bluuebunny/crossref_metadata_2025 huggingface dataset:
Mathematical properties of Hand Incremental Effect Additivity and other synergy theories
Authors: Hanin Leonid , Xie Liyang , Sachs Rainer
Published: May 2023

Synergy theories for multi‐component agent combinations use 1‐agent dose‐effect relations (DERs), known from analyzing previous 1‐agent experiments, to calculate neither‐synergy‐nor‐antagonism combination DERs. Synergy theories are widely used in pharmacology, toxicology, and radiation biology. This article analyzes mathematical properties of one important synergy theory, proposed by John Hand in a little‐known article published in 2000 and here called Hand Incremental Effect Additivity (HIEA). In 2018, Hand's approach was reinvented in a radiobiology study that inadvertently overlooked his paper. We carefully state the assumptions required for mathematically rigorous development of HIEA and other synergy theories. Under these assumptions, studying synergy/antagonism between any number of agents can be done on a single 2d plot. We show that HIEA combination DER is in general not well‐defined in that it can “blow up” at finite total dose. We also formulate necessary and sufficient conditions on 1‐agent DERs preventing such pathology. Using weighted harmonic means, we study the betweenness property of HIEA synergy theory and demonstrate that Hand's combination DER has a systematic tendency for betweenness violation. On the positive side, we introduce the concept of a strongly dominant agent and show that the presence of such an agent ensures the betweenness property. We show also that the betweenness property holds for another major synergy theory, Loewe–Berenbaum Additivity. Our emphasis in this article on synergy theories that can handle any number of agents was motivated by applications to the study of toxic effects of galactic cosmic rays on astronauts during interplanetary travel.
Solution of fractional Sawada–Kotera–Ito equation using Caputo and Atangana–Baleanu derivatives
Authors: Khirsariya Sagar R. , Rao Snehal B.
Published: May 2023

In the present work, the fractional‐order Sawada–Kotera–Ito problem is solved by considering nonlocal Caputo and nonsingular Atangana–Baleanu (ABC) derivatives. The methodology used is an application of the Shehu transform and the Adomian decomposition method. The obtained solution is more accurate when using the ABC type derivative as compared to the Caputo sense, when using the proposed ADShTM method (Adomian decomposition Shehu transform method). The results so obtained by the ADShTM using Caputo and ABC operators are compared, establishing the superiority of the proposed method. The numerical results demonstrate that the application of the ABC derivative is not only relatively more effective and reliable but also straightforward to achieve high precision solution.
Super‐wideband two‐arm antenna for future generations of mobile communications
Authors: Ouf Eman G. , Abo El‐Hassan May , Farahat Asmaa E. , Hussein Khalid F. A. , Mohassieb Shaimaa A.
Published: May 2023

In this paper, a modified rhombic‐shaped wide‐flare two‐arm antenna is proposed for super‐wideband applications of the next generations of mobile technologies. To enhance antenna input impedance and to improve its performance, the copper arms are lithographed on a dielectric substrate with multilayers and fed through a wideband balun that is designed to feed the balanced two‐arm antenna through the conventional (unbalanced) coaxial line. The proposed antenna is fabricated for experimental validation of the simulation results. It is shown through electromagnetic simulation as well as experimental measurements that the proposed antenna is operational in the range of frequencies (). Parametric study is performed to obtain the optimum design of the proposed antenna. The distributions of the surface current on the antenna arms at different frequencies are presented and discussed for more understanding of the antenna operation over the entire frequency band. It is shown that the antenna has a radiation efficiency of greater than 96%, percentage bandwidth of 164%, ratio bandwidth of 10, bandwidth‐to‐dimension ratio of 1360, and maximum gain that exceeds .
Robust quantitative susceptibility mapping via approximate message passing with parameter estimation
Authors: Huang Shuai , Lah James J. , Allen Jason W. , Qiu Deqiang
Published: May 2023

Purpose

For quantitative susceptibility mapping (QSM), the lack of ground‐truth in clinical settings makes it challenging to determine suitable parameters for the dipole inversion. We propose a probabilistic Bayesian approach for QSM with built‐in parameter estimation, and incorporate the nonlinear formulation of the dipole inversion to achieve a robust recovery of the susceptibility maps.

Theory

From a Bayesian perspective, the image wavelet coefficients are approximately sparse and modeled by the Laplace distribution. The measurement noise is modeled by a Gaussian‐mixture distribution with two components, where the second component is used to model the noise outliers. Through probabilistic inference, the susceptibility map and distribution parameters can be jointly recovered using approximate message passing (AMP).

Methods

We compare our proposed AMP with built‐in parameter estimation (AMP‐PE) to the state‐of‐the‐art L1‐QSM, FANSI, and MEDI approaches on the simulated and in vivo datasets, and perform experiments to explore the optimal settings of AMP‐PE. Reproducible code is available at:
https://github.com/EmoryCN2L/QSM_AMP_PE.

Results

On the simulated Sim2Snr1 dataset, AMP‐PE achieved the lowest NRMSE, deviation from calcification moment and the highest SSIM, while MEDI achieved the lowest high‐frequency error norm. On the in vivo datasets, AMP‐PE is robust and successfully recovers the susceptibility maps using the estimated parameters, whereas L1‐QSM, FANSI and MEDI typically require additional visual fine‐tuning to select or double‐check working parameters.

Conclusion

AMP‐PE provides automatic and adaptive parameter estimation for QSM and avoids the subjectivity from the visual fine‐tuning step, making it an excellent choice for the clinical setting.
Implementation and verification of a user‐defined element (UEL) for coupled thermal‐hydraulic‐mechanical‐chemical (THMC) processes in saturated geological media
Authors: Zhou Xiang , Zhang Yida
Published: May 2023

Efficient and accurate modeling of the coupled thermal‐hydraulic‐mechanical‐chemical (THMC) processes in various rock formations is indispensable for designing energy geo‐structures such as underground repositories for high‐level nuclear wastes. This work focuses on developing and verifying an implicit finite element solver for generic coupled THMC problems in geological settings. Starting from the mass, momentum, and energy balance laws, a specialized set of governing equations and a thermoporoelastic constitutive model is derived. This system is then solved by an implicit finite element (FE) scheme. Specifically, the residuals and the Jacobians are scripted in a user‐defined element (UEL) subroutine which is then combined with the general‐purpose FE software Abaqus Standard to solve initial‐boundary value problems. Considering the complexity of the system, the UEL development follows a stepwise manner by first solving the coupled hydraulic‐mechanical (HM) and thermal‐hydraulic‐mechanical (THM) equations before moving on to the full THMC problem. Each implementation step consists of at least one verification test by comparing computed results with closed‐form analytical solutions to ensure that the various coupling effects are correctly realized. To demonstrate the robustness of the algorithm and to validate the UEL, a three‐dimensional case study is performed with reference to the in‐situ heating test of ATLAS at Belgium in 1980s. A hypothetical radionuclide leakage event is then simulated by activating the chemical‐concentration degree of freedom and prescribing a constant high concentration at the heater's surface. The model predicts a limited contaminated regime after six years considering both diffusion and advection effects on species transport.
Understanding factors influencing primary treatment with intradetrusor onabotulinumtoxinA versus augmentation cystoplasty in patients with spina bifida
Authors: Li Belinda , Peard Leslie M. , Zhao Shilin , Graham M. Kyle , Adams Cyrus , Taylor Abby S. , Thomas John C. , Pope John C. , Adams Mark C. , Brock John W. , Clayton Douglass B.
Published: May 2023

Purpose

Surgical interventions in the urologic management of children with neurogenic bladder secondary to spina bifida aim to preserve upper tract function, prevent urinary tract infections, and optimize quality of life. However, since the introduction of intravesical onabotulinumtoxinA (Botox) in the management of these patients, the indications for choosing Botox over augmentation cystoplasty (AC) remain undefined. The objective of this study was to determine which factors lead patients to undergo Botox versus AC as a primary surgical treatment after failing medical management.

Methods

We retrospectively reviewed the records of pediatric patients with myelomeningocele undergoing either primary Botox or primary AC at our institution between 2013 and 2018. We recorded demographic and clinical information. We identified 10 important clinical decision‐making factors: bladder trabeculation, vesicoureteral reflux, or hydronephrosis on imaging; end‐filling pressure (EFP) ≥40 cm H2O, detrusor overactivity, detrusor‐sphincter dyssynergia, or reduced capacity on urodynamic studies; physician‐perceived bladder hostility; and patient/family desire for continence and independence. The presence of these factors was compared between patients undergoing either primary Botox or primary AC.

Results

We identified 14 and 50 myelomeningocele patients who underwent primary AC and primary Botox, respectively. We found no significant differences in age, sex, race, or history of reconstructive surgery (antegrade continence enema or catheterizable channel). For the 10 decision‐making factors, desire for independence/continence (p = <0.001) and reduced capacity (p = 0.002) were significantly associated with AC, while trabeculation (p = 0.006), EFP ≥40 cm H2O (p = 0.029), rising slope (p = 0.019), and physician‐perceived hostility (p = 0.012) were significantly more common with Botox.

Conclusions

At our institution, quality of life measures prompted AC over objective urodynamic or imaging findings before attempting Botox. These findings support a shared decision‐making approach when considering surgical intervention for neurogenic bladder secondary to myelomeningocele.
Chronic kidney disease awareness and updates on the management of diabetic kidney disease
Authors: Hamza Wigdan , Burton James O
Published: May 2023

The prevalence of chronic kidney disease (CKD) is rising worldwide and is a major contributor to morbidity and mortality. It is estimated to affect over 800 million people globally.

CKD and its complications carry a substantial financial burden to the NHS in both primary and secondary care. The lack of public awareness of CKD and its complications leads to a reduction in planned follow‐up attendance; clinician awareness of the biomarkers of CKD and progression is still lacking. Measures to improve awareness are needed.

Diabetes mellitus remains the single most common cause of progressive renal impairment and over 40% of patients with diabetes will develop diabetic kidney disease in their lifetime. A multidisciplinary approach to management and early intervention are therefore key to halt the progress of diabetic kidney disease. The National Institute for Health and Care Excellence has set clear guidelines for the management of diabetic kidney disease, highlighting newer therapeutic agents like SGLT2 inhibitors. New guidelines are also in place for referral to secondary care involving the Kidney Failure Risk Equation, as it identifies patients at increased risk of progressing to end stage kidney disease.

Without robust measures for early detection and management of CKD, progression to kidney failure may occur, exacerbating the increase in cardiovascular disease, premature deaths and poor quality of life. This article is a call to action for the optimal and timely management of CKD. Copyright © 2023 John Wiley & Sons.
The weather's no joke for people living with diabetes
Authors: Greener Mark
Published: May 2023

Climate change – presaging heat waves and cold snaps – along with drivers for global warming are likely to affect the epidemiology and management of diabetes, warns Mark Greener in his examination here of the published evidence to date.

It has been shown that diabetes and climate change perpetuate each other in several ways. New literature offers detailed, thought‐provoking and worrying summaries.
Towards quantum state preparation with materials science: An analytical review
Authors: Sood Vaishali , Chauhan Rishi Pal
Published: May 2023

The field of quantum computing has undergone significant expansion and development in recent years. A quantitative and comprehensive examination of the research domain is essential to comprehend research trends and directions in the field. Henceforth, the current paper conducts a scientometric analysis of the academic literature on quantum computing retrieved from the Scopus database to understand the recent advances made by researchers in the domain. The analysis evaluates the state of the discipline's research by examining the most prominent journals and highly referenced articles. CiteSpace is leveraged to visualize the intellectual landscape of quantum state preparation by performing document co‐citation and author co‐citation analysis. The analysis reveals that trapped ions, photonic qubits, superconducting qubits, nitrogen‐vacancy centers, and nuclear spin qubits are the primary research topics in quantum computing. Furthermore, the most current research issues that require attention in the field are measurement‐based qubits, Majorana fermions, and quantum dots.
Automatic Counting Method of Fry Based on Computer Vision
Authors: Li Juan , Sun Jingnong , Cui Xuerong , Jiang Bin , Li Shibao , Liu JianHang
Published: May 2023

Nowadays, fish farming plays an essential role in aquaculture. In the process of fry sales, the traditional manual counting method takes a great deal of time. Because the fish are constantly moving in the water, they are difficult to count and are likely to be unnecessarily damaged. With the rise of computer vision, fry counting based on image processing is also developing. It has the advantages of having high accuracy and fast processing speed. The primary counting process is divided into detection, adhesion segmentation, and fry counting. First, we improved the maximum interclass variance threshold selection method, and we extracted the histogram features under different channels to detect the fry; then, a matching segmentation method based on concave and skeleton crossing points was used to segment the adherent fry to improve the counting accuracy, the concaves were detected by CNN. We tested the method on real fry data sets, and the average accuracy reached 97%. Our approach had better accuracy than any existing current fish counting methods. © 2023 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC.
State‐of‐the‐art review of leak diagnostic experiments: Toward a smart water network
Authors: Bakhtawar Beenish , Zayed Tarek
Published: May 2023

Effective water pipeline leak detection and localization can help water practitioners save water losses and reduce pipe rehabilitation budgets. Different sensing technologies can provide essential data aiding model development for predicting future leaks in the water distribution networks. Solutions for applying different sensing technologies to real water distribution networks are being developed for real‐time data collection, precise leak localization, reducing false alarms, and continuous pipeline monitoring. Experiments of different scales and specifications have been conducted to test the application and effectiveness of sensing technologies for leak diagnosis in water pipelines. Quality data collection is especially crucial for the successful implementation of these experiments. However, practitioners need help designing effective leak detection and localization experiments, wasting time, and resources. There needs to be a greater understanding of the design parameters for more accurate testing, such as sensor selection, sensor placement, ambient noise sources, and system operations. The current study, therefore, delineates design parameters for design leak diagnosis experiments for lab, testbed, and real networks. For application in real water networks, expert opinion is used to help identify the benefits and limitations and the implementation issues of available sensing technologies. An example experiment design using multi‐sensing technologies for smart leak diagnostics in Hong Kong is also presented. The study can guide water practitioners and researchers to design a multi‐sensing leak diagnostic experiments enabling a smart and sustainable utility management.

This article is categorized under:

Engineering Water > Methods

Engineering Water > Sustainable Engineering of Water

Science of Water > Water Extremes
Outlier or Pioneer? the Development of Policy on E-Cigarettes in England
Authors: Berridge Virginia
Published: May 2023

In England, support for nicotine replacement therapy and for nicotine as a harm reduction agent expanded from the 1990s. The Labour government gave support as part of its anti-tobacco strategy and focus on inequalities. Action on Smoking and Health (ASH) the main anti-smoking activist organisation, also changed position. When e-cigarettes came on the scene ASH was important in including them within harm reduction and in assembling a coalition of support which included regulatory agencies. The coalition government also gave support. Medicinal licensing was intended but events in the European Parliament saw a consumer product approach adopted. The US EVALI epidemic did not affect England but shook public confidence. Recently, medicinal licensing has come back onto the agenda with a greater focus on young people.
Methode
Authors: Becker-Hingst Nadine
Published: May 2023

Im Rahmen der Methode werden zunächst das Studiendesign und der Ablauf der Studie sowie die verschiedenen Erhebungsinstrumente, die zur Diagnostik und Beantwortung der Forschungsfragen eingesetzt wurden, beschrieben. Des Weiteren werden das Rekrutierungsprocedere, die Ein- und Ausschlusskriterien sowie eine deskriptive Beschreibung der entstandenen Stichproben dargestellt. Abschließend wird das Vorgehen bei der statistischen Auswertung der Ergebnisse vorgestellt.
TRIM21 ameliorates hepatic glucose and lipid metabolic disorders in type 2 diabetes mellitus by ubiquitination of PEPCK1 and FASN
Authors: Zhang Kaini , Yang Chen , Zhou Xin , Liang Jin , Guo Jianjin , Li Min , Zhang Yi , Shao Shulin , Sun Peng , Li Kai , Huang Jingjing , Chen Fang , Liang Xiubin , Su Dongming
Published: May 2023

Hepatic glucose and lipid metabolism disorders promote the development and progression of type 2 diabetes mellitus (T2DM), yet the underlying mechanisms are not fully understood. Here, we identify tripartite motif-containing protein 21 (TRIM21), a class IV TRIM family member, as a pivotal regulator of hepatic metabolism in T2DM for the first time. Bioinformatic analysis suggests that TRIM21 expression is significantly reduced in T2DM patients. Intriguingly, in a mouse model of obese diabetes, TRIM21 expression is predominantly reduced in the liver rather than in other metabolic organs. It is further demonstrated that hepatic overexpression of TRIM21 significantly ameliorates glucose intolerance, insulin resistance, hepatic steatosis, and dyslipidemia in obese diabetic mice. In contrast, the knockdown of TRIM21 promotes glucose intolerance, insulin resistance, and triglyceride accumulation. Mechanistically, both phosphoenolpyruvate carboxykinase 1 (PEPCK1) and fatty acid synthase (FASN) are the hepatic targets of TRIM21. We revealed that TRIM21 promotes the degradation of PEPCK1 and FASN through a direct protein–protein interaction mediated K48-linked ubiquitination. Notably, overexpression of PEPCK1 and FASN essentially abolished the beneficial effects achieved by TRIM21 overexpression in obese diabetic mice. Overall, our data demonstrate that TRIM21 is a novel regulator of hepatic metabolic disorder, and suggest TRIM21 as a promising therapeutic target for T2DM.
Therapiealternativen bei amyopathischer MDA5-positiver Dermatomyositis
Authors: Schumacher Falk , Wollsching-Strobel Maximilian , Kroppen Doreen , Schwarz Sarah Bettina , Strunk Johannes , Windisch Wolfram , Berger Melanie
Published: May 2023

Wir berichten über den Fall eines atypischen Therapieverlaufs bei amyopathischer MDA5-Antikörper-positiver Dermatomyositis mit Lungenbeteiligung. Aufgrund der schlechten Prognose erfolgte initial neben der Gabe von Prednisolon die frühzeitige Therapie mit Cyclophosphamid, gefolgt von Rituximab. Aufgrund des Therapieversagens erfolgte die Umstellung der Basistherapie auf Mycophenolat-Mofetil. Hierunter zeigte sich ein überraschend rascher positiver Verlauf bezüglich der Lungenveränderungen, der Hautveränderungen und der allgemeinen Krankheitsaktivität.
A unique resistance mechanism is associated with RBgh2 barley powdery mildew adult plant resistance
Authors: Moolhuijzen Paula , Ge Cynthia , Palmiero Elzette , Ellwood Simon R.
Published: May 2023

Key message

Gene expression at the RBgh2 locus indicates involvement in cAMP/G-protein-coupled signalling and innate immunity in barley powdery mildew adult plant resistance.

Barley powdery mildew is a globally significant disease, responsible for reduced grain yield and quality. A major effect adult plant resistance gene, RBgh2, was previously found in a landrace from Azerbaijan. The atypical phenotype suggested different underlying genetic factors compared to conventional resistance genes and to investigate this, genome-wide gene expression was compared between sets of heterogeneous doubled haploids. RBgh2 resistance is recessive and induces both temporary genome-wide gene expression changes during powdery mildew infection together with constitutive changes, principally at the RBgh2 locus. Defence-related genes significantly induced included homologues of genes associated with innate immunity and pathogen recognition. Intriguingly, RBgh2 resistance does not appear to be dependent on salicylic acid signalling, a key pathway in plant resistance to biotrophs. Constitutive co-expression of resistance gene homologues was evident at the 7HS RBgh2 locus, while no expression was evident for a 6-transmembrane gene, predicted in silico to contain both G-protein- and calmodulin-binding domains. The gene was disrupted at the 5′ end, and G-protein-binding activity was suppressed. RBgh2 appears to operate through a unique mechanism that co-opts elements of innate immunity.
An analytical approach of multiple-aisle shuttle-based storage and retrieval systems
Authors: Eder Michael
Published: May 2023

This paper deals with a method for performance calculation of shuttle-based storage and retrieval system (SBS/RS) with tier-captive aisle-changing shuttles and different storage strategies. The shuttles are assigned to a certain number of aisles in this system. The invented approach takes place in the design process of SBS/RS. A continuous time open-queueing system with a limited capacity approach is applied. A discrete spatial value approach determines the inter-arrival times and service times. A probability-based model mentions the aisle changing. This approach is validated by comparison to a Monte-Carlo simulation. A European material handling provider gave the data used in this comparison to validate this approach. Finally, an example of the usage in the design process of SBS/RS of the invented analytical approach is depicted. The result is an increase in throughput with an increasing number of aisles per shuttle. Likewise, the storage strategy greatly influences the throughput between random storage and retrieval and same aisle storage and retrieval.
Decidability of CPC-irreducibility of subshifts of finite type over free groups
Authors: Ban Jung-Chao , Chang Chih-Hung , Wu Yu-Liang
Published: May 2023

This paper attempts to study the irreducibility on complete prefix code (CPC-irreducibility) of a Markov shift over a free group, a topological mixing property first considered for shift spaces over free semigroups that induces chaotic behavior such as the existence of a dense set of periodic points. An example shows that the $$({\textsf{d}},{\textsf{c}})$$

(
d
,
c
)

-reduction, an effective algorithm of determination of CPC-irreducibility of Markov shifts over free semigroups (Ban et al. in J Stat Phys 177:1043–1062, 2019), fails for general Markov shifts over free groups. This paper reveals an algorithm for determining the CPC-irreducibility of Markov shifts over both free semigroups and groups. Furthermore, such an examination is finitely checkable, and an upper bound for the complexity of the algorithm is provided.
Trauma and orthopaedic surgery response at the world’s largest sporting event: an analysis of the FIFA World Cup Qatar 2022
Authors: Salman Loay A. , Alzobi Osama Z. , Hatnouly Ashraf T. , Al Haneedi Yaman , Abousamhadaneh Maamoun , Hameed Shamsi , Al Ateeq Al Dosari Mohamed , Ahmed Ghalib
Published: May 2023

Purpose

The purpose of this study is to analyse the impact of the FIFA World Cup Qatar 2022 on the Orthopaedic Surgery department at Hamad Medical Corporation and its response to the challenges posed by the world’s largest sporting event.

Methods

A retrospective analysis was conducted on the epidemiology, crisis management plan, and training program adaptations at the Orthopaedic Surgery department during the World Cup. Descriptive analysis of the number and types of surgeries performed, patient demographics, and the disaster preparedness plan were performed.

Results

During the tournament period (November–December 2022), 706 patients (4.22% football fans) were operated on, with an average age of 44 ± 17 years. Most patients were males, 67%. Of the 706 patients, 60.33% were emergency cases, 38.24% were elective, 1.27% were limb-saving, and one life-saving procedure was performed, comparable to pre-tournament numbers. The patients were of 77 different nationalities, reflecting the diverse background of Qatar’s population and the international fanbase of the tournament.

Conclusions

This analysis provides valuable insights for future mega sporting events and highlights the importance of crisis management and training program adaptation for optimal patient care and resident training advancement. The findings demonstrate the crucial role of the Orthopaedic Surgery Department in responding to the challenges posed by large-scale events.
Can Axillary Lymph Node Dissection be Omitted in Breast Cancer Patients with Metastatic Sentinel Lymph Nodes Undergoing Mastectomy? A Systematic Review and Meta‐Analysis of Real‐World Evidence
Authors: Chen Fulong , Li Xiaowen , Lin Xianjun , Chen Lijia , Lin Zhaoling , Wu Hao , Chen Jishang
Published: May 2023

Background

The omission of axillary lymph node dissection (ALND) in patients with breast cancer who have metastatic sentinel lymph nodes (SLNs) undergoing mastectomy remains controversial. This meta‐analysis explored the clinicopathological factors affecting the selection of ALND and the influences of ALND on survival outcomes in patients receiving mastectomy with positive SLNs.

Methods

Eligible studies published prior to 31 December 2022 were selected by searching the Embase, Web of Science and PubMed databases. Pooled analyses were performed using the number of events for clinicopathological parameters and HRs with 95% CIs for survival outcomes including disease‐free survival (DFS), overall survival (OS), distant recurrence‐free survival (DRFS) and locoregional recurrence‐free survival (LRFS).

Results

A total of 10 retrospective studies enrolling only breast cancer patients with limited SLN metastases (no more than 3 positive SLNs or micrometastatic SLNs) undergoing mastectomy were included. Performing ALND in mastectomy patients who had limited SLN metastases was significantly correlated with invasive ductal carcinomas, larger tumors, lymphovascular invasion, higher tumor grade, macrometastatic SLNs, more positive SLNs, extranodal extension, positive surgical margins, negative ER, administration of adjuvant chemotherapy and nonwhite race (P < 0.05). However, performing ALND did not result in significantly longer OS, DFS, LRFS or DRFS (P > 0.05) in these patients.

Conclusion

The present meta‐analysis indicated that ALND may be safely avoided in patients with breast cancer who had limited SLN metastases undergoing mastectomy. Further well‐designed randomized clinical trials are warranted to validate our results.
Impact of extended sinus surgery on allograft infection, allograft function and overall survival in cystic fibrosis lung transplant recipients
Authors: Meier Manuel , Schuurmans Macé M. , Vital Domenic , Inci Ilhan , Holzman David , Soyka Michael B.
Published: May 2023

Background

Studies investigating the impact of sinus surgery for cystic fibrosis (CF) patients performed early after lung transplantation (Ltx) are scarce. Recent studies evaluating frequency of respiratory infections and graft outcomes are not available.

Objectives/hypothesis

To determine whether there is a difference in allograft infection, allograft function and overall survival among CF lung transplant recipients with and without concomitant sinus surgery.

Study design

Retrospective single-center study.

Methods

We examined 71 CF patients who underwent Ltx between 2009 and 2019 at our center. Fifty-nine patients had sinus surgery before or/and after transplantation and twelve did not undergo sinus surgery. We assessed the survival, the diagnosis of chronic allograft dysfunction (CLAD) and all elevated (> 5 mg/l) c-reactive protein episodes during the observed period. The infectious events of the upper and lower airways were categorized in mild infections (5–15 mg/l CRP) and severe infections (> 15 mg/l CRP).

Results

There was no difference in the long-time overall survival (p = 0.87) and no benefit in the short-term survival at 4 year post-transplant (p = 0.29) in both groups. There was no difference in both groups concerning CLAD diagnosis (p = 0.92). The incidence of severe upper and lower airway infections (CRP > 15 mg/l) was significantly decreased in the sinus surgery group (p = 0.015), whereas in mild infections there was a trend to decreased infections in the sinus surgery group (p = 0.056).

Conclusions

CF patients undergoing Ltx benefit from extended endoscopic sinus surgery (eESS) in terms of frequency of severe infectious events of the upper and lower airways. There was no difference in overall survival and frequency of CLAD in the two groups.
Short- and long-term outcomes of robotic-assisted versus video-assisted thoracoscopic lobectomy in non-small cell lung cancer patients aged 35 years or younger: a real-world study with propensity score-matched analysis
Authors: Pan Hanbo , Zhang Jiaqi , Tian Yu , Zou Ningyuan , Zhu Hongda , Gu Zenan , Jin Weiqiu , Ning Junwei , Jiang Long , Huang Jia , Luo Qingquan
Published: May 2023

Purpose

This study compared short- and long-term outcomes of robotic-assisted thoracoscopic surgery (RATS) versus video-assisted thoracoscopic surgery (VATS) for lobectomy in young adults aged ≤ 35 years with non-small cell lung cancer (NSCLC), aiming to assess the superiority of RATS over VATS for this special group of patients.

Methods

A total of 1355 consecutive NSCLC cases aged 18–35 years undergoing RATS (n = 105) or VATS (n = 1250) between 2014 and 2021 were retrospectively identified from a prospectively maintained database. Propensity score matching (PSM) was applied to establish a 1:3 RATS versus VATS ratio. Baseline clinicopathological characteristics, perioperative outcomes, lymph node (LN) assessment, and long-term survival were investigated.

Results

Following PSM, 105 and 315 cases were in the RATS and VATS groups, respectively. RATS led to a shorter postoperative hospital stay than VATS (4.0 ± 1.5 vs 4.3 ± 1.7 days, p = 0.02). The two groups were comparable in other perioperative outcomes and postoperative complications (all p > 0.05). Moreover, RATS assessed more LNs (9.4 ± 4.4 vs 8.3 ± 3.6, p = 0.03), especially N1 LNs (4.2 ± 3.1 vs 3.5 ± 2.2, p = 0.02), than VATS. By comparison, no difference in 5-year recurrence-free survival (RFS), overall survival (OS), or recurrence or mortality patterns was found between the two groups (all p > 0.05). Further subgroup analyses also observed similar long-term outcomes between the two groups regarding age, gender, and smoking history. Finally, Cox’s analyses found that the surgical approach was not independently correlated with RFS or OS.

Conclusion

RATS shortened postoperative hospital stay, assessed more N1 and total LNs, and achieved comparable long-term outcomes to VATS for very young NSCLC patients.
Influence of Laser Power and Scan Speed on the Formation of Hot Cracks during the Processing of High-speed Steel HS2-2-2 by Laser Powder Bed Fusion
Authors: Lücke Tim Gerrit , Schüller Luke , Vogelpoth Andreas , Laag Thomas , Saewe Jasmin , Häfner Constantin Leon
Published: May 2023

The manufacturing of high-speed steel (HSS) components using the laser powder bed fusion (LPBF) process could create an unprecedented combination of the materials’ mechanical properties and the design freedom enabled by the process to unlock new applications, such as milling heads with functionally optimized cooling channels. However, the processing of HSS with the LPBF process shows high susceptibility to cracking. This contribution aims to reduce hot cracking for the processing of HS2-2‑2 by investigating the influences of preheating temperature, laser power, and scan speed on the formation of hot cracks. The density and melt pool geometry of the produced parts are measured to further examine the relationship between the processing conditions and the resulting properties. The influence of various process parameters on the formation of hot cracks can be demonstrated. Further investigation shows a relation between hot cracking and the melt pool geometry. With a narrow and shallow melt pool, influenced by laser power and scan speed, the number of hot cracks can be reduced.
How does research activity align with research need in chronic subdural haematoma: a gap analysis of systematic reviews with end-user selected knowledge gaps
Authors: Gillespie Conor S. , Fung Kwan Wai , Alam Ali M. , Yanez Touzet Alvaro , Dhesi Jugdeep , Edlmann Ellie , Coles Jonathan , Menon David K. , Hutchinson Peter J. , Stubbs Daniel J. , Davies Benjamin M. ,   On behalf of the ICENI Collaboration
Published: May 2023

Background

Chronic subdural haematoma (CSDH) is increasingly common. Although treatment is triaged and provided by neurosurgery, the role of non-operative care, alongside observed peri-operative morbidity and patient complexity, suggests that optimum care requires a multi-disciplinary approach. A UK consortium (Improving Care in Elderly Neurosurgery Initiative [ICENI]) has been formed to develop the first comprehensive clinical practice guideline. This starts by identifying critical questions to ask of the literature. The aim of this review was to consider whether existing systematic reviews had suitably addressed these questions.

Methods

Critical research questions to inform CSDH care were identified using multi-stakeholder workshops, including patient and public representation. A CSDH umbrella review of full-text systematic reviews and meta-analysis was conducted in accordance with the PRISMA statement (CRD42022328562). Four databases were searched from inception up to 30 April 2022. Review quality was assessed using AMSTAR-2 criteria, mapped to critical research questions.

Results

Forty-four critical research questions were identified, across 12 themes. Seventy-three articles were included in the umbrella review, comprising 206,369 patients. Most reviews (86.3%, n=63) assessed complications and recurrence after surgery. ICENI themes were not addressed in current literature, and duplication of reviews was common (54.8%, n=40). AMSTAR-2 confidence rating was high in 7 (9.6%) reviews, moderate in 8 (11.0%), low in 10 (13.7%) and critically low in 48 (65.8%).

Conclusions

The ICENI themes have yet to be examined in existing secondary CSDH literature, and a series of new reviews is now required to address these questions for a clinical practice guideline. There is a need to broaden and redirect research efforts to meet the organisation of services and clinical needs of individual patients.
Problems and alternatives of testing significance using null hypothesis and P-value in food research
Authors: Choi Won-Seok
Published: May 2023

A testing method to identify statistically significant differences by comparing the significance level and the probability value based on the Null Hypothesis Significance Test (NHST) has been used in food research. However, problems with this testing method have been discussed. Several alternatives to the NHST and the P-value test methods have been proposed including lowering the P-value threshold and using confidence interval (CI), effect size, and Bayesian statistics. The CI estimates the extent of the effect or difference and determines the presence or absence of statistical significance. The effect size index determines the degree of effect difference and allows for the comparison of various statistical results. Bayesian statistics enable predictions to be made even when only a small amount of data is available. In conclusion, CI, effect size, and Bayesian statistics can complement or replace traditional statistical tests in food research by replacing the use of NHST and P-value.
Bias in the Representative Volume Element method: Periodize the Ensemble Instead of Its Realizations
Authors: Clozeau Nicolas , Josien Marc , Otto Felix , Xu Qiang
Published: May 2023

We study the representative volume element (RVE) method, which is a method to approximately infer the effective behavior $$a_{\textrm{hom}}$$

a
hom

of a stationary random medium. The latter is described by a coefficient field a(x) generated from a given ensemble $$\langle \cdot \rangle $$

⟨
·
⟩

and the corresponding linear elliptic operator $$-\nabla \cdot a\nabla $$

-
∇
·
a
∇

. In line with the theory of homogenization, the method proceeds by computing $$d=3$$

d
=
3

correctors (d denoting the space dimension). To be numerically tractable, this computation has to be done on a finite domain: the so-called representative volume element, i.e., a large box with, say, periodic boundary conditions. The main message of this article is: Periodize the ensemble instead of its realizations. By this, we mean that it is better to sample from a suitably periodized ensemble than to periodically extend the restriction of a realization a(x) from the whole-space ensemble $$\langle \cdot \rangle $$

⟨
·
⟩

. We make this point by investigating the bias (or systematic error), i.e., the difference between $$a_{\textrm{hom}}$$

a
hom

and the expected value of the RVE method, in terms of its scaling w.r.t. the lateral size L of the box. In case of periodizing a(x), we heuristically argue that this error is generically $$O(L^{-1})$$

O
(

L

-
1

)

. In case of a suitable periodization of $$\langle \cdot \rangle $$

⟨
·
⟩

, we rigorously show that it is $$O(L^{-d})$$

O
(

L

-
d

)

. In fact, we give a characterization of the leading-order error term for both strategies and argue that even in the isotropic case it is generically non-degenerate. We carry out the rigorous analysis in the convenient setting of ensembles $$\langle \cdot \rangle $$

⟨
·
⟩

of Gaussian type, which allow for a straightforward periodization, passing via the (integrable) covariance function. This setting has also the advantage of making the Price theorem and the Malliavin calculus available for optimal stochastic estimates of correctors. We actually need control of second-order correctors to capture the leading-order error term. This is due to inversion symmetry when applying the two-scale expansion to the Green function. As a bonus, we present a stream-lined strategy to estimate the error in a higher-order two-scale expansion of the Green function.
Applicability of an active matrix metalloproteinase-8 point-of-care test in an oral and maxillofacial surgery clinic: a pilot study
Authors: Kallio Essi , Puolakkainen Tero , Tervahartiala Taina , Snäll Johanna , Marttila Emilia , Sorsa Timo , Uittamo Johanna
Published: May 2023

Objectives

Matrix metalloproteinases are enzymes that participate in numerous inflammatory responses and have been targeted as biomarkers in numerous pathologic states. The detection of active matrix metalloproteinase-8 (aMMP-8) using a mouthrinse point-of-care test (POCT) has emerged as a diagnostic marker for periodontitis and other systemic inflammatory states. The objective of this pilot study was to assess the applicability of aMMP-8 POCT in an oral and maxillofacial surgery clinic and to evaluate the relationship between aMMP-8 levels and different patient groups.

Materials and methods

aMMP-8 POCT samples were collected from patients in an oral and maxillofacial surgery clinic during a one-month period. aMMP-8 levels were analyzed using a chairside lateral-flow immunotest and a digital reader. Clinically relevant patient variables were collected and descriptively evaluated. aMMP-8 levels over 20 ng/ml were considered to be elevated.

Results

A total of 115 patients were interviewed of which 112 agreed to the test (97.4%). Elevated aMMP-8 levels were observed in 58 (51.8%) patients. Bone loss was noted in 75 (67.0%) patients. Of these patients, aMMP-8 levels were elevated in 47 (62.7%) patients. Patients at an increased risk of infection had 35.5% higher aMMP-8 values on average compared to patients with no prior illnesses.

Conclusion

aMMP-8 POCT provides a non-invasive and reliable method for measuring aMMP-8 levels. Future studies are warranted to assess the clinical relevance between elevated aMMP-8 levels and specific patient groups.

Clinical relevance

The rapid availability of the test score allows an immediate impact on treatment planning.
Global Radiomic Features from Mammography for Predicting Difficult-To-Interpret Normal Cases
Authors: Siviengphanom Somphone , Gandomkar Ziba , Lewis Sarah J. , Brennan Patrick C.
Published: May 2023

This work aimed to investigate whether global radiomic features (GRFs) from mammograms can predict difficult-to-interpret normal cases (NCs). Assessments from 537 readers interpreting 239 normal mammograms were used to categorise cases as 120 difficult-to-interpret and 119 easy-to-interpret based on cases having the highest and lowest difficulty scores, respectively. Using lattice- and squared-based approaches, 34 handcrafted GRFs per image were extracted and normalised. Three classifiers were constructed: (i) CC and (ii) MLO using the GRFs from corresponding craniocaudal and mediolateral oblique images only, based on the random forest technique for distinguishing difficult- from easy-to-interpret NCs, and (iii) CC + MLO using the median predictive scores from both CC and MLO models. Useful GRFs for the CC and MLO models were recognised using a scree test. The CC and MLO models were trained and validated using the leave-one-out-cross-validation. The models’ performances were assessed by the AUC and compared using the DeLong test. A Kruskal–Wallis test was used to examine if the 34 GRFs differed between difficult- and easy-to-interpret NCs and if difficulty level based on the traditional breast density (BD) categories differed among 115 low-BD and 124 high-BD NCs. The CC + MLO model achieved higher performance (0.71 AUC) than the individual CC and MLO model alone (0.66 each), but statistically non-significant difference was found (all p > 0.05). Six GRFs were identified to be valuable in describing difficult-to-interpret NCs. Twenty features, when compared between difficult- and easy-to-interpret NCs, differed significantly (p < 0.05). No statistically significant difference was observed in difficulty between low- and high-BD NCs (p = 0.709). GRF mammographic analysis can predict difficult-to-interpret NCs.
A 3D Radiomics-Based Artificial Neural Network Model for Benign Versus Malignant Vertebral Compression Fracture Classification in MRI
Authors: Chiari-Correia Natália S. , Nogueira-Barbosa Marcello H. , Chiari-Correia Rodolfo Dias , Azevedo-Marques Paulo M.
Published: May 2023

To train an artificial neural network model using 3D radiomic features to differentiate benign from malignant vertebral compression fractures (VCFs) on MRI. This retrospective study analyzed sagittal T1-weighted lumbar spine MRIs from 91 patients (average age of 64.24 ± 11.75 years) diagnosed with benign or malignant VCFs from 2010 to 2019, of them 47 (51.6%) had benign VCFs and 44 (48.4%) had malignant VCFs. The lumbar fractures were three-dimensionally segmented and had their radiomic features extracted and selected with the wrapper method. The training set consisted of 100 fractured vertebral bodies from 61 patients (average age of 63.2 ± 12.5 years), and the test set was comprised of 30 fractured vertebral bodies from 30 patients (average age of 66.4 ± 9.9 years). Classification was performed with the multilayer perceptron neural network with a back-propagation algorithm. To validate the model, the tenfold cross-validation technique and an independent test set (holdout) were used. The performance of the model was evaluated using the average with a 95% confidence interval for the ROC AUC, accuracy, sensitivity, and specificity (considering the threshold = 0.5). In the internal validation test, the best model reached a ROC AUC of 0.98, an accuracy of 95% (95/100), a sensitivity of 93.5% (43/46), and specificity of 96.3% (52/54). In the validation with independent test set, the model achieved a ROC AUC of 0.97, an accuracy of 93.3% (28/30), a sensitivity of 93.3% (14/15), and a specificity of 93.3% (14/15). The model proposed in this study using radiomic features could differentiate benign from malignant vertebral compression fractures with excellent performance and is promising as an aid to radiologists in the characterization of VCFs.
Nonlinear vibrations of a composite circular plate with a rigid body
Authors: Meng Ying , Mao Xiaoye , Ding Hu , Chen Liqun
Published: May 2023

The influence of weights is usually ignored in the study of nonlinear vibrations of plates. In this paper, the effect of structure weights on the nonlinear vibration of a composite circular plate with a rigid body is presented. The nonlinear governing equations are derived from the generalized Hamilton’s principle and the von Kármán plate theory. The equilibrium configurations due to weights are determined and validated by the finite element method (FEM). A nonlinear model for the vibration around the equilibrium configuration is established. Moreover, the natural frequencies and amplitude-frequency responses of harmonically forced vibrations are calculated. The study shows that the structure weights introduce additional linear and quadratic nonlinear terms into the dynamical model. This leads to interesting phenomena. For example, considering weights increases the natural frequency. Furthermore, when the influence of weights is considered, the vibration response of the plate becomes asymmetrical.