bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Thieno [2,3-b]pyridine Anticancer Compound Lowers Cancer Stem Cell Fraction Inducing Shift of Lipid to Glucose Metabolism
Authors: Pervan Matij , Marijan Sandra , Markotić Anita , Pilkington Lisa I. , Haverkate Natalie A. , Barker David , Reynisson Jóhannes , Meić Luka , Radan Mila , Čikeš Čulić Vedrana
Published: September 2022

Due to the role of cancer stem cells (CSCs) in tumor resistance and glycosphingolipid (GSL) involvement in tumor pathogenesis, we investigated the effect of a newly synthesized compound (3-amino-N-(3-chloro-2-methylphenyl)-5-oxo-5,6,7,8-tetrahydrothieno[2,3-b]quinoline-2-carboxamide 1 on the percentage of CSCs and the expression of six GSLs on CSCs and non-CSCs on breast cancer cell lines (MDA-MB-231 and MCF-7). We also investigated the effect of 1 on the metabolic profile of these cell lines. The MTT assay was used for cytotoxicity determination. Apoptosis and expression of GSLs were assessed by flow cytometry. A GC–MS-coupled system was used for the separation and identification of metabolites. Compound 1 was cytotoxic for both cell lines, and the majority of cells died by treatment-induced apoptosis. The percentage of CSCs was significantly lower in the MDA-MB-231 cell line. Treatment with 1 caused a decrease of CSC IV6Neu5Ac-nLc4Cer+ MDA-MB-231 cells. In the MCF-7 cell line, the percentage of GalNAc-GM1b+ CSCs was increased, while the expression of Gg3Cer was decreased in both CSC and non-CSC. Twenty-one metabolites were identified by metabolic profiling. The major impact of the treatment was in glycolysis/gluconeogenesis, pyruvate and inositol metabolism. Compound 1 exhibited higher potency in MBA-MB-231 cells, and it deserves further examination.
Effects of Image Processing Using Honeycomb-Removal and Image-Sharpening Algorithms on Visibility of 27-Gauge Endoscopic Vitrectomy
Authors: Tasaki Kuniharu , Nishimura Tomohisa , Hida Taro , Maruo Kazushi , Oshika Tetsuro
Published: September 2022

Endoscopic vitrectomy with small gauge probes has clinical potentials, but intraocular visibility is inherently limited by low resolution and dim illumination due to the reduced number of optic fibers. We investigated whether honeycomb-removal and image-sharpening algorithms, which enable real-time processing of live images with a delay of 0.004 s, can improve the visibility of 27-gauge endoscopic vitrectomy. A total of 33 images during endoscopic vitrectomy were prepared, consisting of 11 original images, 11 images after the honeycomb-removal process, and 11 images after both honeycomb-removal and image-sharpening procedures. They were randomly presented to 18 vitreous surgeons, who rated each image on a 10-point scale. The honeycomb-removal algorithm almost completely suppressed honeycomb artifacts without degrading the background image quality. The implementation of image-sharpening algorithms further improved endoscopic visibility by optimizing contrast and augmenting image clarity. The visibility score was significantly improved from 4.27 ± 1.78 for the original images to 4.72 ± 2.00 for the images after the honeycomb-removal process (p < 0.001, linear mixed effects model), and to 5.40 ± 2.10 for the images after both the honeycomb-removal and image-sharpening procedures (p < 0.001). When the visibility scores were analyzed separately for 10 surgeons who were familiar with endoscopic vitrectomy and 8 surgeons who were not, similar results were obtained. Image processing with honeycomb-removal and image-sharpening algorithms significantly improved the visibility of 27-gauge endoscopic vitrectomy.
Does Physical Activity Moderate the Relationship between Myopia and Functional Status in Children 9–11 Years of Age?
Authors: Modrzejewska Monika , Domaradzki Jarosław , Jedziniak Wojciech , Florkiewicz Beata , Zwierko Teresa
Published: September 2022

Although previous studies have reported an association between physical activity (PA) and myopia in school-aged children, little is known about the link between myopia and children’s functional status. The purpose of this study was to investigate dynamic balance control in relation to the daily PA levels of myopic schoolchildren aged 9–11 years (n = 52) versus a non-myopic control group (n = 53). A single leg stance test performed on the instability platform of the Biodex Balance System was used to assess balance control. The overall stability index (OSI), anterior-posterior stability index (APSI) and medial-lateral stability index (MLSI) were analyzed. PA levels were calculated using the World Health Organization European Childhood Obesity Surveillance Initiative family record form. Myopes and non-myopes were separated into three subgroups based on PA level (low, moderate and high). Myopia significantly affected OSI (F = 40.46, p < 0.001), APSI (F = 33.93, p < 0.001) and MLSI (F = 49.51, p < 0.001). There were significant differences (p < 0.001) between myopic and non-myopic children with low and moderate levels of PA, whilst there were no differences between compared children with high levels of PA. High PA levels had a positive impact on balance control in myopes. Our results showed that PA levels moderate the relationship between myopia and children’s functional status.
Abu Dhabi Neural Mapping (ADNM) during Minimally Invasive Thyroidectomy Enables the Early Identification of Non-Recurrent Laryngeal Nerve and Prevents Voice Dysfunction
Authors: Hassan Iyad , Hassan Lina , Gamal Ibrahim , Ibrahim Mohamad , Omer Abdel Rahman
Published: September 2022

The aim of this study was to evaluate the diagnostic accuracy of a neuromonitoring protocol—the Abu Dhabi Neural Mapping protocol (ADNM)—using a new device, Nim-Vital™, during minimally invasive thyroidectomy in the early identification of non-recurrent laryngeal nerve (n-RLN) problems and the preservation of its function. Method: Patients with thyroid disorders that required thyroid resection, who were admitted to the Department of Surgery at Burjeel Hospital, Abu Dhabi, between January and July 2022, were included in the study. The data were extracted from a prospective database and were analyzed retrospectively. All nerves at risk were identified and exposed at seven precisely defined anatomical points, with strict adherence to the intraoperative technical steps of neuromonitoring. These were sequentially applied to the vagal nerve (VN), the superior laryngeal nerve (SLN), and the recurrent laryngeal nerve (RLN). In the next step after the creation of the skin-platysma flap, the strap muscle’s lateral border was moved from the medial limb of the sternocleidomastoid without using any electrical device and without any manipulation of the thyroid gland. The VN was exposed in the carotid sheath and then stimulated using a monopolar probe at a precisely defined point above the clavicle, using anatomical landmarks. Results: In total, 136 women with a mean age of 40 years (range 18–74) and 36 men with a mean age of 42 (range 21–66), demonstrating 270 nerves at risk, were included in the analysis. Indications for surgery were malignancy in 70 cases, toxic goiter/Graves in 23 cases, retrosternal goiter in 21, and symptomatic multinodular goiter in 64 cases. Of these, 100 patients received a total thyroidectomy, 46 received a right lobectomy, and 24 received a left lobectomy only. For a total thyroidectomy, the median skin-to-skin surgery duration was 52 min (range 24–104 min) and the median hospital stay was 2 days (range 1–4 days). In 4 cases (4/146; 2.74%) the pre-dissection stimulation of the vagal nerve (VN1) at the ADNM’s precisely defined point did not create any signal or proper EMG-curve that indicated the existence of the non-RLN. Proximal dissection of the right VN at a precisely defined point by the ADNM’s level of incisura of the larynx created a positive signal. The separation point of the right non-RLN from the VN was discovered in all four patients. The postoperative video-laryngoscopy confirmed bilateral mobile vocal cords in all cases. Conclusions: Following the ADNM protocol during thyroid surgery minimizes the risk of a non-laryngeal nerve injury and prevents voice dysfunction.
Utility of Fine-Gauge Balloon Catheter for EUS-Guided Hepaticogastrostomy
Authors: Yagi Shin , Kurita Yusuke , Sato Takamitsu , Hasegawa Sho , Hosono Kunihiro , Kobayashi Noritoshi , Endo Itaru , Saigusa Yusuke , Kubota Kensuke , Nakajima Atsushi
Published: September 2022

Background and Purpose: During endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), tract dilation is one of the most important steps, and the placement of conventional metal stents with 8.5 Fr delivery devices is difficult due to the large outer shape of the device. Fine-gauge balloon catheters have become popular because of their stricture penetration ability and ease of dilation. This study aimed to evaluate the utility of fine-gauge balloon catheters. Patients and Methods: This retrospective study involved 38 patients who underwent conventional metal stent placement. The patients were classified into two groups: those who underwent dilation with a fine-gauge balloon catheter before initial metal stenting (balloon dilation group) and those who underwent bougie dilation only (non-balloon dilation group). We evaluated the stenting success rate after initial dilation and adverse events. Results: Seventeen and twenty-one patients were included in the balloon dilation and non-balloon dilation groups, respectively. The stenting success rate after initial dilation was 100% (17/17) in the balloon dilation group and 71.4% (15/21) in the non-balloon dilation group (p = 0.024). As adverse events, peritonitis was observed in one case (4.8%) in the balloon dilation group, and in three cases (14.3%) in the non-balloon dilation group (p = 0.613). Conclusions: Dilation using a fine-gauge balloon catheter before conventional metal stent with 8.5 Fr delivery device placement is considered effective in EUS-HGS.
Dynamic Parameters of Hypothermic Machine Perfusion—An Image of Initial Graft Function in Adult Kidney Transplantation?
Authors: Weberskirch Sebastian , Katou Shadi , Reuter Stefan , Kneifel Felicia , Morgul Mehmet , Becker Felix , Houben Philipp , Pascher Andreas , Vogel Thomas , Radunz Sonia
Published: September 2022

Kidney allografts are subjected to ischemia reperfusion injury during the process of transplantation. Hypothermic machine perfusion (HMP) of deceased donor kidneys from organ procurement until transplantation is associated with a superior outcome when compared to static cold storage (SCS). Nevertheless, cold ischemia time (CIT) remains an independent risk factor for delayed graft function (DGF) in HMP-preserved kidney allografts as well. We performed a retrospective single-center study including all adult recipients who underwent deceased donor kidney-only transplantation at our center between January 2019 and December 2020. Beside the clinicopathological donor and recipient data, flow and resistance data during HMP were assessed. Short- and long-term kidney allograft outcome after end-ischemic HMP and SCS were analyzed and compared. Organ preservation consisted of either SCS (n = 88) or HMP (n = 45). There were no differences in recipient demographics and donor details between groups. CIT was significantly longer in the HMP group (16.5 [8.5–28.5] vs. 11.3 [5.4–24.1], p < 0.0001). The incidence of DGF as well as serum creatinine at discharge and at 1 year post transplant were comparable between groups. Duration of SCS prior to HMP was comparable among grafts with and without DGF. Flow rate and organ resistance at the start of HMP were significantly worse in DGF-kidney grafts (arterial flow 22.50 [18.00–48.00] vs. 51.83 [25.50–92.67] ml/min, p = 0.0256; organ resistance 123.33 [57.67–165.50] vs. 51.33 [28.17–111.50] mmHg/mL/min, p = 0.0050). Recipients with DGF had significantly worse creatinine levels at discharge (2.54 [1.08–7.64] vs. 1.67 [0.90–6.56], p < 0.0001) and at 1 year post transplant (1.80 [1.09–7.95] vs. 1.59 [0.87–7.40], p = 0.0105). In conclusion, baseline HMP parameters could be applied as a predictive tool for initial graft function, which in turn determines long-term outcome.
Survival of Breast Cancer by Stage, Grade and Molecular Groups in Mallorca, Spain
Authors: Pascual Maria Clara , Montaño Juan José , Franch Paula , Sánchez-Contador Carmen , Ramos Maria
Published: September 2022

The aims of this study are: (1) to determine cause-specific survival by stage, grade, and molecular groups of breast cancer, (2) to identify factors which explain and predict the likelihood of survival and the risk of dying from this cancer; and (3) to find out the distribution of breast cancer cases by stage, grade, and molecular groups in females diagnosed in the period 2006–2012 in Mallorca (Spain). We collected data regarding age, date and diagnostic method, histology, laterality, sublocation, pathological or clinical tumor size (T), pathological or clinical regional lymph nodes (N), metastasis (M) and stage, histologic grade, estrogen and progesterone receptors status, HER-2 expression, Ki67 level, molecular classification, date of last follow-up or date of death, and cause of death. We identified 2869 cases. Cause-specific survival for the entire sample was 96% 1 year after diagnosis, 91% at 3 years and 87% at 5 years. Relative survival was 96.9% 1 year after diagnosis, 92.6% at 3 years and 88.5% at 5 years. The competing-risks regression model determined that patients over 65 years of age and patients with triple negative cancer have worse prognoses, and as stages progress, the prognosis for breast cancer worsens, especially from stage III.
Current Challenges in the Treatment of the Omphalocele—Experience of a Tertiary Center from Romania
Authors: Ţarcă Elena , Cojocaru Elena , Trandafir Laura Mihaela , Luca Alina Costina , Tiutiucă Răzvan Călin , Butnariu Lăcrămioara Ionela , Costea Claudia Florida , Radu Iulian , Moscalu Mihaela , Ţarcă Viorel
Published: September 2022

Omphalocele is a congenital abdominal wall defect with a constant incidence in recent decades, sometimes representing a real burden for neonatal intensive care units due to prolonged hospitalization and the evolution to death. In our study, we aimed to detect the main risk factors of an unfavorable evolution in the case of omphalocele. Methods: Retrospective cohort study of all neonates with omphalocele treated in our tertiary pediatric hospital during the last three decades; from 158 patients, 139 patients were eligible for the study. We tried to determine the risk of death using logistic regression model. Results: If the neonate develops sepsis, then there is an increased risk (13.03 times) of evolution to death. Similarly, the risk of death is 10.82 times higher in the case of developing acute renal failure, 6.28 times higher in the case of associated abnormalities, 5.54 in the case of developing hemorrhagic disease, and 3.78 in the case of conservative treatment (applied for giant omphalocele or severe chromosomal abnormalities). Prematurity increases by 3.62 times the risk of death. All six independent variables contributed 61.0% to the risk of death. The area under the ROC curve is 0.91, meaning that the diagnostic accuracy of our logistic regression model is very good for predicting the contribution of the six independent variables to the risk of death. Conclusion: Although in the past 30 years we witnessed several improvements in the antenatal diagnosis and management of omphalocele, survival rate remained constant, 47.5% overall. Much effort is still needed to eliminate the risk factors for death in this condition.
Superiority of Direct Oral Anticoagulants over Vitamin K Antagonists in Oncological Patients with Atrial Fibrillation: Analysis of Efficacy and Safety Outcomes
Authors: Parrini Iris , Lucà Fabiana , Rao Carmelo Massimiliano , Parise Gianmarco , Micali Linda Renata , Musumeci Giuseppe , La Meir Mark , Colivicchi Furio , Gulizia Michele Massimo , Gelsomino Sandro
Published: September 2022

Background and aim. Cancer and atrial fibrillation (AF) may be associated, and anticoagulation, either with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs), is necessary to prevent thromboembolic events by reducing the risk of bleeding. The log incidence rate ratio (IRR) and 95% confidence interval were used as index statistics. Higgin’s I2 test was adopted to assess statistical inconsistencies by considering interstudy variations, defined by values ranging from 0 to 100%. I2 values of less than 40% are associated with very low heterogeneity among the studies; values between 40% and 75% indicate moderate heterogeneity, and those greater than 75% suggest severe heterogeneity. The aim of this meta-analysis was to compare the safety and efficacy of VKAs and DOACs in oncologic patients with AF. Methods. A meta-analysis was conducted comparing VKAs to DOACs in terms of thromboembolic events and bleeding. A meta-regression was conducted to investigate the differences in efficacy and safety between four different DOACs. Moreover, a sub-analysis on active-cancer-only patients was conducted. Results. A total of eight papers were included. The log incidence rate ratio (IRR) for thromboembolic events between the two groups was −0.69 (p < 0.005). The meta-regression did not reveal significant differences between the types of DOACs (p > 0.9). The Log IRR was −0.38 (p = 0.008) for ischemic stroke, −0.43 (p = 0.02) for myocardial infarction, −0.39 (p = 0.45) for arterial embolism, and −1.04 (p = 0.003) for venous thromboembolism. The log IRR for bleeding events was −0.43 (p < 0.005), and the meta-regression revealed no statistical difference (p = 0.7). The log IRR of hemorrhagic stroke, major bleeding, and clinically relevant non-major bleeding between the VKA and DOAC groups was −0.51 (p < 0.0001), −0.45 (p = 0.03), and 0.0045 (p = 0.97), respectively. Similar results were found in active-cancer patients for all the endpoints except for clinically-relevant non-major bleedings. Conclusions. DOACs showed better efficacy and safety outcomes than VKAs. No difference was found between types of DOACs.
Three-Dimensional Geometric Analysis of Balloon-Expandable Covered Stents Improves Classification of Complications after Fenestrated Endovascular Aneurysm Repair
Authors: van der Riet Claire , Schuurmann Richte C. L. , Verhoeven Eric L. G. , Katsargyris Athanasios , Tielliu Ignace F. J. , Resch Timothy , Bokkers Reinoud P. H. , de Vries Jean-Paul P. M.
Published: September 2022

In balloon-expandable covered stent (BECS) associated complications after fenestrated endovascular aneurysm repair (FEVAR), geometric analysis may determine the cause of failure and influence reintervention strategies. This study retrospectively classifies BECS-associated complications based on computed tomographic angiography (CTA) applied geometric analysis. BECS-associated complications of FEVAR-patients treated in two large vascular centers between 2012 and 2021 were included. The post-FEVAR CTA scans of complicated Advanta V12 BECSs were analyzed geometrically and complications were classified according to its location in the BECS. BECS fractures were classified according to an existing classification system. In 279 FEVAR-patients, 34 out of the 683 included Advanta V12 BECS (5%) presented with a complication. Two Advanta V12 complications occurred during the FEVAR procedure and 32 occurred during follow-up of which five post-FEVAR CTA scans were missing or not suitable for analysis. In the remaining 27 BECSs complications were classified as (endoleaks (n = 8), stenoses (n = 4), occlusions (n = 6), fractures (n = 3), and a combination of complications (n = 6)). All BECSs associated complications after FEVAR with available follow up CTA scans could be classified. Geometric analysis of BECS failure post-FEVAR can help to plan the reintervention strategy.
Custom-Made Devices Represent a Promising Tool to Increase Correction Accuracy of High Tibial Osteotomy: A Systematic Review of the Literature and Presentation of Pilot Cases with a New 3D-Printed System
Authors: Zaffagnini Stefano , Dal Fabbro Giacomo , Belvedere Claudio , Leardini Alberto , Caravelli Silvio , Lucidi Gian , Agostinone Piero , Mosca Massimiliano , Neri Maria , Grassi Alberto
Published: September 2022

Background: The accuracy of the coronal alignment corrections using conventional high tibial osteotomy (HTO) falls short, and multiplanar deformities of the tibia require consideration of both the coronal and sagittal planes. Patient-specific instrumentations have been introduced to improve the control of the correction. Clear evidence about customized devices for HTO and their correction accuracy lacks. Methods: The databases PUBMED and EMBASE were systematically screened for human and cadaveric studies about the use of customized devices for high tibial osteotomy and their outcomes concerning correction accuracy. Furthermore, a 3D-printed customized system for valgus HTO with three pilot cases at one-year follow-up was presented. Results: 28 studies were included. The most commonly used custom-made devices for HTO were found to be cutting guides. Reported differences between the achieved and targeted correction of hip-knee-ankle angle and the posterior tibial slope were 3° or under. The three pilot cases that underwent personalized HTO with a new 3D-printed device presented satisfactory alignment and clinical outcomes at one-year follow-up. Conclusion: The available patient-specific devices described in the literature, including the one used in the preliminary cases of the current study, showed promising results in increasing the accuracy of correction in HTO procedure.
Meeting the Challenges of Myocarditis: New Opportunities for Prevention, Detection, and Intervention—A Report from the 2021 National Heart, Lung, and Blood Institute Workshop
Authors: Čiháková Daniela , Shi Yang , Adhikari Bishow , Bandettini W. Patricia , Cunningham Madeleine W. , Danthi Narasimhan , Friedrich Matthias G. , Liu Peter , Longacre Lisa Schwartz , Mann Douglas L. , Swirski Filip K. , Tang W. H. Wilson , Zhou Guofei , Cooper, Jr. Leslie T.
Published: September 2022

The National Heart, Lung, and Blood Institute (NHLBI) convened a workshop of international experts to discuss new research opportunities for the prevention, detection, and intervention of myocarditis in May 2021. These experts reviewed the current state of science and identified key gaps and opportunities in basic, diagnostic, translational, and therapeutic frontiers to guide future research in myocarditis. In addition to addressing community-acquired myocarditis, the workshop also focused on emerging causes of myocarditis including immune checkpoint inhibitors and SARS-CoV-2 related myocardial injuries and considered the use of systems biology and artificial intelligence methodologies to define workflows to identify novel mechanisms of disease and new therapeutic targets. A new priority is the investigation of the relationship between social determinants of health (SDoH), including race and economic status, and inflammatory response and outcomes in myocarditis. The result is a proposal for the reclassification of myocarditis that integrates the latest knowledge of immunological pathogenesis to refine estimates of prognosis and target pathway-specific treatments.
Frequency, Characteristics, and Predictive Factors of Adverse Drug Events in an Adult Emergency Department according to Age: A Cross-Sectional Study
Authors: Lohan Laura , Marin Grégory , Faucanie Marie , Laureau Marion , Perier Damien , Pinzani Véronique , Giraud Isabelle , Villiet Maxime , Sebbane Mustapha , Sultan Ariane , Breuker Cyril
Published: September 2022

Adverse drug events (ADEs) are a major public health concern, given their consequences in terms of morbi-mortality and associated healthcare costs. Many studies have focused on the elderly, who are considered particularly vulnerable in this respect. We aimed to determine and compare the frequency, characteristics, and predictive factors of ADEs according to age in an adult population. A prospective seven-year cross-sectional study was conducted in a university hospital emergency department. Structured medication reviews and ADE detection were performed. Patient data and ADE characteristics were collected. Descriptive statistics and logistic regression were performed in two age groups: Group 1 (age < 65 years) and 2 (age ≥ 65 years). Among the 13,653 patients included, 18.4% in Group 1 and 22.6% in Group 2 experienced an ADE. Differences were identified in terms of the ADE type (more ADEs due to noncompliance in Group 1) and ADE symptoms (greater bleeding in Group 2). In the multivariable analysis, several specific predictive factors were identified, including kidney failure and antidiabetic drug use in Group 1 and inappropriate prescription and antithrombotic treatment in Group 2. Analysis by age provided a more refined vision of ADEs as we identified distinct profiles of iatrogenesis. These results will lead to a better detection of ADEs.
Anemia in Celiac Disease: Prevalence, Associated Clinical and Laboratory Features, and Persistence after Gluten-Free Diet
Authors: Seidita Aurelio , Mansueto Pasquale , Compagnoni Stella , Castellucci Daniele , Soresi Maurizio , Chiarello Giorgio , Cavallo Giorgia , De Carlo Gabriele , Nigro Alessia , Chiavetta Marta , Mandreucci Francesca , Giuliano Alessandra , Disclafani Rosaria , Carroccio Antonio
Published: September 2022

Anemia is considered to be the most frequent extra-intestinal manifestation of Celiac Disease (CD). We assessed frequency, severity, morphologic features, and pathogenic factors of anemia in patients of the Sicilian Regional Network of Celiac Disease and attempted to identify putative pre-diet factors influencing anemia persistence. We retrospectively analyzed CD patients admitted to three centers between 2016–2020. 159 patients entered the study (129 females). More than half (54.7%) had mild-moderate, hypochromic and microcytic anemia, associated with below normal total serum iron and ferritin, indicative of iron deficiency anemia (IDA). One year after diagnosis, 134 patients were following ‘strict’ GFD. Hypochromic and microcytic anemia persisted in 46% of subjects who were anemic at diagnosis. Patients with persistent anemia had at diagnosis a higher prevalence of female gender (p = 0.02), lower body mass index (BMI, p = 0.01), higher prevalence of poly/hypermenorrhea (p = 0.02) and atopy (p = 0.04), and lower ferritin levels (p = 0.05) than the whole group of non-anemic ones. IDA is found in more than 50% of CD patients at diagnosis; nevertheless, in a lot of women IDA is not corrected by ‘strict’ GFD. Low BMI and poly/hypermenorrhea at diagnosis characterize this subgroup, suggesting that IDA might be due to iron loss rather than malabsorption, or to their coexistence/overlap.
Laparoscopic Versus Robot-Assisted Pyeloplasty in Adults—A Single-Center Experience
Authors: Carmona Orel , Dotan Zohar A. , Haifler Miki , Rosenzweig Barak , Zilberman Dorit E.
Published: September 2022

Background: Laparoscopic (LP) and robot-assisted pyeloplasty (RAP) are minimally invasive techniques for correcting uretero-pelvic junction obstruction (UPJO). We retrospectively compared the clinical outcomes of all adults who underwent RAP (n = 41) to those who underwent LP (n = 24) for UPJO at our institution between 2003–2022. Methods: Age, sex, body mass index, surgical side, past abdominal/endoscopic surgeries, pre- and postoperative renal scans, pre- and postoperative serum creatinine levels, operative time (OT), presence of crossing vessels, estimated blood loss, postoperative complications, length of hospital stay, time to JJ stent removal, follow-up length, and postoperative hydronephrosis were analyzed. Results: The groups were demographically comparable. The mean total and skin-to-skin OTs (minutes) were significantly longer in the RAP group than in the LP group (242.4 ± 55 vs. 161.4 ± 40 p < 0.001; 163.7 ± 41.8 vs. 124.3 ± 30.3 p = 0.006, respectively). Hospital stay (days) was shorter in the RAP group (3.3 ± 2.1 vs. 7.3 ± 2.5 p < 0.001). Postoperative complication rates were identical for both groups. The LP group had a significantly longer follow-up period (85.2 ± 73 vs. 19 ± 14 months p < 0.001). The success rates for the LP and RAP groups were 87.5% and 90.6% (p = 0.708). Conclusions: RAP achieves equivalent results to LP, in adult patients. A longer OT may be expected with the robotic system since it can handle more complicated cases.
The Economic Impact of Flood Zone Designations on Residential Property Valuation in Miami-Dade County
Authors: Shu Evelyn G. , Porter Jeremy R. , Wilson Bradley , Bauer Mark , Pope Mariah L.
Published: September 2022

In the United States, flood events are the most economically damaging type of natural disaster. Some of the most widely used tools for understanding property flood risk in the United States are the Flood Insurance Rate Maps (FIRMs) produced by the Federal Emergency Management Agency (FEMA). Numerous previous studies have attempted to estimate the impact on property valuation from a home’s being mapped into a Special Flood Hazard Area (SFHA) within FIRMs. However, as these maps have widely served as the source of data about true flood risk, there have been limits on the ability of researchers to disentangle these zone designation impacts as due to actual flood risk or as due to perceived flood risk. New advancements in flood modeling have allowed for the prediction of high-quality property-level flood inundation, both now and in the future. By integrating these flood modeling advancements, true flood risk may be controlled for in models looking to explore the avenues by which property valuation impacts occur. To this end, this study builds on insights from recent research looking at the valuation of single-family residential properties in Miami-Dade County (MDC), which utilizes a high-resolution floodplain model to estimate the impact of actual property inundation on sales prices. By controlling for actual property flood risk, impacts of SFHA designations are estimated in MDC through implementation of a difference in difference model which utilizes the release of updated FIRMS in 2009 and the 217,222 transactions and 120,693 property designation changes which occurred within the dataset.
Geosite Assessment in the Beigua UNESCO Global Geopark (Liguria, Italy): A Case Study in Linking Geoheritage with Education, Tourism, and Community Involvement
Authors: Marescotti Pietro , Castello Giulia , Briguglio Antonino , Caprioglio Maria Cristina , Crispini Laura , Firpo Marco
Published: September 2022

The inventory and the assessment of geosites plays a very important role in highlighting scientific, geotouristic, and geoeducational potential, as well as the ability to identify any criticalities and vulnerabilities of the geological heritage of a territory. Within a geopark, these assessment activities are also crucial for developing land management strategies and policies that not only meet the need to protect geological and natural heritage, but also to promote sustainable economic development of the area and local communities. The Beigua UNESCO Global Geopark (Liguria, Italy) includes fifty-four sites known for their significant geological values. In this work, we have combined a study aimed at the qualitative and quantitative evaluation of 10 of the 54 sites with the results of an analysis of the educational, touristic, and land management activities that have been developed on these sites from 2011 to 2021. The quantitative assessment of the ten selected sites reveals their high scientific value and considerable touristic and/or educational potential. Thus, they represent not only scientific geological heritage to be preserved but also a significant tourism resource for the geopark territory. This is confirmed by the great success of geotouristic and geoeducational initiatives developed in the park over the last ten years, and by the growing involvement of the local communities, institutions, entrepreneurial activities, as well as environmental, sports, and cultural associations. These results highlight some important aspects for the management of geological heritage and associated values within a geopark.
Comparative Performance of Deep Learning and Radiologists for the Diagnosis and Localization of Clinically Significant Prostate Cancer at MRI: A Systematic Review
Authors: Roest Christian , Fransen Stefan J , Kwee Thomas C , Yakar Derya
Published: September 2022

Background: Deep learning (DL)-based models have demonstrated an ability to automatically diagnose clinically significant prostate cancer (PCa) on MRI scans and are regularly reported to approach expert performance. The aim of this work was to systematically review the literature comparing deep learning (DL) systems to radiologists in order to evaluate the comparative performance of current state-of-the-art deep learning models and radiologists. Methods: This systematic review was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Studies investigating DL models for diagnosing clinically significant (cs) PCa on MRI were included. The quality and risk of bias of each study were assessed using the checklist for AI in medical imaging (CLAIM) and QUADAS-2, respectively. Patient level and lesion-based diagnostic performance were separately evaluated by comparing the sensitivity achieved by DL and radiologists at an identical specificity and the false positives per patient, respectively. Results: The final selection consisted of eight studies with a combined 7337 patients. The median study quality with CLAIM was 74.1% (IQR: 70.6–77.6). DL achieved an identical patient-level performance to the radiologists for PI-RADS ≥ 3 (both 97.7%, SD = 2.1%). DL had a lower sensitivity for PI-RADS ≥ 4 (84.2% vs. 88.8%, p = 0.43). The sensitivity of DL for lesion localization was also between 2% and 12.5% lower than that of the radiologists. Conclusions: DL models for the diagnosis of csPCa on MRI appear to approach the performance of experts but currently have a lower sensitivity compared to experienced radiologists. There is a need for studies with larger datasets and for validation on external data.
MND Phenotypes Differentiation: The Role of Multimodal Characterization at the Time of Diagnosis
Authors: Meo Giuseppe , Ferraro Pilar M. , Cillerai Marta , Gemelli Chiara , Cabona Corrado , Zaottini Federico , Roccatagliata Luca , Villani Flavio , Schenone Angelo , Caponnetto Claudia
Published: September 2022

Pure/predominant upper motor neuron (pUMN) and lower motor neuron (pLMN) diseases have significantly better prognosis compared to amyotrophic lateral sclerosis (ALS), but their early differentiation is often challenging. We therefore tested whether a multimodal characterization approach embedding clinical, cognitive/behavioral, genetic, and neurophysiological data may improve the differentiation of pUMN and pLMN from ALS already by the time of diagnosis. Dunn’s and chi-squared tests were used to compare data from 41 ALS, 34 pLMN, and 19 pUMN cases with diagnoses confirmed throughout a 2-year observation period. Area under the curve (AUC) analyses were implemented to identify the finest tools for phenotypes discrimination. Relative to ALS, pLMN showed greater lower limbs weakness, lower UMN burden, and progression rate (p < 0.001–0.04). PUMN showed a greater frequency of lower limbs onset, higher UMN burden, lower ALSFRS-r and MRC progression rates (p < 0.001–0.03), and greater ulnar compound muscle action potential (CMAP) amplitude and tibial central motor conduction time (CMCT) (p = 0.05–0.03). The UMN progression rate was the finest measure to identify pLMN cases (AUC = 90%), while the MRC progression rate was the finest tool to identify pUMN (AUC = 82%). Detailed clinical and neurophysiological examinations may significantly improve MNDs differentiation, facilitating prognosis estimation and ameliorating stratification strategies for clinical trials enrollment.
A Deep Learning Framework for Automatic Sleep Apnea Classification Based on Empirical Mode Decomposition Derived from Single-Lead Electrocardiogram
Authors: Setiawan Febryan , Lin Che-Wei
Published: September 2022

Background: Although polysomnography (PSG) is a gold standard tool for diagnosing sleep apnea (SA), it can reduce the patient’s sleep quality by the placement of several disturbing sensors and can only be interpreted by a highly trained sleep technician or scientist. In recent years, electrocardiogram (ECG)-derived respiration (EDR) and heart rate variability (HRV) have been used to automatically diagnose SA and reduce the drawbacks of PSG. Up to now, most of the proposed approaches focus on machine-learning (ML) algorithms and feature engineering, which require prior expert knowledge and experience. The present study proposes an SA detection algorithm to differentiate a normal and apnea event using a deep-learning (DL) framework based on 1D and 2D deep CNN with empirical mode decomposition (EMD) of a preprocessed ECG signal. The EMD is ideally suited to extract essential components which are characteristic of the underlying biological or physiological processes. In addition, the simple and compact architecture of 1D deep CNN, which only performs 1D convolutions, and pretrained 2D deep CNNs, are suitable for real-time and low-cost hardware implementation. Method: This study was validated using 7 h to nearly 10 h overnight ECG recordings from 33 subjects with an average apnea-hypopnea index (AHI) of 30.23/h originated from PhysioNet Apnea-ECG database (PAED). In preprocessing, the raw ECG signal was normalized and filtered using the FIR band pass filter. The preprocessed ECG signal was then decomposed using the empirical mode decomposition (EMD) technique to generate several features. Several important generated features were selected using neighborhood component analysis (NCA). Finally, deep learning algorithm based on 1D and 2D deep CNN were used to perform the classification of normal and apnea event. The synthetic minority oversampling technique (SMOTE) was also applied to evaluate the influence of the imbalanced data problem. Results: The segment-level classification performance had 93.8% accuracy with 94.9% sensitivity and 92.7% specificity based on 5-fold cross-validation (5fold-CV), meanwhile, the subject-level classification performance had 83.5% accuracy with 75.9% sensitivity and 88.7% specificity based on leave-one-subject-out cross-validation (LOSO-CV). Conclusion: A novel and robust SA detection algorithm based on the ECG decomposed signal using EMD and deep CNN was successfully developed in this study.
A Manufacturing Process Simulation of Toughened Cyanate-Ester-Based Composite Structures with Respect to Stress Relaxation
Authors: Gort Nicolas , Schadt Fabian , Liebisch Martin , Brauner Christian , Wille Tobias
Published: September 2022

The objectives of this study were to experimentally determine the effects of the stress relaxation of a cyanate-ester-based composite, derive and integrate constitutive equations into commercial FEM software, and apply this approach to understand the formation of residual stress in a typical aerospace structure—namely, a stiffened panel. In preliminary studies, a cyanate-ester-based composite with increased fracture toughness for high-temperature applications was developed. High curing temperatures up to 260 °C will inevitably lead to high process-induced stresses. To assess the magnitude of impact on the development of internal stresses, the relaxation behavior of the neat resin was measured and characterized. The system was toughened, and the effect of stress relaxation increased as the temperature got closer to the glass transition temperature of the toughener, which was approximately 240 °C. With the use of an incremental linear viscoelastic model, the relaxation behavior was integrated into a process model with a holistic approach. A stiffened panel was manufactured and used as the validation use case. The displacement field was validated with an optical 3D measuring system, and good agreement was found between the simulated and experimental results. The maximum difference between the elastic and the viscoelastic solution was found to be 15%. Furthermore, the stress magnitude in the transverse material direction resulted in a more critical value higher than the material strength.
Thermal Conductivity of Helium and Argon at High Pressure and High Temperature
Authors: Hsieh Wen-Pin , Tsao Yi-Chi , Lin Chun-Hung
Published: September 2022

Helium (He) and argon (Ar) are important rare gases and pressure media used in diamond-anvil cell (DAC) experiments. Their thermal conductivity at high pressure–temperature (P-T) conditions is a crucial parameter for modeling heat conduction and temperature distribution within a DAC. Here we report the thermal conductivity of He and Ar over a wide range of high P-T conditions using ultrafast time-domain thermoreflectance coupled with an externally heated DAC. We find that at room temperature the thermal conductivity of liquid and solid He shows a pressure dependence of P0.86 and P0.72, respectively; upon heating the liquid, He at 10.2 GPa follows a T0.45 dependence. By contrast, the thermal conductivity of solid Ar at room temperature has a pressure dependence of P1.25, while a T−1.37 dependence is observed for solid Ar at 19 GPa. Our results not only provide crucial bases for further investigation into the physical mechanisms of heat transport in He and Ar under extremes, but also substantially improve the accuracy of modeling the temperature profile within a DAC loaded with He or Ar. The P-T dependences of the thermal conductivity of He are important to better model and constrain the structural and thermal evolution of gas giant planets containing He.
Effect of Aggregate Size and Water/Cement on Compressive Strength and Physiological Performance of Planting Concrete
Authors: Chen Jianguo , Du Weilian , Zhao Guanqi , Shi Mingsheng , Xue Binghan
Published: September 2022

Planting concrete, an eco-friendly concrete in which plants can grow directly, has been widely used in roof greening and the slopes of rivers. Porosity and compressive strength are important indicators for evaluating the properties of planting concrete. By preparing planting concrete with different aggregate gradations (10–30 mm, 20–40 mm) and water–cement ratios (0.25, 0.27, 0.29, 0.31, 0.33), the effect of aggregate gradation and water–cement ratio on the porosity and compressive strength of the planting concrete was analyzed, the intrinsic relationship between aggregate gradation and plane pore parameters was studied, the strength growth pattern and microscopic strengthening mechanism were studied, the relationship between porosity and compressive strength of the planting concrete were explored, and a tall fescue planting experiment was carried out to evaluate the plantation performance of the planting concrete. The results show that under the same conditions of water–cement ratio, the smaller the particle size of the aggregate, the smaller the porosity of the plane, and the denser the structure. The average diameter of the planting concrete shows an exponential relationship with the porosity of plane. The early growth of the compressive strength of the planting concrete is rapid; the compressive strength has a linear relationship at the ages of 7 days and 28 days. Compared to polynomial and logarithmic functions, the exponential function gives a better insight into the relationship between the porosity and compressive strength of the planting concrete. Tall fescue seeds germinate and grow well; height, cover, and leaf rootstock and element content of plants can be used as indicators to assess the performance of vegetated concrete planting.
Materials and Processes for Sustainable Energy and Environmental Systems
Authors: Howaniec Natalia
Published: September 2022

Developments in materials and processes for sustainable energy and environmental systems are of special importance in the world of depleting natural resources, serious environmental concerns, increasing energy demand, and disturbances in the global energy market affecting energy supply chains [...]
An Electrical Contacts Study for Tetrahedrite-Based Thermoelectric Generators
Authors: Coelho Rodrigo , De Abreu Yassine , Carvalho Francisco , Branco Lopes Elsa , Gonçalves António Pereira
Published: September 2022

High electrical and thermal contact resistances can ruin a thermoelectric device’s performance, and thus, the use of effective diffusion barriers and optimization of joining methods are crucial to implement them. In this work, the use of carbon as a Cu11Mn1Sb4S13 tetrahedrite diffusion barrier, and the effectiveness of different fixation techniques for the preparation of tetrahedrite/copper electrical contacts were investigated. Contacts were prepared using as jointing materials Ni and Ag conductive paints and resins, and a Zn-5wt% Al solder. Manual, cold- and hot-pressing fixation techniques were explored. The contact resistance was measured using a custom-made system based on the three points pulsed-current method. The legs interfaces (Cu/graphite/tetrahedrite) were investigated by optical and scanning electron microscopies, complemented with energy-dispersive X-ray spectroscopy, and X-ray diffraction. No interfacial phases were formed between the graphite and the tetrahedrite or Cu, pointing to graphite as a good diffusion barrier. Ag water-based paint was the best jointing material, but the use of hot pressing without jointing materials proves to be the most reliable technique, presenting the lowest contact resistance values. Computer simulations using the COMSOL software were performed to complement this study, indicating that high contact resistances strongly reduce the power output of thermoelectric devices.
A Novel Process for the Containment of SO2 Emissions from Class C Fly Ash in the Fired Materials by Haüyne Formation
Authors: Sokolar Radomir , Nguyen Martin
Published: September 2022

Class C fly ash has been receiving increasing attention due to the gradual transition of thermal power plants all over the world to the fluidized bed combustion technology with sulfur dioxide emissions capture. This research investigates the utilization of class C fly ash in fired ceramic materials with simultaneous efficient and novel containment of sulfur dioxide emissions in the flue gas during firing. A number of experiments were conducted by addition of sodium water glass with different molar ratios of SiO2:Na2O, sodium carbonate, and different ratios of sodium carbonate to water glass to the class C fly ash to examine the optimal combination and quantity for the creation and formation of the mineral phase haüyne which resulted in reduction and containment of SO2 emissions. Results revealed that a 12% dose of sodium water glass with a low molar ratio of 1.7 (SiO2:Na2O) combined with class C fly ash was more effective in the formation of haüyne and the resulting decrease of SO2 in the flue gas was more substantial. The newly formed mineral phase haüyne was identified by an X-ray diffraction analysis and scanning electron microscopy with energy dispersive X-ray spectroscopy. Outcomes reveal a potential for utilization of class C fly ash in the fired materials by containment of sulfur dioxide into their structure.