th order of the truncation error and deviating from the standard mapping ($L_2$-projection for example) by $O(h^p)$. In a one-dimensional case, this mapping can be found in the class of local mappings. In more dimensions, the existence of a local mapping with such properties is guaranteed only under additional assumptions.
Geometry of Lines on a Cubic Four-Fold
Authors: Gounelas Frank , Kouvidakis Alexis
Published: March 2023

For a general cubic four-fold $X\subset {\mathbb {P}}^5$ with Fano scheme of lines $F$, we prove a number of properties of the universal family of lines $I\to F$ and various subloci. We first describe the moduli and ramification theory of the genus four fibration $p:I\to X$ and explore its relation to a birational model of $F$ in $I$. The main part of the paper is devoted to describing the locus $V\subset F$ of triple lines, i.e., the fixed locus of the Voisin map $\phi :F\dashrightarrow F$, in particular proving it is an irreducible projective singular surface of class $21\textrm {c}_2({\mathcal {U}}_F)$ and detailing its intersection with the locus $S$ of second type lines. A consequence of the analysis of the singularities of $V$ is a geometric proof of the fact that if $X$ is very general, then the number of singular (necessarily 1-nodal) rational curves in $F$ of primitive class is 3780.
Mixed Eulerian Numbers and Peterson Schubert Calculus
Authors: Horiguchi Tatsuya
Published: March 2023

Let $\Phi $ be a root system. Postnikov introduced and studied the mixed $\Phi $-Eulerian numbers. These numbers indicate the mixed volumes of $\Phi $-hypersimplices. As specializations of these numbers, one can obtain the usual Eulerian numbers, the Catalan numbers, and the binomial coefficients. Recent work of Berget–Spink–Tseng gave a simple computation for the mixed $\Phi $-Eulerian numbers when $\Phi $ is of type $A$. In this paper, we connect a relation between mixed $\Phi $-Eulerian numbers and Peterson Schubert calculus. By using the connection, we provide a combinatorial model for the computation of Berget–Spink–Tseng in terms of left–right diagrams that were introduced by Abe–Horiguchi–Kuwata–Zeng for the purpose of Peterson Schubert calculus. We also derive a simple computation for the mixed $\Phi $-Eulerian numbers in arbitrary Lie types from Peterson Schubert calculus.
ELF-EM fields in the multi-layer spherical ‘Earth-ionosphere’ model based on WKB
Authors: Gao Ya , Di Qing-Yun , Fu Chang-Min , Zhang Yi-Lang
Published: March 2023

With a high signal-to-noise ratio and a great depth of exploration, the wireless electromagnetic method (WEM) has wide applications in the exploration of deep mineral resources and oil and gas reservoirs. Extremely low-frequency electromagnetic (ELF) waves emitted from a horizontal antenna are used to achieve synchronous acquisition for different receivers of multi-coverage information in a global region. However, previous research based on a planar model ignored the curvature of the Earth. This work focuses on the electromagnetic fields (EM fields) in the model of a spherical ‘Earth ionosphere’ to extend the coverage of WEM. By transferring the EM fields from a vertical electric dipole (VED) as well as a vertical magnetic dipole (VMD) in the multi-layered medium of the Earth, we obtain the formulae for the EM fields emitted by a horizontal electric dipole (HED) by using a reciprocity theorem. The correctness of the proposed method is verified by comparing it with the approximate analytical formula and previous work. Based on the above results, we have studied the propagation and frequency characteristics of electromagnetic fields in a spherical waveguide consisting of the ionosphere and earth. The results show that the electromagnetic fields under the spherical model produce interference effects that are different from those of the planar model. The electromagnetic response of the layered Earth was then discussed, and its potential as an electromagnetic technique for exploring the deep Earth was demonstrated.
Robust clustering of the local Milky Way stellar kinematic substructures with Gaia eDR3
Authors: Ou Xiaowei , Necib Lina , Frebel Anna
Published: March 2023

Understanding local stellar kinematic substructures in the solar neighbourhood helps build a complete picture of the formation of the Milky Way, as well as an empirical phase space distribution of dark matter that would inform detection experiments. We apply the clustering algorithm hdbscan on the Gaia early third data release to identify a list of stable clusters in velocity space and action-angle space by taking into account the measurement uncertainties and studying the stability of the clustering results. We find 1405 (497) stars in 23 (6) robust clusters in velocity space (action-angle space) that are consistently not associated with noise. We discuss the kinematic properties of these structures and study whether many of the small clusters belong to a similar larger cluster based on their chemical abundances. They are attributed to the known structures: the Gaia Sausage-Enceladus, the Helmi Stream, and globular cluster NGC 3201 are found in both spaces, while NGC 104 and the thick disc (Sequoia) are identified in velocity space (action-angle space). Although we do not identify any new structures, we find that the hdbscan member selection of already known structures is unstable to input kinematics of the stars when resampled within their uncertainties. We therefore present the stable subset of local kinematic structures, which are consistently identified by the clustering algorithm, and emphasize the need to take into account error propagation during both the manual and automated identification of stellar structures, both for existing ones as well as future discoveries.
Cosmic ray ionization rate versus dust fraction: Which plays a crucial role in the early evolution of the circumstellar disc?
Authors: Kobayashi Yudai , Takaishi Daisuke , Tsukamoto Yusuke
Published: March 2023

We study the formation and early evolution of young stellar objects (YSOs) using three-dimensional non-ideal magnetohydrodynamic (MHD) simulations to investigate the effect of cosmic ray ionization rate and dust fraction (or amount of dust grains) on circumstellar disc formation. Our simulations show that a higher cosmic ray ionization rate and a lower dust fraction lead to (i) a smaller magnetic resistivity of ambipolar diffusion, (ii) a smaller disc size and mass, and (iii) an earlier timing of outflow formation and a greater angular momentum of the outflow. In particular, at a high cosmic ray ionization rate, the discs formed early in the simulation are dispersed by magnetic braking on a time-scale of about 104 yr. Our results suggest that the cosmic ray ionization rate has particularly a large impact on the formation and evolution of discs, while the impact of the dust fraction is not significant.
Dual Ownership and Risk-Taking Incentives in Managerial Compensation
Authors: Chen Tao , Zhang Li , Zhu Qifei
Published: March 2023

This article studies how the three-way interaction among shareholders, creditors, and managers shapes firms’ executive compensation. Firms with a higher ownership share by “dual holders”—institutional investors that simultaneously hold equity and bond of the company—adopt a less risk-inducing compensation structure: less stock options and more inside debt. Exploiting financial institution mergers that increase or decrease dual ownership for portfolio companies, we identify a causal link between dual ownership and CEO compensation policies. Mutual fund proxy voting data suggest that shareholder voting is an important channel for dual holders to implement less convex contracts.
Knowledge, attitude, and practice of sexual healthcare and its influencing factors among oncology nurses: a multicenter study
Authors: Xie Jianfei , Zhou Yi , Luo Xiaofei , Cheng Qinqin , Luo Yating , Kang Yue , Wan Ziyu , Xiao Panpan , Zhou Xing , Liu Xiangyu , Duan Yinglong , Cheng Andy SK
Published: March 2023

Background

The provision of sexual healthcare plays an integral role in the field of oncology nursing. However, limitations in the knowledge, attitude, and practice perspectives of oncology nurses require detailed study.

Aim

In this study the authors sought to describe the knowledge, attitude, and practice of oncology nurses regarding sexual healthcare from a nationwide perspective and to explore the factors that influence them.

Methods

This was a cross-sectional descriptive study using stratified random sampling of certified oncology nurses from 55 hospitals in 6 provinces in Central South China. In total, 2530 nurses participated and completed the Knowledge, Attitude and Practice questionnaire of Sexual Health Care (KAP of SHC), the Nurses Clinic Communication Competency Scale, the Nurses Professional Values Scale, and the General Self-efficacy Scale. Multivariate linear regression was used to explore influencing factors.

Outcomes

The primary variable was the knowledge, attitude, and practice of sexual healthcare provision. Secondary variables included professional value, clinical communication competency, self-efficacy, and demographic factors.

Results

The median KAP of SHC score was 139 (possible range 72 to 288). Attitude of SHC scored highest, followed by knowledge and practice scores. Professional values were positively associated with knowledge (odds ratio [OR] = 0.057; 95% CI: 0.023–0.091; P < .01) and attitude (OR = 0.319; 95% CI: 0.268–0.370, P < .01) of SHC. Clinical communication competency was only positively related to the attitude of SHC (OR = 3.960; 95% CI: 2.701–5.218, P < .01). Self-efficacy was positively related to KAP and the knowledge (OR = 0.616; 95% CI: 0.506–0.725, P < .01), attitude (OR = 0.187; 95% CI: 0.052–0.322, P < .01), and practice (OR = 0.840; 95% CI: 0.735-0.944, P < .01) of SHC.

Clinical Implications

Knowledge assistance, attitude training, and practice coaching resources must be on the agenda to optimize professional practice for oncology nurses.

Strengths and Limitations

This study provides data based on the Knowledge, Attitude, Belief and Practice (KABP) model in a nationwide sample of oncology nurses. In addition, the relationship between self-efficacy and KAP of SHC has been explored for the first time. The limitations are that this study may have some bias and did not take into account mediating relationships.

Conclusions

Oncology nurses exhibit moderate levels of KAP of SHC. It is noteworthy that self-efficacy and position are the only 2 factors that influenced all aspects of KAP of SHC.
Differential phosphoproteome analysis of rat brain regions after organophosphorus compound sarin intoxication
Authors: Chaubey Kalyani , Alam Syed Imteyaz , Waghmare Chandra Kant , Bhattacharya Bijoy K
Published: March 2023

Introduction

Sarin is a highly toxic organophosphorus nerve agent that irreversibly inhibits neuronal enzyme acetylcholinesterase. In the prevailing scenario, it is of paramount importance to develop early diagnosis and medical countermeasures for sarin exposure. A deeper understanding of the molecular mechanism of sarin intoxication and perturbations in the associated cellular processes is likely to provide valuable clues for the elucidation of diagnostic markers and therapeutic targets for sarin exposure.

Methods

Present study, uncovered the changes in phosphorylation patterns of multiple proteins in different rat brain regions after sarin intoxication using 2-DE/MS approach. It provided a holistic view of the phosphorylation-mediated changes in the cellular proteome and highlighted various signaling and response pathways affected at an early time point of sarin intoxication.

Results

We found total 22 proteins in the cortex, 25 proteins in the corpus striatum, and 17 proteins in the hippocampus, showed ≥1.5 fold changes (hyper- or hypo- phosphorylated) with respect to control, either at 2.5 h or 1 d after sarin exposure. These results indicated the differential expression of phosphoproteins involved in protein folding in the endoplasmic reticulum, carbon metabolism, metabolic function, and energy metabolism.

Conclusion

Four candidates (protein disulfide-isomerase A3, heat shock cognate 71 kDa protein, alpha-enolase, and creatine kinase B-type), hyperphosphorylated in all three brain regions, can be further studied to understand the molecular mechanism behind neurodegenerative changes mediated by sarin exposure. The study sheds light on major pathogenic processes initiated during sarin intoxication and provides putative diagnostic markers/therapeutic targets for further validation.
TERT Promoter Mutational Analysis as an Ancillary Diagnostic Tool for Diagnostically Challenging Melanocytic Neoplasms
Authors: Boutko Anastasiya , Asadbeigi Sepideh , Roth Andrew , Lampley Nathaniel , Olivares Shantel , Dittmann David , Dittmann David , Jennings Lawrence , Gerami Pedram
Published: March 2023

Telomerase reverse transcriptase promoter mutations (TPMs) have been shown to be common in melanoma and uncommon in benign nevi. To assess the use of TPMs as an ancillary diagnostic tool, we report the concordance of the TPM status with the final diagnosis in clinical cases with distinct differential diagnostic scenarios: dysplastic nevus versus melanoma, atypical Spitz nevus versus melanoma, atypical deep penetrating nevus (DPN) versus melanoma, and atypical blue nevus versus malignant blue nevus. In a control cohort, we found a positive TPM in 51/70 (73%) of the total melanomas with the highest frequency in vertical growth phase melanoma cases. Conversely, only 2/35 (6%) dysplastic nevi in our control cases were TPM-positive and b were severely atypical dysplastic nevi. Our clinical cohort of 257 cases had a positive TPM in 24% of cases diagnosed as melanoma and in 1% of cases with a benign diagnosis. The overall concordance of the TPM status with the final diagnosis was 86%. The TPM status had the greatest concordance (95%) with the final diagnosis in the atypical DPN versus melanoma group, with the rest of the groups ranging between 50% and 88%. Overall, our results suggest that TPMs are most useful in the differential diagnosis of atypical DPN versus melanoma. It also has some value in the differential diagnosis of atypical Spitz tumor versus melanoma and dysplastic nevus versus melanoma, whereas in our cohort, it did not contribute meaningfully to differentiating malignant blue nevus and atypical blue nevus.
Iatrogenic Calcinosis Cutis in the Pediatric Patient: Case Report and Literature Review
Authors: Manrique Monica , Escandón Joseph M. , Paredes-Gutierrez Juliana , Mantilla-Rivas Esperanza , Nasser Jacob S. , Oh Haley S. , Duarte-Bateman Daniela , Oh Albert K. , Rogers Gary F.
Published: March 2023

Calcinosis cutis is the term used to describe the deposition of calcium compounds within the skin and subcutaneous tissue, which can occur after the administration of intravenous calcium compounds. Its etiology is broad, and the clinical presentation is variable, creating a diagnostic challenge. Although iatrogenic calcinosis cutis is extremely uncommon, awareness and early diagnosis of this entity can reduce the risks of severe complications, including soft tissue damage, restricted joint mobility, and even nerve compression. Clinical suspicion should prompt a thorough review of the medical history and appropriate radiographic studies. Evidence of extensive soft tissue calcification must be present on radiographic imaging to confirm the diagnosis. Iatrogenic calcinosis cutis is managed conservatively, and resolution of symptoms is expected within 2 months of symptom onset. Herein we report the case of an infant with DiGeorge syndrome who developed iatrogenic calcinosis cutis after receiving an intraoperative infusion of calcium gluconate. Our patient presented with right lower extremity swelling, erythema, and warmth over a broad area of the leg centered on the entry point of the venipuncture. This was initially mistaken and managed as cellulitis, but once an accurate diagnosis was made, the symptoms gradually resolved with conservative care and no functional sequelae. We also present the literature on iatrogenic and idiopathic calcinosis cutis in the pediatric population.
Decreasing Time Intervals in Recurring Capsular Contracture? A Single Center Retrospective Study over 6 Years
Authors: Jakob Vivian L. , Keck Maike , Lohmeyer Jörn A.
Published: March 2023

Background:

Although breast implants of the current generation can, in principle, remain in the body for life, follow-up operations of the augmented or reconstructed breasts are regularly necessary. Capsular contracture is the leading cause for revisional surgery. The aim of this study was to evaluate indications and changes in time intervals between consecutive implant replacements with a focus on capsular contracture.

Methods:

In the period from 2012 to 2017, all patients with breast implant replacements or removals at our institution were identified. From the medical file, the time of the first implantation and earlier replacements were analyzed for indication and timing of surgery.

Results:

A total of 498 operations for implant replacement or removal were analyzed in 323 patients. Including prior operations, 717 procedures could be evaluated. If capsular contracture was the indication, revision surgery was performed on average 14.3 years or 8.4 years in aesthetic or reconstructive cases, respectively. In patients with more than one implant removal or replacement, we saw a reduction in the time interval between the first, second, and third follow-up operation.

Conclusions:

The main indication to perform implant replacements or removals was capsular contracture recurring at increasingly shorter intervals. Patients must be informed about this possible progression when changing implants, but also before the first operation. If capsular contracture occurs after a rather short time period in reconstructive cases, the opportunity of an alternative approach (eg, autologous reconstruction) instead of a renewed implant change should be discussed with the patient.
Screening of liver cancer with abbreviated MRI
Authors: Ronot Maxime , Nahon Pierre , Rimola Jordi
Published: March 2023

Current recommendations for the surveillance of HCC are based on the semiannual liver ultrasound (with or without serum alpha-fetoprotein) in patients with cirrhosis and in subgroups with chronic hepatitis B infection. However, the sensitivity of this strategy is suboptimal for the detection of early-stage tumors, especially in obese patients, due to interoperator variability and poor adherence. The detection rate of focal liver lesions is excellent with MRI, making it the best alternative candidate for surveillance. However, performing a full contrast-enhanced MRI is unrealistic because of limited availability and health economics. Abbreviated MRI (AMRI) corresponds to the acquisition of a limited number of sequences with a high detection rate. The theoretical benefits of AMRI are a reduced acquisition time (≤10 min) with improved time-effectiveness and cost-effectiveness compared with conventional MRI, and greater accuracy than ultrasound. Numerous protocols may be performed, including T1-weighted, T2-weighted, and DWI sequences, with or without contrast administration. Although published studies report promising per-patient results, they should be interpreted with caution. Indeed, most studies were simulated, retrospectively reviewing a subset of sequences in relatively small populations who underwent a full MRI. They also included groups that were not representative of screening populations. In addition, most were published by Asian groups, with at-risk populations that were different from Western populations. There are no existing longitudinal studies that directly compare the different AMRI approaches or AMRI to ultrasound. Finally, it is possible that 1 approach will not fit all patients and that strategies should be tailored to the risk of HCC, in particular in relation to the cost and availability of AMRI. Several trials are ongoing to evaluate these questions.
Longitudinal Changes in Peripapillary and Macular Vessel Densities in Glaucomatous Eyes With a Single-Hemifield Retinal Nerve Fiber Layer Defect
Authors: Seo Min-Hwan , Park Ji-Hye , Yoon Sumin , Yoo Chungkwon , Kim Yong Yeon
Published: March 2023

Précis:

The peripapillary vessel density decreased significantly in the affected hemiretina compared with that in the intact hemiretina in glaucomatous eyes with a single-hemifield retinal nerve fiber layer defect.

Purpose:

To evaluate the difference in the change rates of peripapillary vessel density (pVD) and macular vessel density (mVD) measured using optical coherence tomography angiography (OCTA) in glaucomatous eyes with a single-hemifield retinal nerve fiber layer (RNFL) defect.

Materials And Methods:

We performed a retrospective, longitudinal study of 25 patients with glaucoma who were followed up for at least 3 years, with a minimum of 4 visits after baseline OCTA. At each visit, all participants underwent OCTA examination, and the pVD, mVD were measured by removing the large vessels. Changes in the pVD, mVD, peripapillary RNFL thickness (pRNFLT), and macular ganglion cell inner plexiform layer thickness were investigated in the affected and intact hemispheres, and the differences between the 2 hemispheres were compared.

Results:

In the affected hemiretina, the pVD, mVD, pRNFLT, and mCGIPLT were reduced than that in the intact hemiretina (all, P < 0.001). The changes in pVD and mVD were statistically significant at the 2-year and 3-year follow-ups in the affected hemifield (all, P<0.05). However, pVD and mVD did not show statistically significant changes in the intact hemiretina throughout the follow-up visits. Although the pRNFLT decreased significantly at the 3-year follow-up, the macular ganglion cell inner plexiform layer thickness showed no statistical change at any follow-up visit. Compared with the intact hemisphere, pVD was the only parameter that showed significant changes throughout the follow-up period.

Conclusion:

Although pVD and mVD decreased in the affected hemiretina, the reduction in pVD was significant compared with that in the intact hemiretina.
Public Perception of Marijuana Use for the Treatment of Glaucoma
Authors: Yakobashvili Daniela , Shah Ronak , Oydanich Marko , Khouri Albert S.
Published: March 2023

The use of marijuana for the treatment of glaucoma has been widely debated amongst ophthalmologists and glaucoma specialists. Recent evidence suggests the majority of ophthalmologists do not support the use of marijuana as active treatment for glaucoma. However, there has been no investigation into understanding the public’s direct perception of the efficacy of marijuana in glaucoma treatment. By using Twitter as a tool to understand the public’s thoughts, tweets were analyzed over the last 2 years. Of the 700 tweets analyzed, 72% (n=503) of tweets were in favor of cannabis use in the treatment of glaucoma, whereas 18% (n=124) were evidently opposed. The majority of those in favor came from accounts of individual users (n=391; 56%) whereas those that opposed marijuana as a treatment came from accounts of health care media, ophthalmologists, and other health care workers. The discrepancy between the public and ophthalmologists and other health care professionals requires recognition and further action to better educate the public on the role of marijuana in glaucoma treatment.
Remote Contrast Sensitivity Testing Seems to Correlate With the Degree of Glaucomatous Macular Damage
Authors: Sohail Marium , Hirji Sitara H. , Liebmann Jeffrey M. , Glass Lora D. , Blumberg Dana M.
Published: March 2023

Précis:

Remote contrast sensitivity (CS) testing through a free downloadable home test correlates with glaucomatous macular damage measured by 10-2 visual field (VF) testing.

Purpose:

To assess the feasibility and validity of home CS monitoring as a measure of glaucomatous damage using a free downloadable smartphone application.

Methods:

Twenty-six participants were asked to remotely use the Berkeley Contrast Squares (BCS) application, a free downloadable tool that records the user’s CS for varying degrees of visual acuity. An instructional video detailing how to download and use the application was sent to the participants. Subjects were asked to send logarithmic CS results with a minimum 8-week test-retest window, and test-retest reliability was measured. Results were validated against office-based CS testing that was collected within the previous 6 months. Validity analysis was also carried out to determine whether CS as measured by BCS is a good predictor of 10-2 and 24-2 VF mean deviation (MD).

Results:

There was a high BCS test-retest reliability with an intraclass correlation coefficient score of 0.91 and a significant correlation between repeat test results and baseline test scores (Pearson, 0.86, P < 0.0001). There was significant agreement between unilateral CS scores as measured by BCS and office-based CS testing (b = 0.94, P < 0.0001, 95% CI: 0.61 to 1.27). Unilateral CS as measured by BCS was significantly associated with 10-2 VF MD (r
2 = 0.27, P = 0.006, 95% CI: 3.7 to 20.6), but not with 24-2 VF MD (P = 0.151).

Conclusion:

This study suggests that a free, rapid home CS test correlates with glaucomatous macular damage as measured by 10-2 VF.
Quantified versus willful handgrip exercises for the prevention of PICC-related thrombosis: A meta-analysis and systematic review
Authors: Luo Hongliang , Jin Cheng , Li Xiaohong , Jiang Yinzhu , Zhou Jing
Published: March 2023

Background:

Thrombosis is a common yet serious complication in patients with peripherally inserted central venous catheter (PICC), the prevention of thrombosis is very important to the prognosis of PICC patients. We aimed to evaluate the effects of quantified versus willful grip exercises for the prevention of PICC-related thrombosis, to provide evidence to the clinical nursing care of PICC patients.

Methods:

Two authors searched PubMed et al databases for randomized controlled trials (RCTs) comparing the effects of quantified versus willful grip exercises in PICC patients up to August 31, 2022. Quality assessment and data extraction were independently performed by 2 researchers, and meta-analysis was performed using RevMan 5.3 software.

Results:

15 RCTs involving 1741 PICC patients were finally included in this meta-analysis. Synthesized outcomes indicated that compared with willful grip exercises, quantified grip exercises reduced the incidence of PICC-related thrombosis (odds ratio = 0.19, 95% confidence interval [CI]: 0.12–0.31) and infection (odds ratio = 0.30, 95% CI: 0.15–0.60) in PICC patients, increased the maximum venous velocity (mean difference = 3.02, 95% CI: 1.87–4.17) and mean blood flow (mean difference = 3.10, 95%CI: 1.57–4.62) in PICC patients (all P < .05). There were no publication biases amongst the synthesized outcomes (all P > .05).

Conclusion:

Quantified grip exercises can effectively reduce the occurrence of PICC-related thrombosis and infection, improve the venous hemodynamics. Limited by study population and regions, large-sample, and high-quality RCTs are still needed in the future to further evaluate the effects and safety of quantified grip exercises in PICC patients.
CPR quality with rotation of every 1 versus 2 minutes as characteristics of rescuers: A randomized crossover simulation study
Authors: Kim Dong Hun , Seo Young Woo , Jang Tae Chang
Published: March 2023

Background:

Fatigue and rotation time are key factors affecting the quality of cardiopulmonary resuscitation (CPR). This study aimed to investigate the effects of rotation time on CPR duration, and sex on chest compression quality.

Methods:

In this randomized crossover simulation study, we enrolled 100 paramedic students stratified by sex and randomly grouped into 28 male and 22 female pairs. In the 2- and 1-minute scenarios, 2 participants performed CPR for 20 minutes with a rotation cycle of 2 minutes and 1 minute, respectively. After taking a break, they changed over and performed CPR again for 20 minutes. The switching of roles was performed with the students positioned on opposite sides of the mannequin. For chest compression quality, a set was defined as CPR performed by 1 pair in a 2-minute scenario for 4 minutes. The quality of CPR in each set was compared between the 2 groups.

Results:

The 1-minute group showed significantly higher chest compression depth than the 2-minute group (54.0 [51.5–57.0] vs 52.5 [48.5–56.5] mm, P = .001, respectively). The female 2-minute group showed decreased chest compression depth over time, and the 1-minute group showed significantly increased chest compression depth during all sets except the 2nd set (54.0 [51.9–55.1] vs 50.5 [48.5–53.8] mm [P = .030], 52.3 [49.4–54.5] vs 50.8 [47.0–53.1] mm [P = .080], 52.8 [49.8–54.5] vs 48.8 [45.4–51.6] mm [P = .002], 51.5 [48.5–53.3] vs 48.3 [44.5–50.6] mm [P = .004], and 50.8 [48.9–54.1] vs 47.5 [44.6–50.1] mm [P = .001], respectively). The fatigue scores in the 2-minute group were significantly higher during sets 4 and 5 than those in the 1-minute group.

Conclusion:

When rescuer fatigue increases during prolonged CPR owing to their physical strength and skill levels, the rotation of rescuers every minute would be helpful in maintaining high-quality CPR.
Efficacy of intradiscal injection of platelet-rich plasma in the treatment of discogenic low back pain: A single-arm meta-analysis
Authors: Peng Bing , Xu Baoshan , Wu Weiyong , Du Lilong , Zhang Tongxing , Zhang Jianqiang
Published: March 2023

Background:

Discogenic low back pain (DLBP) has been influencing people’s quality of life. Research on platelet-rich plasma (PRP) for DLBP has increased in recent years, but systematic summaries are lacking. This study analyzes all published studies related to the use of intradiscal injection of PRP for the treatment of DLBP and summarizes evidence-based medicine for the efficacy of this biologic treatment for DLBP.

Methods:

Articles published from the inception of the database to April 2022 were retrieved from PubMed, the Cochrane Library, Embase, ClinicalTrial, the Chinese National Knowledge Infrastructure, Wanfang, Chongqing VIP Chinese Scientific Journals, and the Chinese Biomedicine databases. After the rigorous screening of all studies on PRP for DLBP, a meta-analysis was performed.

Results:

Six studies, including 3 randomized controlled trials and 3 prospective single-arm trials, were included. According to this meta-analysis, pain scores decreased by >30% and >50% from baseline, with incidence rates of 57.3%, 50.7%, and 65.6%, and 51.0%, 53.1%, and 51.9%, respectively, after 1, 2, and 6 months of treatment. The Oswestry Disability Index scores decreased by >30% with an incidence rate of 40.2% and by >50% with an incidence rate of 53.9% from baseline after 2 and 6 months, respectively. Pain scores decreased significantly after 1, 2, and 6 months of treatment (standardized mean difference: 1 month, −1.04, P = .02; 2 months, −1.33, P = .003; and 6 months, −1.42, P = .0008). There was no significant change (P > .05) in the pain scores and the incidence rate when pain scores decreased by >30% and >50% from baseline between 1 and 2 months, 1 and 6 months, and 2 and 6 months after treatment. No significant adverse reactions occurred in any of the 6 included studies.

Conclusion:

Intradiscal injection of PRP is effective and safe in the treatment of DLBP, and there was no significant change in the patient’s pain 1, 2, and 6 months after PRP treatment. However, confirmation is required by additional high-quality studies due to the limitations of the quantity and quality of the included studies.