bluuebunny/crossref_metadata_2025 huggingface dataset:
Passive Ambitions, Active Limitations: Defence AI in India
Authors: Mohan Shimona
Published: July 2024

India has been known by its ‘IT hub’ moniker for a while now and has sought to replicate this success in AI as well. However, while India has seen numerous knee-jerk developments and concentrated efforts around AI, it still has a hazy conception of how to establish a well-oiled AI ecosystem. Moreover, while civilian AI is still promoted through a whole-of-government approach, military AI is still comparatively much less prioritized despite India’s uniquely hostile neighbourhood and technologically advanced adversaries. In the last 5 years or so, India has established a few dedicated military AI bodies and unveiled several AI products for defence, either at the level of the tri-services or military R&D centrally – these include LAWS, robots, drones, radars, identification and recognition systems, translators, and monitoring and predictive systems. Despite these strides, the lack of institutionalization, incentivization, funding, upgradation and coordinated activity around military AI poses specific limitations to how efficiently India’s military AI ambitions are being realized. These restrictions are interestingly juxtaposed against India’s current focus on the indigenization of its defence technology production as it partners more vociferously with a diverse set of allies. If it intends to constructively work towards the grand ambitions it must become a military AI power, India needs to ensure that it looks at AI as the highly diversified technology it is, instead of the siloed approach it has adopted with respect to AI development, deployment and governance so far.
‘Overtaking on the Curve’? Defense AI in China
Authors: Lee John
Published: July 2024

China has a clear focus on AI’s importance to the future military balance, and a well-developed and resourced system for developing relevant technologies. Yet by the judgment of seemingly most Chinese and many foreign analysts, the People’s Liberation Army (PLA) remains far from implementing revolutionary uses of defense AI and is still grappling with institutional reforms and the demands of joint operations.

But Chinese thinkers are working through the possibilities for AI to provide both symmetric and asymmetric tools for high-end conflict. China is already applying AI for military logistics optimization, training simulation and wargaming and weapons development. AI’s utility for data processing, decision support and enhanced command and control (C2) provides a path to the information dominance prized by Chinese military theory. Beyond current frameworks for kinetic and cyber operations, Chinese theorists are exploring new applications for AI such as intelligent systems and cognitive warfare.

The Chinese Communist Party follows a materialist conception of human development and wields authority over all social institutions in China, including the PLA. Official judgments about AI’s structural importance, and of the need for China to be equipped for long-term strategic competition with the US, are thus unlikely to change. China is leveraging its dynamic civilian economy to boost defense AI development, within the larger context of a national drive for the commanding heights of AI and other emerging technologies.

Whether methods that have worked as part of an integrated global economy can still deliver results under growing “decoupling” pressures from the US remains to be seen. The US in late 2022 introduced export controls targeting China’s access to advanced semiconductors, which were expressly justified by the imperative to constrain Chinese advances in defense AI.

But China’s internal means for AI development are now sufficiently robust that analysts of military and strategic global affairs will find it imperative to watch this space, even as it becomes increasingly opaque.
Evolution Not Revolution: Defence AI in Australia
Authors: Layton Peter
Published: July 2024

Middle power Australia has an active defence Artificial Intelligence (AI) program underway with a well-defined innovation pathway and numerous experimentation projects. The Australian Defence Force sees AI mainly being used in human–machine teams to improve efficiency, increase combat power, achieve decision superiority, and lower risks to combat personnel. The major equipment acquisition plan for the next two decades sets out six AI-relevant projects: one navy, one army, three air force and one in the information and cyber domain. Associated with this investment is a high expectation that Australian AI companies will have considerable involvement in the projects. The Australian defence AI sector, though, consists mainly of small and medium-sized companies that may need to partner with large prime contractors to achieve the requisite industrial heft. There are also wider national concerns about whether Australia will have a large enough AI workforce over the next decade to handle both commercial and defence demands. Accordingly, Australia is involved with collaborative AI developments with the United States including the “loyal wingman” fast jet drone, autonomous submarines and surface vessels, and robot land vehicles. Current defence AI plans will most likely lead to evolutionary improvements not revolutionary changes. AI is envisaged as being used to either enhance, augment, or replace existing capability. This approach means the future ADF will do things better, but it won’t necessarily be able to do better things.
Bright Prospects, Big Challenges: Defence AI in the United Kingdom
Authors: Payne Kenneth
Published: July 2024

The UK is strategically positioned to capitalize on advancements in AI, especially in the realm of national security. It has taken significant steps in this direction by formulating an AI strategy for defence and national security, engaging in collaborative efforts across government, industry, and academia. The British military is actively experimenting with autonomous platforms and exploring new doctrines for their effective utilization, including aerial drone swarms, pilotless “loyal wingmen,” unmanned submersibles, and tactical ground robots. Partnerships with industry and academia are being strengthened, and autonomous systems are already being employed in data processing and intelligence analysis. However, several challenges lie ahead, including uncertainty regarding AI’s future development and concerns about its ethical implications and performance, particularly in the face of adversarial countermeasures and potential biases. Britain’s aspiration to maintain full spectrum military and intelligence capabilities on a global scale while undergoing significant technological transformation presents formidable challenges, especially given the need to balance these ambitions with a large and growing defence budget. Economic and political uncertainties, including those stemming from Brexit and low productivity, further complicate the situation. These challenges extend beyond immediate defence budgeting, impacting the country’s research base, attractiveness to investment, and ability to attract high-skilled migration. Despite these obstacles, the UK remains committed to advancing its defence capabilities and leveraging AI to address evolving security threats.
Cautious Data-Driven Evolution: Defence AI in Finland
Authors: Järvinen Sami O.
Published: July 2024

Finland has ambitious civilian AI goals and a highly ranked research and education system, but defence AI policies are somewhat less ambitious. Defence AI was first piloted for support functions, followed by applications in military capabilities now emerging in various R&D projects. The Finnish Defence Forces (FDF) lists AI as a priority research area with use cases identified in virtually all areas of defence. AI’s disruptive impact is already visible on the battlefield in autonomous systems, and a further revolution may emerge through dynamic electromagnetic spectrum management. Transceivers combining communications with electronic warfare capabilities could simultaneously provide situational awareness and achieve blue force communications inoffensively to civilian frequencies all the while intercepting enemy communications. Such AI applications could enable new concepts of fighting, but this would require the FDF’s organizational culture to become more conducive to experimentation. The FDF recognizes data availability and management as key for AI development, in particular machine learning. FDF’s new holistic Data Concept aims at more flexible data utilization, but legal and organizational barriers pose several challenges. Apart from a few innovative projects, Finland’s defence AI seems to be somewhat lagging behind the ambitious national AI policies of others, with a cautious and very gradual approach. Publicly available information paints a picture of AI being procured in military-off-the-shelf systems, even if FDF’s R&D portfolio hints at the possibility of various original applications. Finland’s NATO membership, its F-35 acquisition and corresponding industrial R&D cooperation with the U.S. may significantly boost AI development.
On the Social and Material Lives of Health Concepts in the Wild
Authors: Yaron Gili
Published: July 2024

In the last decade, Positive Health has taken the Netherlands by storm, having been widely adopted in Dutch healthcare and the public sector at large. But does this new concept deliver on its promises? In their chapter on Positive Health, Van der Linden and Schermer tackle this question by approaching it as a conceptual engineering project. Positive Health, they conclude, ultimately falls short in achieving its aims. But given this disappointing verdict, how can the new health concept’s success be explained? In this short reflection, I draw on my ethnographic fieldwork into Positive Health and key works in Science and Technology Studies to gain insight in the concept’s eager uptake. As I demonstrate, following Positive Health ‘in the wild’ affords a deeper understanding of its social and material life. This not only helps explain the concept’s widespread adoption, but also opens up new vistas for conceptual engineering as a scholarly approach.
Does gravitational wave assist vacuum steering and Bell nonlocality?
Authors: Wu Shu-Min , Wang Rui-Di , Huang Xiao-Li , Wang Zejun
Published: July 2024

Abstract

We study quantum steering and Bell nonlocality harvested by the local interaction of two Unruh-DeWitt detectors with the vacuum massless scalar field, both in the presence of gravitational waves and in Minkowski spacetime. It is shown that quantum steerability under the influence of gravitational waves can be greater than or less than quantum steerability in Minkowski spacetime, which means that the gravitational waves can amplify or degrade the harvested steering. In particular, a resonance effect occurs when the energy gap of the detector is tuned to the frequency of the gravitational wave. We also find that the harvesting-achievable separation range of vacuum steering can be expanded or reduced by the presence of gravitational waves, which depends on the energy gap, the gravitational wave frequency, and the duration of the gravitational wave action. It is interesting to note that two detector systems that satisfy the Bell inequality in most parameter spaces, regardless of the existence of gravitational waves, indicating that steering harvesting cannot be considered to be nonlocal.
Cryopreservation of human kidney organoids
Authors: Mashouf Parham , Tabibzadeh Nahid , Kuraoka Shohei , Oishi Haruka , Morizane Ryuji
Published: July 2024

Recent advances in stem cell research have led to the creation of organoids, miniature replicas of human organs, offering innovative avenues for studying diseases. Kidney organoids, with their ability to replicate complex renal structures, provide a novel platform for investigating kidney diseases and assessing drug efficacy, albeit hindered by labor-intensive generation and batch variations, highlighting the need for tailored cryopreservation methods to enable widespread utilization. Here, we evaluated cryopreservation strategies for kidney organoids by contrasting slow-freezing and vitrification methods. 118 kidney organoids were categorized into five conditions. Control organoids followed standard culture, while two slow-freezing groups used 10% DMSO (SF1) or commercial freezing media (SF2). Vitrification involved V1 (20% DMSO, 20% Ethylene Glycol with sucrose) and V2 (15% DMSO, 15% Ethylene Glycol). Assessment of viability, functionality, and structural integrity post-thawing revealed notable differences. Vitrification, particularly V1, exhibited superior viability (91% for V1, 26% for V2, 79% for SF1, and 83% for SF2 compared to 99.4% in controls). 3D imaging highlighted distinct nephron segments among groups, emphasizing V1’s efficacy in preserving both podocytes and tubules in kidney organoids. Cisplatin-induced injury revealed a significant reduction in regenerative capacities in organoids cryopreserved by flow-freezing methods, while the V1 method did not show statistical significance compared to the unfrozen controls. This study underscores vitrification, especially with high concentrations of cryoprotectants, as an effective approach for maintaining kidney organoid viability and structure during cryopreservation, offering practical approaches for kidney organoid research.
How to chew gum: the post-ingestion fate of foliar secondary compounds consumed by a eucalypt herbivore
Authors: De Souza Natalia M. , Hayes R. Andrew , Brooks Peter R. , Nahrung Helen F.
Published: July 2024

Herbivorous insects require mechanisms to deal with defence compounds produced by their host plants. Despite an array of secondary compounds associated with defence, eucalypts are hosts to many insect species that readily obtain nutrients also produced by these plants. Gonipterus weevils are foliage-feeding eucalypt specialists as larvae and adults, with a notable characteristic of protecting their eggs with a hardened frass-like substance. The aim of this study was to assess plant, weevil frass and egg capsule chemistry to determine how the weevil eliminates plant secondary metabolites. We hypothesised that noxious compounds would be metabolised prior to elimination and that egg capsules would be composed of frass and additional substances. Weevils were fed on Eucalyptus globulus plants for seven days, with their frass and egg capsules collected daily, and the damaged, first, fully-expanded leaves of the host collected at the end of the assay. Compounds present in each sample were extracted in hexane and analysed by gas chromatography-mass spectrometry. The most abundant compounds in each sample were waxes and terpenoids, and metabolism of 1,8-cineole was evident, with two metabolites that may have semiochemical activity. Comparative analysis revealed significant differences between all samples, with shared compounds varying in relative proportions and exclusive compounds in sample type. These findings contribute to the understanding of Gonipterus physiology and highlight the differences between frass and the cover of egg capsules.
Study on the surface layer properties of magnesium alloys after impulse shot peening
Authors: Agnieszka Skoczylas , Kazimierz Zaleski , Krzysztof Ciecieląg , Jakub Matuszak
Published: July 2024

Shot peening is a commonly used method of finishing machine elements in the manufacturing process. One variation of shot peening is the impulse shot peening. This paper presents the influence of impulse shot peening technological conditions on the surface roughness (parameters Ra and Rt), topography, and microhardness. The FEM was used to determine the S11 stresses. In the experiment and simulation tests, AZ31 and AZ91HP magnesium alloy samples were used. Variable parameters in the impulse shot peening process were impact energy E (15–185 mJ), ball diameter d (3–15 mm), and impact density j (3–44 mm−2). As a result of the tests carried out, it was found that after impulse shot peening, the surface topography is change, microirregularities are flattened, and numerous depressions are formed, which can be potential lubrication pockets. The 2D surface roughness parameters for most impulse shot peening conditions are lower than for the pre-machining. The roughness parameters for magnesium alloy AZ91HP are lower than for AZ31. This is most likely due to the lower elongation A. The microhardness after impulse shot peening increased by 20 to 87 HV. As a result of FEM of the impulse shot peening, compressive stresses S11 were created in the surface layer. The depth of occurrence of S11 stresses is from 1.5 to 3.5 mm, and their values for the AZ91HP magnesium alloy samples are 10 to 25% lower than for the AZ31 alloy samples. The most favorable results of the tested properties of the surface layer were obtained for E = 100 mJ, d = 10 mm, and j = 11 mm−2. The abstract serves both as a general introduction to the topic and as a brief, non-technical summary of the main results and their implications.
Fracture liaison service—a multidisciplinary approach to osteoporosis management
Authors: Le Hai V. , Van Benjamin W. , Shahzad Hania , Teng Polly , Punatar Nisha , Agrawal Garima , Wise Bart
Published: July 2024

A fracture liaison service is a systems-level multidisciplinary approach designed to reduce subsequent fracture risk in patients who recently sustained fragility fractures. It is estimated that one in three women and one in five men over the age of 50 years old have osteoporosis. Nonetheless, only 9 to 20% of patients who sustain an initial fragility fracture eventually receive any osteoporosis treatment. With the aim of preventing subsequent fractures, a fracture liaison service (FLS) works through identifying patients presenting with fragility fractures to the hospital and providing them with easier access to osteoporosis care through referrals for bone health and fracture risk assessment and recommendation or initiation of osteoporosis treatment. Currently, there are four major types of FLS models ranging from services that only identify at-risk patients and inform and educate the patient but take no further part in communicating their findings to other stakeholders in patients’ care, to services that identify, investigate, and initiate treatment at the other end of the spectrum. In this article, we review the benefits, challenges, and outcomes of FLS in the American healthcare system with further exploration of the roles each member of the multidisciplinary team can play in improving patients’ bone health.
Antioxidant activity and phenolic content of bee breads from different regions of Türkiye by chemometric analysis (PCA and HCA)
Authors: Can Zehra , Gıdık Betül , Kara Yakup , Kolaylı Sevgi
Published: July 2024

The objective of this study was to assess the antioxidant activity and phenolic compounds of bee bread samples obtained from various regions in Türkiye The goal was to characterize and classify 15 of bee bread samples based on their geographical origins. This investigation employed chemometric techniques, specifically principal component analysis (PCA) and a hierarchical clustering algorithm (HCA), for the inaugural comprehensive analysis of all data encompassing antioxidant activity and phenolic compounds in bee bread. The primary objective was to unveil potential clustering patterns among of bee bread samples based on their geographical origins. According to the results, the Total Phenolic Content (TPC) of bee bread samples ranged from 4.393 to 14.917 mg GAE/g dw, while the Total Flavonoid Content (TFC) exhibited variation within the range of 0.681 to 3.504 mg QE/g dw. p-OH benzoic and p-coumaric acids were detected in all samples. Other phenolic compounds were identified in different proportions among the bee bread samples. This study demonstrated the successful application of the PCA chemometric method to assess the antioxidant activity and phenolic compounds of bee bread samples from various regions of Türkiye. The results revealed effective clustering of the bee bread samples based on their geographical origins.

Graphical Abstract
Association of aortic diameters and mortality in the general population—an MRI-based study
Authors: Mensel Birger , Mahnken Andreas H. , Kaiser Erhard , Völzke Henry , Dörr Marcus , Felix Stephan B. , Ittermann Till , Lieb Wolfgang , Lorbeer Roberto
Published: July 2024

Background

Increased diameters of the aorta are associated with increased mortality risk. In the present analyses, we assessed whether aortic diameters are associated with cardiovascular and all-cause mortality in community-dwelling individuals free of known cardiovascular disease (CVD).

Methods

MRI-derived vascular parameters of the thoracic and abdominal aorta from 2668 participants (median age = 53 years; 51.1% women) of the population-based SHIP-START-2 and SHIP-TREND-0 cohorts without CVD were analyzed. Age- and sex-adjusted, as well as multivariable-adjusted Cox-proportional hazard models, were used to estimate associations of diameters of six different aortic segments to mortality.

Results

Over a median follow-up time of 10.6 years (IQR: 8.7; 12.4), a total of 188 participants (126 men and 62 women) died, of which 38 deaths were due to CVD. In unadjusted models, mortality rates were higher in participants with aortic diameters above the median compared to below the median for all investigated aortic sections (all log-rank p < 0.001). In multivariable-adjusted models, the diameters of the ascending thoracic aorta (HR = 1.34 95% CI: 1.04; 1.72, p = 0.022) and of the infrarenal aorta (HR = 3.75 95% CI: 1.06; 13.3, p = 0.040), modeled continuously, were associated with greater cardiovascular mortality. The diameter of the subphrenic aorta was associated with higher cardiovascular mortality only in the age and sex-adjusted model (HR = 3.65 95% CI: 1.01; 13.3, p = 0.049). None of the investigated aortic segments were associated with all-cause mortality.

Conclusion

Non-indexed diameters of the ascending thoracic and infrarenal aorta were associated with higher cardiovascular mortality but not with all-cause mortality in a population sample free of clinically overt CVD at baseline.

Clinical relevance statement

Increased aortic diameter is associated with cardiovascular mortality and can help to identify high-risk patients.

Key Points

Increased aortic diameter is associated with mortality.

Non-indexed diameters of the ascending and infrarenal aorta are associated with cardiovascular mortality but not all-cause mortality.

Aortic diameter measurements support the estimate of cardiovascular mortality.
Aerodynamic characteristics of the retro propulsion landing burn of vertically landing launchers
Authors: Marwege Ansgar , Gülhan Ali
Published: July 2024

In the frame of the European funded H2020 project RETALT (retro propulsion-assisted landing technologies), the unsteady aerodynamics of vertically descending and landing launchers have been investigated. In this paper, experimental data of the landing burn tested in the Vertical Free-Jet Facility Cologne at DLR in Cologne are presented. The landing burn was simulated with a cold gas jet of pressurized air opposing the wind tunnel free stream. Tests with several jet conditions were compared to results without active jet. Proper orthogonal decomposition of schlieren recordings and spectral analyses of their time histories are performed and are compared to frequencies in pressure measurements. Dominant frequencies were found, which are strongest at Mach 0.8. Especially, a Strouhal number of 0.2 was found to be most dominant. The intensity of the dominant frequencies can be lowered if the engine is active. The normalized root mean square pressure fluctuations are between 0.1 and 0.3 during the landing maneuver. Additionally, the steady flow features scale well with the ambient pressure ratio and the momentum flux ratio. The unsteady flow field dynamics of the subsonic retro propulsion flow field can likely be linked to large-scale turbulent structures in the supersonic jet, triggering large-scale pressure fluctuations and altering the overall flow field.
Adherence to a Mediterranean-style diet and severity of menopausal symptoms in perimenopausal and menopausal women from Australia: a cross-sectional analysis
Authors: Byrne-Kirk Maitilde , Mantzioris Evangeline , Scannell Nicole , Villani Anthony
Published: July 2024

Purpose

To explore the independent associations between adherence to a Mediterranean-style diet and severity of menopausal symptoms in perimenopausal and menopausal women living in Australia.

Methods

Dietary adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS), the Menopause Rating Scale (MRS) was used to assess the severity of menopausal symptoms, and the 36-item short form survey instrument (SF-36) was used to assess health-related quality of life (HRQoL).

Results

A total of n = 207 participants (50.7 ± 4.3 years; BMI: 28.0 ± 7.4 kg/m2) were included in the final analyses. Participants reported low-moderate adherence to a Mediterranean-style diet (5.2 ± 1.8; range: 1–11). Adherence was not associated with severity of menopausal symptoms. However, low consumption of sugar-sweetened beverages was inversely associated with joint and muscle complaints, independent of all covariates (β = -0.149; CI: -0.118, -0.022; P = 0.042). Adherence to a Mediterranean-style diet was positively associated with the physical function subscale of HRQoL (β = 0.173, CI: 0.001, 0.029; P = 0.031) and a low intake of red and processed meat was positively associated with the general health subscale (β = 0.296, CI: 0.005, 0.014; P = < 0.001).

Conclusion

Diet quality may be related to severity of menopausal symptoms and HRQoL in perimenopausal and menopausal women. However, exploration of these findings using longitudinal analyses and robust clinical trials are needed to better elucidate these findings.
Glottic insufficiency caused by vocal fold atrophy with or without sulcus: systematic review of outcome measurements
Authors: van den Broek Emke M. J. M. , Mes Stephanie D. , Heijnen Bas J. , Langeveld Antonius P. M. , van Benthem Peter Paul G. , Sjögren Elisabeth V.
Published: July 2024

Purpose

Identifying outcome measurements instruments (OMIs) to evaluate treatment efficacy in patients with vocal fold atrophy and/or sulcus.

Methods

Systematic review of records published before March 2021 by searching Pubmed and EMBASE. Included studies reported on adults (> 18 year) with dysphonia caused by glottic insufficiency due to vocal fold atrophy with or without sulcus, who were enrolled into a randomized controlled trial, a non-randomized controlled trial, a case-controlled study or a cohort study. All included studies described an intervention with at least one outcome measurement.

Results

A total of 5456 studies were identified. After removing duplicates, screening title and abstract and full text screening of selected records, 34 publications were included in final analysis. From these 50 separate OMIs were recorded and categorized according to the ELS protocol by DeJonckere et al. (Eur Arch Otorhinolaryngol 258: 77–82, 2001). With most OMIs being used in multiple studies the total number of OMIs reported was 265. Nineteen (19) individual OMIs accounted for 80% of reports. The most frequently used OMIs according to category were: VHI and VHI-10 (subjective evaluation); G of GRBAS (perceptual evaluation); F0, Jitter and Shimmer (acoustic evaluation); MPT and MFR (aerodynamic evaluation) and glottic closure and mucosal wave (endoscopic evaluation). Of these OMIs VHI had a high percentage of significance of 90%.

Conclusion

This systematic review identifies the most used OMIs in patients with glottic incompetency due to vocal fold atrophy and/or sulcus as a step toward defining a Core Outcome Set (COS) for this population.

PROSPERO registration

238274.
Endoscopic vacuum therapy (eVAC) combined with continuous perianastomotic irrigation for prevention of anastomotic leak after surgical ampullectomy
Authors: Meier Olga , Ferrari Carlo , Ehrsam Jonas Peter , Porreca Annamaria , Seewald Stefan , Groth Stefan , Gutzwiller Jean-Pierre , Schmidt Jan
Published: July 2024

Purpose

Transduodenal surgical ampullectomy (tAMP) with papillary reimplantation is a valid alternative to pancreaticoduodenectomy for lesions of the periampullary region not amenable to endoscopic resection. As tAMP is burdened by high rates of biliopancreatic-enteric anastomotic leak, we tested preventive endoluminal vacuum therapy (eVAC) combined with post-operative continuous perianastomotic irrigation (CPI) to reduce such anastomotic leak.

Methods

Between 10/2013 and 09/2023, 37 patients undergoing laparotomic tAMP (with or without jejunal transposition) and papillary reimplantation at Hirslanden Klinik Zurich were retrospectively analysed; of these, 16 received prophylactic eVAC combined with CPI, while the remaining represented the historical cohort.

Results

The eVAC-CPI-group and the historical-cohort were homogeneous in demographic characteristics. Surgery in the prophylactic eVAC-CPI-group lasted about 30 min longer due to eVAC application (p = 0.008). The biliopancreatico-enteric anastomotic leak rates were 6.2% in the eVAC-CIP-group vs. 19.0% in the historical-cohort (p = 0.266). Along, a strong trend of less severe post-operative complications in general (p = 0.073), and borderline-significantly less cases of acute pancreatitis (p = 0.057) and tAMP-related re-operations or re-interventions (p = 0.057) in particular, were observed in the eVAC-CPI-group. The only anastomotic leak in the eVAC-CPI-group was successfully managed through repeated cycles of eVAC. The device was well tolerated by all patients; no vacuum/irrigation-related complications or malfunctioning occurred.

Conclusion

Our study is the first to provide some technical insights demonstrating the safety and feasibility of a prophylactic approach with eVAC and perianastomotic irrigation to reduce anastomotic leak after tAMP. Increasing the number of subjects will confirm the benefit of our promising results.
Giant cell carcinoma of the urinary bladder
Authors: Portugal-Gaspar Frederico , Lopez-Beltran Antonio , Paner Gladell P. , Blanca Ana , Gómez Enrique Gómez , Montironi Rodolfo , Cimadamore Alessia , Bilé Andreia , Volavšek Metka , Cheng Liang
Published: July 2024

We present the clinicopathological features of 23 cases of the giant cell subtype of urothelial carcinoma, a rare subtype of bladder cancer recognized in the current World Health Organization classification of urological tumors. Histologically, the architectural pattern of the tumor varied from infiltrating to the solid expansile pleomorphic tumor with giant, bizarre, anaplastic cells. Typical or atypical mitotic figures were frequently present in all cases. Between 10 and 30% of the tumor had a giant cell component. All cases were associated with conventional high-grade urothelial carcinoma, with areas of squamous cell divergent differentiation and micropapillary carcinoma present in six and two cases, respectively. In one case each had sarcomatoid, nested, small cell, or glandular divergent differentiation. At diagnosis, 35% of patients had advanced disease and 12% had distant metastases. When comparing giant cell urothelial carcinoma with conventional urothelial carcinoma in a matched analysis, differences in overall and cancer-specific survival were observed, particularly in the T1 stage category. Immunohistochemical staining showed a similar profile of urothelial lineage with frequent positive expression of uroplakin II, GATA3, CK20, CK7, and S100P in both giant cell and conventional urothelial carcinomas. High Ki67 proliferation (range, 60–90%; mean, 71%) and nuclear p53 accumulation (mutant profile; range, 50–90%; mean, 64%) were observed. Using the 22C3 assay, the expression of PD-L1 was found to be variable in two cases, and beta-HCG was negative. In conclusion, giant cell carcinoma is a subtype of urothelial carcinoma associated with advanced clinical stage and a trend to lower survival rates.
Trans‑anal minimally invasive surgery (TAMIS) versus rigid platforms for local excision of early rectal cancer: a systematic review and meta-analysis of the literature
Authors: Garoufalia Zoe , Rogers Peter , Meknarit Sarinya , Mavrantonis Sofoklis , Aeschbacher Pauline , Ray-Offor Emeka , Emile Sameh Hany , Gefen Rachel , Dourado Justin , Horesh Nir , Wexner Steven D.
Published: July 2024

Background

Available platforms for local excision (LE) of early rectal cancer are rigid or flexible [trans‑anal minimally invasive surgery (TAMIS)]. We systematically searched the literature to compare outcomes between platforms.

Methods

PRISMA-compliant search of PubMed and Scopus databases until September 2022 was undertaken in this random-effect meta-analysis. Statistical heterogeneity was assessed using I2 statistic. Studies comparing TAMIS versus rigid platforms for LE for early rectal cancer were included. Main outcome measures were intraoperative and short-term postoperative outcomes and specimen quality.

Results

7 studies were published between 2015 and 2022, including 931 patients (423 females); 402 underwent TAMIS and 529 underwent LE with rigid platforms. Techniques were similar for operative time (WMD 11.1, 95%CI − 2.6 to 25, p = 0.11), percentage of defect closure (OR 0.7, 95%CI 0.06–8.22, p = 0.78), and peritoneal violation (OR 0.41, 95%CI 0.12–1.43, p = 0.16). Rigid platforms had higher rates of short-term complications (19.1% vs 14.2, OR 1.6, 95%CI 1.07–2.4, p = 0.02), although no significant differences were seen for major complications (OR 1.41, 95%CI 0.61–3.23, p = 0.41). Patients in the rigid platforms group were 3-times more likely to be re-admitted within 30 days compared to the TAMIS group (OR 3.1, 95%CI 1.07–9.4, p = 0.03). Rates of positive resection margins (rigid platforms: 7.6% vs TAMIS: 9.34%, OR 0.81, 95%CI 0.42–1.55, p = 0.53) and specimen fragmentation (rigid platforms: 3.3% vs TAMIS: 4.4%, OR 0.74, 95%CI 0.33–1.64, p = 0.46) were similar between the groups. Salvage surgery was required in 5.5% of rigid platform patients and 6.2% of TAMIS patients (OR 0.8, 95%CI 0.4–1.8, p = 0.7).

Conclusion

TAMIS or rigid platforms for LE seem to have similar operative outcomes and specimen quality. The TAMIS group demonstrated lower readmission and overall complication rates but did not significantly differ for major complications. The choice of platform should be based on availability, cost, and surgeon’s preference.
Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies – results from the EurAKId registry
Authors: Deja Anna , Guzzo Isabella , Cappoli Andrea , Labbadia Raffaella , Bayazit Aysun Karabay , Yildizdas Dincer , Schmitt Claus Peter , Tkaczyk Marcin , Cvetkovic Mirjana , Kostic Mirjana , Hayes Wesley , Shroff Rukshana , Jankauskiene Augustina , Virsilas Ernestas , Longo Germana , Vidal Enrico , Mir Sevgi , Bulut Ipek Kaplan , Pasini Andrea , Paglialonga Fabio , Montini Giovanni , Yilmaz Ebru , Correia Costa Liane , Teixeira Ana , Schaefer Franz ,   for the ESCAPE Network
Published: July 2024

Background

Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children.

Methods

The study involved children included in the EurAKId registry (NCT 02960867), who underwent CKRT treatment. We analysed patient characteristics and CKRT parameters. The primary end point was mean circuit lifetime (MCL). Secondary end points were number of elective circuit changes and occurrence of dialysis-related complications.

Results

The analysis was composed of 247 children who underwent 37,562 h of CKRT (median 78, IQR 37–165 h per patient). A total of 1357 circuits were utilised (3, IQR 2–6 per patient). MCL was longer in regional citrate anticoagulation (RCA), compared to heparin (HA) and no anticoagulation (NA) (42, IQR 32-58 h; 24, IQR 14-34 h; 18, IQR 12-24 h, respectively, p < 0.001). RCA was associated with longer MCL regardless of the patient’s age or dialyser surface. In multivariate analysis, MCL correlated with dialyser surface area (beta = 0.14, p = 0.016), left internal jugular vein vascular access site (beta = -0.37, p = 0.027), and the use of HA (beta = -0.14, p = 0.038) or NA (beta = -0.37, p < 0.001) vs. RCA. RCA was associated with the highest ratio of elective circuit changes and the lowest incidence of complications.

Conclusion

Anticoagulation modality, dialyser surface, and vascular access site influence MCL. RCA should be considered when choosing first-line anticoagulation for CKRT in children. Further efforts should focus on developing guidelines and clinical practice recommendations for paediatric CKRT.

Graphical abstract
Volatile organic compounds and cancer risk assessment in an intensive care unit
Authors: Lakestani Sanaz
Published: July 2024

Changes caused by air-cleaning devices in the amounts of volatile organic compounds in an intensive care unit were monitored in the study. The cancer risk and hazard index were calculated. The measurements were made for one month at isolated room and two different points and times in the intensive care unit. According to the sampling program, the air-cleaning devices were turned off in weeks 1 and 4 and turned on in weeks 2 and 3. Volatile organic compounds were collected by active sampling. Samples were analyzed by a thermal desorber coupled to a gas chromatography-mass spectrometry instrument with selective ion monitoring. The results showed that the concentrations of benzene, toluene, and o-xylene decreased by about 70% after the air-cleaning devices were installed. The cancer risk assessment for naphthalene was recorded at the highest level of cancer risk (Class A). The hazard index value of naphthalene was recorded at the harmful level when air-cleaning devices were not installed. The concentrations of benzene (p = 0.01), toluene (p = 0.02), ethylbenzene (p = 0.02), styrene (p = 0.01), and m, p-xylene (p = 0.04) before the air-cleaning devices were installed were significantly different from those recorded when the air-cleaning devices were turned on.
Marmorgewinnung und Schmiedetätigkeit im Frühmittelalter – Ein erster Hinweis im Steinbruchrevier Spitzelofen in Kärnten/Österreich
Authors: Karl Stephan , Modl Daniel , Strobl Susanne , Haubner Roland
Published: July 2024

Im römerzeitlichen Marmorsteinbruchrevier Spitzelofen in Kärnten wurde bei archäologischen Ausgrabungen auch Hammerschlag gefunden, der aus einer frühmittelalterlichen Brandschicht stammt. Radiokarbondatierungen dieser Schicht weisen den Befund in das 8. bzw. 9. Jahrhundert n. Chr. Im Zuge der metallurgischen Untersuchung wurde plättchenförmiger Hammerschlag festgestellt. Die Dicke der Plättchen variiert zwischen etwa 30 und 100 µm. Es kann davon ausgegangen werden, dass diese Plättchen durch Verzunderung während des Schmiedevorgangs entstanden. Weiters wurde kugelförmiger Hammerschlag beobachtet, bei dem es sich um ein Gemisch aus geschmolzenem Eisen und Schlacke handelt, das beim Hochtemperaturschmieden (> 1200 °C) vom Werkstück wegspritzt. Diese Teilchen haben einen Durchmesser von etwa 250 µm. Der archäologische Kontext, der Hammerschlag und die Radiokarbondatierungen belegen eine mit der Marmorgewinnung zusammenhängende Schmiedetätigkeit im 8. und 9. Jahrhundert n. Chr. In einer einfachen Feldschmiede wurden die durch die Benutzung stumpf gewordenen Steinbruchwerkzeuge nachgeschärft. Dieser somit indirekt gewonnene Nachweis einer frühmittelalterlichen Steingewinnung am Spitzelofen deckt sich zeitlich mit der Marmorverwendung für die frühmittelalterlichen Flechtwerksteine in Karantanien (772 bis 817/828 n. Chr.).
Ab initio MO study on direct production of H2O, N2O and CO3 from the respective CH2OO “Bee-sting-like” attack at H2, N2 and CO2
Authors: Trac Hue-Phuong , Lin Ming-Chang
Published: July 2024

Context

We have computationally elucidated the mechanism for formation of H2O, N2O and CO3 from the reactions of CH2OO with H2, N2 and CO2, respectively, by the direct attack of the terminal O atom of CH2OO. This unique mechanism, which is characteristically “bee-sting-like” in nature, was found to be closely parallel to their reactions with the O(1D) atom. Reactions with H2 and CO2 take place by side-on attack, while the N2 reaction occurs by end-on attack with predicted barriers, 19.4, 13.1 and 25.3 kcal.mol−1, respectively. The CO2 reaction with CH2OO was found to occur by producing the C2v CO3, O = C < (O)O, instead of its D3h conformer, essentially similar to the O(1D) + CO2 reaction. The rate constants for the three reactions have been computed by the transition state theory (TST) based on the predicted potential energy profiles. We have also utilized the isodesmic nature of the dative bond exchange in the N2 reaction, CH2O → O + N2 = CH2O + N2 → O, to estimate the heat of the formation of CH2OO. Based on the heat of reaction computed at the highest level of theory employed, we obtained ΔfHo0 (CH2OO) = 27.5 kcal.mol−1; the value agrees with the recent results within ± 1 kcal.mol−1.

Methods

All calculations were performed using Gaussian 16 software. Geometry, frequency, and IRC analysis calculations were conducted at the M06-2X/aug-cc-pVTZ level of theory. The heats of reaction have been evaluated at the highest level, CCSD(T)/CBS(T,Q,5)//M06-2x/aug-cc-pvTz.
Towards overcoming barriers to the clinical deployment of mixed reality image-guided navigation systems supporting percutaneous ablation of liver focal lesions
Authors: Spinczyk Dominik , Rosiak Grzegorz , Milczarek Krzysztof , Konecki Dariusz , Żyłkowski Jarosław , Franke Jakub , Pech Maciej , Rohmer Karl , Zaczkowski Karol , Wolińska-Sołtys Ania , Sperka Piotr , Hajda Dawid , Piętka Ewa
Published: July 2024

In recent years, we have observed a rise in the popularity of minimally invasive procedures for treating liver tumours, with percutaneous thermoablation being one of them, conducted using image-guided navigation systems with mixed reality technology. However, the application of this method requires adequate training in using the employed system. In our study, we assessed which skills pose the greatest challenges in performing such procedures. The article proposes a training module characterized by an innovative approach: the possibility of practicing the diagnosis, planning, execution stages and the physical possibility of performing the execution stage on the radiological phantom of the abdominal cavity. The proposed approach was evaluated by designing a set of 4 exercises corresponding to the 3 phases mentioned. To the research group included 10 radiologists and 5 residents in the study. Based on 20 clinical cases of liver tumors subjected to percutaneous thermoablation, we developed assessment tasks evaluating four skill categories: head-mounted display (HMD), ultrasound (US)/computed tomography (CT) image fusion interpretation, tracking system use, and the ability to insert a needle. The results were presented using the Likert scale. The results of our study indicate that the most challenging aspect for radiology specialists is adapting to HMD gesture control, while residents point to intraoperative images of fusion and respiratory movements in the liver as the most problematic. In terms of improving the ability to perform procedures on new patients, the module also allows you to create a new hologram for a different clinical case.
Environmental impact of the variations in solar reflectance index values of some selected dimension stones due to cyclic thermal shock
Authors: Altindag Rasit , Ugur Ibrahim , Sengun Nazmi , Coskun Ahmet , Demirdag Servet
Published: July 2024

Natural stones are widely used environmentally appropriate building materials as dimension stone both for exterior cladding and floor coverings in urban areas. Depending on their solar reflectivity, these materials may absorb more solar radiation, especially with noontime summer sunlight exposure, which may cause both increasing cooling costs in commercial buildings and overheating of a city with the formation of urban heat islands. Solar reflectance index (SRI) is defined as the ability of a surface to reject solar heat which tends to change with physical, chemical and biological degradation processes by varying solar reflectance (SR) and thermal emissivity (TE) values. Weakening of the stone matrix structure by physical degradation mechanism, such as thermal shock (T-S) cycles mostly have significant impact on SRI. Within the scope of this study, SRI values were calculated before and after cyclic T-S by measuring the optical properties such as SR and TE values of 30 selected sedimentary and metamorphic originated carbonate-based natural stone types. The changes in surface properties such as color, roughness, and gloss, that may have an impact on the SRI values were also analyzed. In addition, a multivariate regression analysis was established to predict SRI value from such properties with a high degree of accuracy. Finally, it was found that, initial SRI values of 9 natural stone types (mostly metamorphic originated) have been increased considerably by cyclic T-S and tend to increase their ability to reduce urban temperatures by higher SRI values, one of the most important selection criteria in energy consumption for natural stones.
Levodopa-responsive dystonia, parkinsonism, and treatment-resistant schizoaffective disorder in Williams syndrome
Authors: Reyes Nikolai Gil D. , Bendahan Nathaniel , Swinkin Emily , Lang Anthony E. , Bassett Anne S.
Published: July 2024

Background

Williams syndrome (WS; chromosome 7q11.23 deletion) is a rare, multisystemic, neurodevelopmental disorder with variable penetrance and expressivity. Although movement and psychiatric disorders are known to occur in individuals with WS, parkinsonism, dystonia, and treatment-resistant schizoaffective disorder have not been formally described.

Methods

We present two unrelated cases of adults with molecularly confirmed WS and typical histories of developmental delays, intellectual/learning disabilities, and treatment-responsive anxiety/mood disorder who developed similar noteworthy neuropsychiatric expressions. We reviewed detailed neuropsychiatric histories, laboratory investigations, neuroimaging, and treatment responses and compared data for the two cases.

Results

Both individuals developed treatment-resistant schizoaffective disorder in adulthood requiring multiple trials of antipsychotic treatments. While on clozapine, both patients developed parkinsonism and generalized dystonia with truncal involvement that responded to trials of low-dose levodopa without exacerbating underlying psychotic or affective symptoms.

Conclusion

This report illustrates the novel occurrence of levodopa-responsive movement disorders and treatment-resistant schizoaffective disorder in individuals with WS, adding to the expanding neuropsychiatric phenotypes, and highlighting potential shared underlying mechanisms. The observed treatment response suggests that levodopa, in relatively low doses, may be safe and useful in ameliorating presumed antipsychotic-associated parkinsonism and tardive dystonia in WS.