bluuebunny/crossref_metadata_2025 huggingface dataset:
Index and Sustainability Status of Agricultural Mechanization for Paddy Field in Indonesia
Authors: Putri Renny Eka , Hermansyah Agus , Santosa
Published: January 2024

The use of agricultural machinery is one of the important factors in increasing agricultural production. A quantitative assessment of the agricultural mechanization index and its impact on agricultural production is needed in planning the development of agricultural mechanization nationally. This study aims to determine the value of the agricultural mechanization index which consists of the degree, level, and capacity of agricultural mechanization for tools and agricultural machinery for pre-harvest rice (2-wheel tractor, 4-wheel tractor, water pump, and rice transplanter). This research was conducted in several stages, namely collecting data, observing the working capacity of 3 units of machinery for each type of machinery, processing data and making agricultural mechanization index maps. Based on the results of the study, it was found that the average value of the degree of agricultural mechanization for 2-wheel tractors, 4-wheel tractors, water pumps and rice transplanters was 56.68%, 55.13%, 10.55 % and 13.94%. The average value of mechanization level in Indonesia is 0.45 hp/ha and the average value of mechanization capacity for rice pre-harvest activities in Indonesia is 1.28 kW hour/ha. In addition, based on the results of the classification of mechanization level, cropping index and rice productivity, it can be seen that the provinces of East Java, Central Java, West Java, Banten, DI Yogyakarta and Aceh are provinces that are recommended to increase the number of agricultural machinery, especially 2-wheel tractors, 4-wheel tractors. water pump and rice transplanter.
Discrimination between real and fake honey using portable fluorescence spectroscopy and simca
Authors: Suhandy D , Kusumiyati  , Yulia M , Al Riza DF
Published: January 2024

In the commercial market, real honey and fake honey could not easily be differentiated. For this reason, recently there has been an increasing demand for honey authentication. In this work, we apply portable fluorescence spectroscopy and soft independent modeling of class analogy (SIMCA) method to discriminate real and fake honey available in the commercial market. To afford the price of authentication, an LED-based spectrometer at 365 nm excitation was developed. Three types of samples were used: 100 samples of real honey (Heterotrigona itama), 40 samples of fake honey, and 40 samples of HFCS-55 (high fructose corn syrup). Samples were diluted five times with distilled water. The fluorescence or emission spectra from 357 nm to 725.5 nm were obtained by exciting the samples at 365 nm LED lamps. The resolution of 0.5 nm was used. Identification of real honey, fake honey, and HFCS-55 could be well achieved using two principal components (PC1 and PC2). Real honey of Heterotrigona itama was clustered on the left of PC1. SIMCA was applied and the classification between real honey, fake honey, and HFCS-55 was well established with 100% accuracy could be obtained.
Physical characteristics of extrudate with treatment composition ratio of mixed corn grit-soybean flour and extruder barrel temperature
Authors: Dwinata V F S , Karyadi J N W , Susanti D Y , Samodra A S , Mahanani R S , Rahmawati D K , Sinuhaji P F P
Published: January 2024

Yellow corn is one of the key component in the production of popular RTE snacks. However, corn’s nutritional quality is relatively low, necessitating the incorporation of additional ingredients such as soybean to enrich the protein content. This study primarily aims to explore the influence of soybean flour composition and temperature of barrel on the physical characteristics of extrudates to produce nutrition-rich snacks. The materials utilized in the experiment consisted of corn grit (mesh 24) and soybean flour (mesh 80). Extrudates were produced using SYSLG twin-screw extruder machine with a 10-15 kg/h production capacity. The study’s experimental design employed two factors: the composition factor of soybean flour (at 10%, 20%, and 30%) and the final temperature of the barrel (at 120°C, 130°C, and 140°C). The physical attributes of the extrudates were assessed based on the parameters such as expansion ratio, extrudate texture (hardness), moisture content, WAI, and WSI. The study findings revealed that increased soybean flour composition reduced the expansion properties and a more rigid material texture. On top of that, all extrudates exhibited moisture content of less than 4% (wb). The water absorption index decreased with higher soybean flour composition and barrel temperature, whereas the water solubility index showed an increasing trend. Among the tested conditions, the treatment with temperature of the barrel of 140°C and a soybean ratio of 20% demonstrated the best quality results.
Evaluating Smart Greenhouse Viability Through Engineering Design and Software Cost Modelling
Authors: Nugroho A P , Nasrul R M , Sutiarso L , Falah M A F , Dzaky M A F
Published: January 2024

Introducing smart greenhouse technology in tropical agricultural in Indonesia has the potential to bring about substantial advantages, such as higher crop yields, decreased water consumption, and enhanced food security. Nevertheless, the feasibility of this technology must be evaluated before it can be widely adopted. The objectives of this study were to evaluate the viability of smart greenhouse technology in using the engineering economics and software cost estimation model (SCEM), consider the fixed and variable cost for operational, and effort for developing the supporting modules. The findings of this study suggest that the investment in Smart Greenhouse technology is economically viable and financially justified. The Internal Rate of Return (IRR) of 11% exceeds the 10% discount rate, Benefit Cost Ratio (BCR) of 1.16 signifies that the discounted value of benefits surpasses costs over the project lifetime, with the economics return 16% higher than the break-even level. The Smart Greenhouse investment will become profitable after five years, with positive returns above the minimum threshold. The SCEM analysis shows that the software development workload is significant for some modules, such as Smart Agri Engrow and Smart Agri Nutrigrow. These software cost estimates can now be used for budgeting, planning, and assessing the feasibility of the Smart Greenhouse technology implementation.
Performance test of the combine harvester machine for rice harvesting in Indrapuri, Aceh Besar District
Authors: Idkham M , Dhafir M , Mustaqimah  , Safitri K
Published: January 2024

Paddy is a very important agricultural crop for mankind because more than half of the world’s population and almost the entire population of Indonesia depend on this plant as a source of food. Harvesting is a very important process in rice production, because in this process it is alleged that the level of yield loss is very high. Paddy harvesting can be done by modern farming (combine harvester) and conventional (manual), therefore it is necessary to know the effectiveness by analyzing the performance and efficiency of the two ways. This study aims to examine the performance of rice harvesting using a combine harvester and conventional machines in Indrapuri District, Aceh Besar District. The results of the combine harvester research show that the theoretical field capacity is 0.42 ha/hour, the effective field capacity is 0.25 ha/hour, efficiency is 60.03%, the working capacity is 743.54 kg/hour, the fuel consumption is 10.25 L/hour, and yield loss of 1.31%. Conventional harvesting shows a field capacity of 0.0049 ha/hour/person, thresher working capacity of 172.6908 kg/hour, thresher efficiency of 98.5417%, thresher fuel consumption of 0.5147 L/hour, and the percentage of yield loss is 3.8776%. Based on data on harvesting capacity, the combine harvester shows a better performance then conventional harvesting.
Internet of things based smart system in the modified greenhouse solar dryer for agricultural products
Authors: Nasution I S , Hafiz M I
Published: January 2024

The objective of this study is to develop a smart monitoring and control system for a modified greenhouse dryer for agricultural products utilizing Internet of Things (IoT) technologies and wireless sensor networks. This system enables real-time monitoring of air temperature and humidity, activation of the exhaust fan, adjustment of the heater, and determination of the optimal heating time. The investigation focused on the implementation of a microcontroller in the modified greenhouse system. The system possesses the capability to issue commands for the initiation of the heater and exhaust fan while also facilitating real-time monitoring. The system is equipped with an emergency command that can temporarily halt activities. The system utilizes two different temperature ranges, namely 45°C–50°C and 35°C–65°C, to analyse variations in heater usage across different temperature levels. Both software tools (Telegram and Google Excel spreadsheet) possess the functionality to monitor and regulate the temperature within a greenhouse by utilizing the chat network Telegram. Furthermore, the users possess the capability to store and access data related to the greenhouse system within an Excel spreadsheet.
Determining the Optimal Harvesting Time of Fresh Fruit Bunches Based on the Yield of Oil and Carotene
Authors: Akbar A R M , Wibowo A D , Prabandari P I
Published: January 2024

The timing of harvesting oil palm fruit might affect the quality of the oil palm product. Mostly, The approximate number of palm oil fruits that have broken off from their bunches (loose-fruit) is usually used to measure the ripeness of fruit. The goal of this study was to establish the ideal harvesting period with variations in the amount of palm oil fruits that were loose from their bunches using two indicators: oil yield and carotene content. The variance was dependent on one factor: the number of days after the fruit was discovered unfastened from its bunch. The results showed that the percentage of palm oil fruits that were separated from their bunch and the planting age were both related to the quality of the fresh fruit bunches (FFB). The ideal harvest period can be carried out from day two until day four after the first time of unmounted fruits, which have a high oil yield of 46.6%–48.1% and a yield of carotene of 400–600 ppm.
Optimizing 3D-printed workpieces for radiotherapy application: modelling the CT number and print time
Authors: Kadiri Sehad , Jakupi Kaltrine , Dukovski Vladimir , Hodolli Gezim
Published: January 2024

This study aims to analyze the influence of specific printing parameters, including infilling, print speed, and layer height, on the CT numbers and printing time of 3D-printed workpieces fabricated from Polylactic Acid (PLA). The primary objective is to optimize these parameters to attain desired CT numbers and print time for radiotherapy applications. To achieve this objective, we employed the Taguchi experimental design and regression analysis methodologies. A series of experiments were conducted to systematically assess the effects of varying infilling, print speed, and layer height values on the CT numbers and printing time of the PLA workpieces. The resulting data were then used to create mathematical models for predicting optimal parameter settings. Our investigations revealed that specific adjustments to infilling and layer height significantly influence the CT numbers and printing time of 3D-printed workpieces. By leveraging the developed mathematical models, precise predictions can be made to optimize independent parameters for the desired CT numbers and printing times, enhancing the efficacy of 3D-printed workpieces for radiotherapy applications. This research contributes to the advancement of 3D-printed workpieces utilized in radiotherapy, offering a pathway to enhance the accuracy and efficiency of treatment delivery. The optimization of printing parameters outlined in this study provides a valuable tool for clinicians and researchers in the field, ultimately benefiting patients undergoing radiotherapy treatments.
Detection of liquid chemical analytes using a novel PCF-SPR sensor based on the wavelength sensitivity measurement method
Authors: kumar Sudhir
Published: January 2024

This paper proposes a novel, highly sensitive, dual-coated PCF-SPR sensor for harmful chemical detection. The sensor’s performance is investigated based on the measurement of the wavelength sensitivity method. Silver (Ag) is a plasmonic material, and Ta2O5 is used as an overlayer to enhance its performance. The impact of Ta2O5 thickness and structural parameter variation on sensor performance is also measured. The proposed plasmonic sensor measured the maximum wavelength sensitivity of 23000 nm/RIU. This investigation undoubtedly provides a new approach to designing a PCF-SPR sensor that tunes the range of chemical refractive indices by changing Ta2O5 thickness. Besides, the simplicity, flexibility, and fabrication-friendly design make it applicable for chemical analyte sensing.
Black ZnO nanoparticles synthesized by a green chemistry process
Authors: León-Flores J , Melo-Uscanga E , Pérez-Mazariego J L , Marquina M , Reyes-Damián C , Escamilla R , Gómez R , Arenas-Alatorre J
Published: January 2024

In the present work, the standardization of the methodology to obtain black ZnO nanoparticles from Arabica coffee extract as a reducer agent and stabilizer of the reaction is presented for the first time through a scalable combustion green chemistry process without obtaining dangerous byproducts. The size distribution of the nanoparticles was found between 15 and 30 nm. High-resolution transmission electron microscopy shows distorted regions from the atomic column. Whereas, the estimated energy band gap measured by UV–vis spectroscopy is 2.22 eV, which is 30% value below the typical band gap for bulk ZnO. XPS measurements show a change in the binding energy of black ZnO compared to commercial ZnO. From experimental evidence, it is proposed that the black color of zinc oxide resulted from vacancies in the ZnO structure. The vacancies in the structure were theoretically modeled considering a variation in the Coulomb interaction between Zn—O atoms by applying the Hubbard + U DFT approximation. The theoretical electronic distribution of the influence of vacancies ZnO was compared with the experimental results obtained by Raman, FTIR and the experimental profile of the valence band region. These results open the exploration of green synthesized black zinc oxide nanoparticles to possible technological applications related to catalysis.
An antichain of monomial ideals in a twisted commutative algebra
Authors: Laudone Robert
Published: January 2024

We resolve an open question posed by Nagpal, Sam and Snowden [Selecta. Math. (N.S.) 22 (2016), pp. 913–937] in 2015 concerning a Gröbner theoretic approach to the noetherianity of the twisted commutative algebra

S
y
m
(
S
y

m
2

(

C

∞

)
)

Sym(Sym^2(\mathbf {C}^\infty ))

. We provide a negative answer to their question by producing an explicit antichain. In doing so, we establish a connection to well-studied posets of graphs under the subgraph and induced subgraph relation. We then analyze this connection to suggest future paths of investigation.
Diversification of quantitative morphological traits in wheat
Authors: Shan Yixiang , Osborne Colin P
Published: January 2024

Background and Aims

The development and morphology of crop plants have been profoundly altered by evolution under cultivation, initially through unconscious selection, without deliberate foresight, and later by directed breeding. Wild wheats remain an important potential source of variation for modern breeders; however, the sequence and timing of morphological changes during domestication are not fully resolved.

Methods

We grew and measured 142 wheat accessions representing different stages in wheat evolution, including three independent domestication events, and compared their morphological traits to define the morphospace of each group.

Key Results

The results show that wild and domesticated wheats have overlapping morphospaces, but each also occupies a distinct area of morphospace from one another. Polyploid formation in wheat increased leaf biomass and seed weight but had its largest effects on tiller loss. Domestication continued to increase the sizes of wheat leaves and seeds and made wheat grow taller, with more erect architecture. Associated changes to the biomass of domesticated wheats generated more grains and achieved higher yields. Landrace improvement subsequently decreased the numbers of tillers and spikes, to focus resource allocation to the main stem, accompanied by a thicker main stem and larger flag leaves. During the Green Revolution, wheat height was reduced to increase the harvest index and therefore yield. Modern wheats also have more erect leaves and larger flower biomass proportions than landraces.

Conclusions

Quantitative trait history in wheat differs by trait. Some trait values show progressive changes in the same direction (e.g. leaf size, grain weight), whereas others change in a punctuated way at particular stages (e.g. canopy architecture), and other trait values switch directions during wheat evolution (e.g. plant height, flower biomass proportion). Agronomically valued domestication traits arose during different stages of wheat history, such that modern wheats are the product of >10 000 years of morphological evolution.
A nomogram based on multimodal ultrasound and clinical features for the prediction of central lymph node metastasis in unifocal papillary thyroid carcinoma
Authors: Zhang Xin , Dong Xueying , Ma Chi , Wang Siying , Piao Zhenya , Zhou Xianli , Hou Xiujuan
Published: January 2024

Objectives

To build a predictive model for central lymph node metastasis (CLNM) in unifocal papillary thyroid carcinoma (UPTC) using a combination of clinical features and multimodal ultrasound (MUS).

Methods

This retrospective study, included 390 UPTC patients who underwent MUS between January 2017 and October 2022 and were divided into a training cohort (n = 300) and a validation cohort (n = 90) based on a cut-off date of June 2022. Independent indicators for constructing the predictive nomogram models were identified using multivariate regression analysis. The diagnostic yield of the 3 predictive models was also assessed using the area under the receiver operating characteristic curve (AUC).

Results

Both clinical factors (age, diameter) and MUS findings (microcalcification, virtual touch imaging score, maximal value of virtual touch tissue imaging and quantification) were significantly associated with the presence of CLNM in the training cohort (all P < .05). A predictive model (MUS + Clin), incorporating both clinical and MUS characteristics, demonstrated favourable diagnostic accuracy in both the training cohort (AUC = 0.80) and the validation cohort (AUC = 0.77). The MUS + Clin model exhibited superior predictive performance in terms of AUCs over the other models (training cohort 0.80 vs 0.72, validation cohort 0.77 vs 0.65, P < .01). In the validation cohort, the MUS + Clin model exhibited higher sensitivity compared to the CLNM model for ultrasound diagnosis (81.2% vs 21.6%, P < .001), while maintaining comparable specificity to the Clin model alone (62.3% vs 47.2%, P = .06). The MUS + Clin model demonstrated good calibration and clinical utility across both cohorts.

Conclusion

Our nomogram combining non-invasive features, including MUS and clinical characteristics, could be a reliable preoperative tool to predict CLNM treatment of UPTC.

Advances in knowledge

Our study established a nomogram based on MUS and clinical features for predicting CLNM in UPTC, facilitating informed preoperative clinical management and diagnosis.
Morning blood pressure surge and intracranial atherosclerotic plaque characteristics: a high-resolution magnetic resonance vessel wall imaging study
Authors: Jiang Yuhan , Song Xiaowei , Hou Duoduo , Zhao Xihai , Chen Wenwen , Li Rui , Zheng Zhuozhao , Sang Zhenhua , Wu Jian
Published: January 2024

Objective

To investigate the relationship between morning blood pressure surge (MBPS) and intracranial atherosclerotic plaque burden and vulnerability.

Methods

A total of 267 ischaemic stroke patients were retrospectively analysed. Sleep-trough and prewaking MBPS were calculated from ambulatory blood pressure monitoring (ABPM). Plaque characteristics, including intraplaque haemorrhage (IPH), maximum wall thickness (max WT), and stenosis degree, were obtained from high-resolution MR vessel wall imaging (HR-vwMRI). Linear and logistic regression were used to detect the association.

Results

Subjects with the top tertile of sleep-trough MBPS (≥15.1 mmHg) had a lower prevalence (9.1% vs. 19.6%, P = .029) of severe stenosis (≥70%) than others. Subjects within the top tertile of prewaking MBPS (≥7.6 mmHg) had a lower percentage of IPH (27.3% vs. 40.4%, P = .035) than others. After adjusting for stroke risk factors (age, sex, diabetes, hyperlipidaemia, hyperhomocysteinaemia, smoking, and family stroke history) and 24-h mean systolic blood pressure, 10 mmHg sleep-trough MBPS increment was associated with 0.07mm max WT reduction, and the top tertile MBPS group was associated with a lower chance of severe stenosis (odd ratio = 0.407, 95% CI, 0.175-0.950). Additionally, an increased prewaking MBPS is associated with a lower incidence of IPH, with OR = 0.531 (95% CI, 0.296-0.952). Subgroup analysis demonstrated that the positive findings could only be seen in non-diabetic subjects.

Conclusion

Increment of MBPS is negatively associated with intracranial atherosclerotic plaque burden and vulnerability, and this relationship remains significant in the non-diabetic subgroup.

Advances in knowledge

This study provided evidence that MBPS was associated with the intracranial atherosclerotic plaque burden and vulnerability on HR-vwMRI.
Imaging spectrum in tropical breast infections
Authors: Dhamija Ekta , Gulati Shrea , Hari Smriti
Published: January 2024

While breast carcinoma is the most feared pathology in women with breast lumps, infections continue to be an important aetiology, especially in countries with low to middle socio-economic status. The breast infections or mastitis can present as acute painful breast or recurrent episodes of breast lumps with or without pain. The common causes include puerperal, non-puerperal, and idiopathic mastitis whereas uncommon causes like tuberculosis, filariasis, hydatid and other parasitic infections are still seen in developing countries. Imaging with digital mammography may be difficult due to pain or inadequate due to increased breast density. Ultrasound serves as the modality of choice for detailed assessment in these patients. Since the imaging features are often overlapping with malignancy, biopsy is almost always indicated. However, there are certain imaging findings that may point to the diagnosis of mastitis and can help in accurate radiologic-pathologic correlation. This article aims to illustrate the varied clinico-radiological features of patients with tropical breast infections.
Staging of breast cancer in the breast and regional lymph nodes using contrast-enhanced photon-counting detector CT: accuracy and potential impact on patient management
Authors: Yalon Mariana , Sae-Kho Tiffany , Khanna Akriti , Chang Shaojie , Andrist Boleyn R , Weber Nikkole M , Hoodeshenas Safa , Ferrero Andrea , Glazebrook Katrina N , McCollough Cynthia H , Baffour Francis I
Published: January 2024

Objectives

To describe the feasibility and evaluate the performance of multiphasic photon-counting detector (PCD) CT for detecting breast cancer and nodal metastases with correlative dynamic breast MRI and digital mammography as the reference standard.

Methods

Adult females with biopsy-proven breast cancer undergoing staging breast MRI were prospectively recruited to undergo a multiphasic PCD-CT using a 3-phase protocol: a non-contrast ultra-high-resolution (UHR) scan and 2 intravenous contrast-enhanced scans with 50 and 180 s delay. Three breast radiologists compared CT characteristics of the index malignancy, regional lymphadenopathy, and extramammary findings to MRI.

Results

Thirteen patients underwent both an MRI and PCD-CT (mean age: 53 years, range: 36-75 years). Eleven of thirteen cases demonstrated suspicious mass or non-mass enhancement on PCD-CT when compared to MRI. All cases with metastatic lymphadenopathy (3/3 cases) demonstrated early avid enhancement similar to the index malignancy. All cases with multifocal or multicentric disease on MRI were also identified on PCD-CT (3/3 cases), including a 4 mm suspicious satellite lesion. Four of five patients with residual suspicious post-biopsy calcifications on mammograms were detected on the UHR PCD-CT scan. Owing to increased field-of-view at PCD-CT, a 5 mm thoracic vertebral metastasis was identified at PCD-CT and not with the breast MRI.

Conclusions

A 3-phase PCD-CT scan protocol shows initial promising results in characterizing breast cancer and regional lymphadenopathy similar to MRI and detects microcalcifications in 80% of cases.

Advances in knowledge

UHR and spectral capabilities of PCD-CT may allow for comprehensive characterization of breast cancer and may represent an alternative to breast MRI in select cases.
Imaging of infra-thoracic tuberculosis
Authors: Kanthawang Thanat , Pattamapaspong Nuttaya , Peh Wilfred C G , Hammami Nadia , Bouaziz Mouna Chelli , Ladeb Mohamed Fethi
Published: January 2024

Tuberculosis (TB) is a potentially curable disease that is a leading cause of death globally. While it typically affects the lungs, this disease may involve many extra-pulmonary sites, particularly in patients with risk factors. Extra-pulmonary TB often mimics a variety of different diseases, posing a diagnostic dilemma. Imaging aids in early diagnosis of TB, especially in patients with non-specific or atypical symptoms found at extra-pulmonary infra-thoracic locations. Imaging also helps guide appropriate laboratory investigation, monitor disease progress, and response to treatment. This review aims to highlight the imaging spectrum of TB affecting the infra-thoracic region, that is, gastrointestinal tract, abdominal lymph nodes, peritoneal cavity, intra-abdominal solid organs, and urogenital system.
Multimodality imaging of diseases of the vagina
Authors: Pulappadi Vishnu Prasad , Manchanda Smita , Dhamija Ekta , Jana Manisha
Published: January 2024

Pathologies of the vagina are important causes of symptoms related to the genital tract in women. They can be missed on transabdominal ultrasonography (USG), which is the baseline modality used for evaluation of gynaecological complaints. Transperineal USG and MRI are the imaging modalities of choice for evaluation of the vagina. Diseases of the vagina can be grouped depending upon the age group in which they occur. In children and young adults, congenital anomalies like longitudinal or transverse vaginal septum, imperforate hymen, vaginal aplasia or atresia, and rectovaginal fistula can be seen. Malignant tumours can rarely occur in children, rhabdomyosarcoma being the most common one. Common diseases affecting adults include benign lesions like epidermoid, Gartner duct, and Bartholin cysts, and urogenital fistulas involving the vagina. Endometriosis and other benign tumours of vagina including leiomyoma, fibroepithelial polyp, and angiomyxoma are occasionally seen. Malignant tumours can be primary, the most common one being squamous cell carcinoma, or secondary, due to direct extension from cancers involving the adjacent organs. Characteristic morphological changes occur in the vagina after radiotherapy, which can be identified on imaging. Knowledge about the imaging appearances of these diseases is crucial in guiding appropriate management.
Low-dose palliative radiotherapy for malignant peripheral T-cell lymphoma masked by cellulitis and osteomyelitis: a case report
Authors: Alayed Yasir
Published: January 2024

Classic Hodgkin lymphoma is a potentially curable disease. With the advent of effective systemic regimens with adriamycin, bleomycin, vincristine, and dacarbazine, chemotherapy has become the treatment of choice for advanced Hodgkin lymphoma. However, for advanced Hodgkin lymphoma after chemotherapy, disease relapse rates are still high. This case report highlights how low-dose palliative radiotherapy can be used successfully for the management of an unusual case of recurrent lymphoma with a different histology soon after completing systemic therapy, which was further complicated by an ongoing local infection.
Anatomical variations in the circle of Willis on magnetic resonance angiography in a south Trinidad population
Authors: Diljohn Jason , Rampersad Fidel , Maharaj Paramanand , Parmesar Kristyn
Published: January 2024

Objectives

This article seeks to determine the prevalence of a complete circle of Willis (CoW) and its common morphological variations in a south Trinidad population, while also investigating the influence of gender, age, and ethnicity on CoW morphology.

Methods

A prospective, descriptive, cross-sectional study was done on the magnetic resonance images for consecutive patients who had a brain MRI/magnetic resonance angiography at a tertiary health institution in south Trinidad between October 2019 and September 2020. Patients with significant cerebrovascular disease and/or a history of prior neurosurgical intervention were excluded.

Results

A complete CoW was seen in 24.3%, with more complete circles observed in younger participants (≤45 years) and Afro-Trinidadians. No gender predilection for a complete CoW was demonstrated. The most common variations in the anterior and posterior parts of the circle were a hypoplastic anterior communicating artery (8.6%, n = 13) and bilateral aplastic posterior communicating arteries (18.4%, n = 28), respectively.

Conclusions

Significant variations exist in the CoW of a south Trinidad population with a frequency of complete in 24.3%, and more complete circles in younger patients and Afro-Trinidadians. Gender did not influence CoW morphology.

Advances in knowledge

Structural abnormalities in the CoW may be linked to future incidence of cerebrovascular diseases and should therefore be communicated to the referring physician in the written radiology report. Knowledge of variant anatomy and its frequency for a particular populations is also required by neurosurgeons and neuro-interventional radiologists to help with preprocedural planning and to minimize complications.
Differences of white matter structure for diffusion kurtosis imaging using voxel-based morphometry and connectivity analysis
Authors: Kanazawa Yuki , Ikemitsu Natsuki , Kinjo Yuki , Harada Masafumi , Hayashi Hiroaki , Taniguchi Yo , Ito Kosuke , Bito Yoshitaka , Matsumoto Yuki , Haga Akihiro
Published: January 2024

Objectives

In a clinical study, diffusion kurtosis imaging (DKI) has been used to visualize and distinguish white matter (WM) structures’ details. The purpose of our study is to evaluate and compare the diffusion tensor imaging (DTI) and DKI parameter values to obtain WM structure differences of healthy subjects.

Methods

Thirteen healthy volunteers (mean age, 25.2 years) were examined in this study. On a 3-T MRI system, diffusion dataset for DKI was acquired using an echo-planner imaging sequence, and T1-weghted (T1w) images were acquired. Imaging analysis was performed using Functional MRI of the brain Software Library (FSL). First, registration analysis was performed using the T1w of each subject to MNI152. Second, DTI (eg, fractional anisotropy [FA] and each diffusivity) and DKI (eg, mean kurtosis [MK], radial kurtosis [RK], and axial kurtosis [AK]) datasets were applied to above computed spline coefficients and affine matrices. Each DTI and DKI parameter value for WM areas was compared. Finally, tract-based spatial statistics (TBSS) analysis was performed using each parameter.

Results

The relationship between FA and kurtosis parameters (MK, RK, and AK) for WM areas had a strong positive correlation (FA-MK, R2 = 0.93; FA-RK, R2 = 0.89) and a strong negative correlation (FA-AK, R2 = 0.92). When comparing a TBSS connection, we found that this could be observed more clearly in MK than in RK and FA.

Conclusions

WM analysis with DKI enable us to obtain more detailed information for connectivity between nerve structures.

Advances in knowledge

Quantitative indices of neurological diseases were determined using segmenting WM regions using voxel-based morphometry processing of DKI images.
State of the art: radiomics and radiomics-related artificial intelligence on the road to clinical translation
Authors: Majumder Shweta , Katz Sharyn , Kontos Despina , Roshkovan Leonid
Published: January 2024

Radiomics and artificial intelligence carry the promise of increased precision in oncologic imaging assessments due to the ability of harnessing thousands of occult digital imaging features embedded in conventional medical imaging data. While powerful, these technologies suffer from a number of sources of variability that currently impede clinical translation. In order to overcome this impediment, there is a need to control for these sources of variability through harmonization of imaging data acquisition across institutions, construction of standardized imaging protocols that maximize the acquisition of these features, harmonization of post-processing techniques, and big data resources to properly power studies for hypothesis testing. For this to be accomplished, it will be critical to have multidisciplinary and multi-institutional collaboration.
Statin therapy after elective abdominal aortic aneurysm repair improves long-term survival
Authors: Lilja Fredrik , Wanhainen Anders , Mani Kevin
Published: January 2024

Background

Patients with abdominal aortic aneurysms are at high risk of cardiovascular events. Although statin therapy is indicated for most of these patients, no specific recommendation regarding the intensity of therapy exists. The aim of this study was to assess the possible effect of statin therapy on survival of patients undergoing abdominal aortic aneurysm repair and to investigate if high-intensity statin therapy was superior to low–moderate-intensity therapy.

Methods

Data from nationwide Swedish registers on hospital admissions, operations, and medications for patients undergoing elective abdominal aortic aneurysm repair from 2006 to 2018 were collected. The effect of statin use was evaluated in three separate propensity score matched cohorts: perioperative mortality was analysed according to whether patients were on statins before abdominal aortic aneurysm repair or not; long-term survival was assessed according to whether patients were on statins during follow-up or not; and, for those on statins after surgery, long-term survival was analysed according to whether patients were on high-intensity or low–moderate-intensity statin therapy.

Results

Preoperative statin use did not reduce 90-day perioperative mortality (OR 0.99, 95% c.i. 0.77 to 1.28), whilst there was a marked benefit regarding long-term survival for postoperative statin users (HR 1.43, 95% c.i. 1.34 to 1.54). High-intensity statin therapy had no advantage over low–medium-intensity statin therapy with regards to long-term survival (HR 1.00, 95% c.i. 0.80 to 1.25).

Conclusion

In this nationwide propensity score matched cohort study, preoperative statin treatment had no benefit regarding 90-day perioperative survival, but postoperative statin treatment markedly improved long-term survival. No additional benefit regarding high-dose statin treatment could be confirmed in this analysis.
Diagnostic accuracy of cross-sectional and endoscopic imaging in ampullary tumours: systematic review
Authors: de Wilde Anouk J , de Jong Evelien J M , Gurusamy Kurinchi S , Abu Hilal Mohammad , Besselink Marc G , Dewulf Maxime J L , Geurts Sandra M E , Neumann Ulf P , Olde Damink Steven W M , Poley Jan-Werner , Tjan-Heijnen Vivianne C G , de Vos-Geelen Judith , Wiltberger Georg , Coolsen Mariëlle M E , Bouwense Stefan A W
Published: January 2024

Background

Differentiation between adenomas and carcinomas of the ampulla of Vater is crucial for therapy and prognosis. This was a systematic review of the literature on the accuracy of diagnostic modalities used to differentiate between benign and malignant ampullary tumours.

Methods

A literature search was conducted in PubMed, Embase, CINAHL, and the Cochrane Library. Studies were included if they reported diagnostic test accuracy information among benign and malignant ampullary tumours, and used pathological diagnosis as the reference standard. Risk of bias was assessed using Quality Assessment on Diagnostic Accuracy Studies (QUADAS) 2 and QUADAS-C.

Results

Ten studies comprising 397 patients were included. Frequently studied modalities were (CT; 2 studies), endoscopic ultrasonography (EUS; 3 studies), intraductal ultrasonography (IDUS; 2 studies), and endoscopic forceps biopsy (3 studies). For CT, the reported sensitivity for detecting ampullary carcinoma was 44 and 95%, and the specificity 58 and 60%. For EUS, the sensitivity ranged from 63 to 89% and the specificity between 50 and 100%. A sensitivity of 88 and 100% was reported for IDUS, with a specificity of 75 and 93%. For forceps biopsy, the sensitivity ranged from 20 to 91%, and the specificity from 75 to 86%. The overall risk of bias was scored as moderate to poor. Data were insufficient for meta-analysis.

Conclusion

To differentiate benign from malignant ampullary tumours, EUS and IDUS seem to be the best diagnostic modalities. Sufficient high-quality evidence, however, is lacking.
An observational cohort study on the effects of extended postoperative antibiotic prophylaxis on surgical-site infections in low- and middle-income countries
Authors:   Clean Cut Investigators Group, Nofal Maia R. , Zhuang Alex Y. , Gebeyehu Natnael , Starr Nichole , Haile Sara Taye , Woldeamanuel Habtamu , Tesfaye Assefa , Alemu Senait Bitew , Bekele Abebe , Mammo Tihitena Negussie , Weiser Thomas G. , Abdukadir Abdi Amin , Abebe Belay Mellese , Admasu Ananya K. , Alito Tibebu Abebe , Ambulkar Reshma , Arimino Sedera , Arusi Muhudin , Aynalem Nardos , Bajaj Varnica , Delelo Tilahun Selfago , Gutu Motuma , Habte Feleke , Hurrisa Gezahegn Assefa , Kunte Aditya , Rocabado Karoline , Shiferaw Matiyas Asrat , Harrell-Shreckengost Constance , Tiruneh Agazi , Zamorano Roberto , Abreha Milena , Aguilera Constanza , Lima Bella , Kebede Hillena
Published: January 2024

Background

Worldwide, approximately one in six inpatient antibiotic prescriptions are for surgical-infection prophylaxis, including postoperative prophylaxis. The WHO recommends against prolonged postoperative antibiotics to prevent surgical-site infection. However, in many low- and middle-income countries, postoperative antibiotic prophylaxis is common due to perceptions that it protects against surgical-site infection and data informing recommendations against antibiotic administration are largely derived from high-income countries. The aim of this study was to describe postoperative antibiotic-prescribing patterns and related surgical-site infection rates in hospitals in low- and middle-income countries.

Methods

Patients from 19 hospitals in Ethiopia, Madagascar, India, and Bolivia with wound class I and II operations were included. Data on antibiotic administration, indication, surgical-site infection, length of hospital stay, and adherence to perioperative infection-prevention standards were collected by trained personnel. The association between postoperative antibiotic prophylaxis for greater than or equal to 24 h and surgical-site infection was analysed via modified robust Poisson regression, controlling for patient and procedural factors and degree of adherence to perioperative infection-prevention practices.

Results

Of 8714 patients, 92.9% received antibiotics for prophylaxis after surgery and 27.7% received antibiotics for greater than or equal to 24 h. Patients receiving postoperative prophylaxis for greater than or equal to 24 h did not have lower surgical-site infection rates (Relative risk 1.09 (95% c.i. 0.89 to 1.33); P = 0.399), but the length of hospital stay was 1.4 days longer (P < 0.001).

Conclusion

Prolonged postoperative antibiotics did not reduce surgical-site infection, but pervasive use was associated with a longer length of hospital stay, in resource-limited healthcare systems. With the growing threat of antimicrobial resistance, surgical initiatives to implement antimicrobial stewardship programmes in low- and middle-income countries are critical.
Prevalence of abdominal aortic aneurysm (AAA) in first-degree relatives: detecting AAA in adult offspring of AAA patients
Authors: Fattahi Nina , Linné Anneli , Roy Joy , Stenman Malin , Svensjö Sverker , Nilsson Olga , Hultgren Rebecka
Published: January 2024

Background

First-degree relatives of patients with abdominal aortic aneurysm (AAA) may have an increased risk of developing the disease. The primary aim was to report the prevalence of AAA in adult male and female offspring of patients with AAA. The secondary aim was to explore the efficiency of a registry-based detection route, and the third aim was to report contemporary prevalence in the population.

Methods

Adult offspring of individuals with AAA and matched controls were identified through national registries. The examination included questionnaires and ultrasound examinations of the infrarenal aorta. Aortic pathology was defined as an aortic diameter ≥25 mm, AAA ≥30 mm.

Results

The participation rate among male and female adult offspring was 64% (350/543) and 69% (402/583), respectively. A lower participation rate was found in male and female controls (51% and 52%). No difference in prevalence of AAA was observed between male adult offspring and controls (0.9%, c.i. 0.2 to 2.3%) or in the female population (prevalence of 0.2% in adult offspring and controls). Aortic pathology and previously diagnosed AAA were detected in 5.3% (c.i. 3.3 to 8.0%) of male adult offspring and 2.3% (c.i. 1.1 to 4.2%) in controls. Aortic pathology was more prevalent among adult offspring of females with AAA.

Conclusion

The prevalence of AAA in the general population is low, but aortic pathology is notably higher among male first-degree relatives. Increased awareness should be directed towards individuals with a possible hereditary predisposition, particularly offspring of females with AAA and older smokers. Risk factor-based targeted screening of adult offspring of patients with AAA after registry-based detection should be further explored.

Trial registration

ClinicalTrials.gov identifier, NCT4623268
Huntington’s disease affects mitochondrial network dynamics predisposing to pathogenic mitochondrial DNA mutations
Authors: Neueder Andreas , Kojer Kerstin , Gu Zhenglong , Wang Yiqin , Hering Tanja , Tabrizi Sarah , Taanman Jan-Willem , Orth Michael
Published: January 2024

Huntington’s disease (HD) predominantly affects the brain, causing a mixed movement disorder, cognitive decline and behavioural abnormalities. It also causes a peripheral phenotype involving skeletal muscle. Mitochondrial dysfunction has been reported in tissues of HD models, including skeletal muscle, and lymphoblast and fibroblast cultures from patients with HD. Mutant huntingtin protein (mutHTT) expression can impair mitochondrial quality control and accelerate mitochondrial ageing.

Here, we obtained fresh human skeletal muscle, a post-mitotic tissue expressing the mutated HTT allele at physiological levels since birth, and primary cell lines from HTT CAG repeat expansion mutation carriers and matched healthy volunteers to examine whether such a mitochondrial phenotype exists in human HD. Using ultra-deep mitochondrial DNA (mtDNA) sequencing, we showed an accumulation of mtDNA mutations affecting oxidative phosphorylation. Tissue proteomics indicated impairments in mtDNA maintenance with increased mitochondrial biogenesis of less efficient oxidative phosphorylation (lower complex I and IV activity). In full-length mutHTT expressing primary human cell lines, fission-inducing mitochondrial stress resulted in normal mitophagy. In contrast, expression of high levels of N-terminal mutHTT fragments promoted mitochondrial fission and resulted in slower, less dynamic mitophagy. Expression of high levels of mutHTT fragments due to somatic nuclear HTT CAG instability can thus affect mitochondrial network dynamics and mitophagy, leading to pathogenic mtDNA mutations.

We show that life-long expression of mutant HTT causes a mitochondrial phenotype indicative of mtDNA instability in fresh post-mitotic human skeletal muscle. Thus, genomic instability may not be limited to nuclear DNA, where it results in somatic expansion of the HTT CAG repeat length in particularly vulnerable cells such as striatal neurons. In addition to efforts targeting the causative mutation, promoting mitochondrial health may be a complementary strategy in treating diseases with DNA instability such as HD.
Scaling behaviours of deep learning and linear algorithms for the prediction of stroke severity
Authors: Bourached Anthony , Bonkhoff Anna K , Schirmer Markus D , Regenhardt Robert W , Bretzner Martin , Hong Sungmin , Dalca Adrian V , Giese Anne-Katrin , Winzeck Stefan , Jern Christina , Lindgren Arne G , Maguire Jane , Wu Ona , Rhee John , Kimchi Eyal Y , Rost Natalia S
Published: January 2024

Deep learning has allowed for remarkable progress in many medical scenarios. Deep learning prediction models often require 105–107 examples. It is currently unknown whether deep learning can also enhance predictions of symptoms post-stroke in real-world samples of stroke patients that are often several magnitudes smaller. Such stroke outcome predictions however could be particularly instrumental in guiding acute clinical and rehabilitation care decisions. We here compared the capacities of classically used linear and novel deep learning algorithms in their prediction of stroke severity. Our analyses relied on a total of 1430 patients assembled from the MRI-Genetics Interface Exploration collaboration and a Massachusetts General Hospital–based study. The outcome of interest was National Institutes of Health Stroke Scale–based stroke severity in the acute phase after ischaemic stroke onset, which we predict by means of MRI-derived lesion location. We automatically derived lesion segmentations from diffusion-weighted clinical MRI scans, performed spatial normalization and included a principal component analysis step, retaining 95% of the variance of the original data. We then repeatedly separated a train, validation and test set to investigate the effects of sample size; we subsampled the train set to 100, 300 and 900 and trained the algorithms to predict the stroke severity score for each sample size with regularized linear regression and an eight-layered neural network. We selected hyperparameters on the validation set. We evaluated model performance based on the explained variance (R2) in the test set. While linear regression performed significantly better for a sample size of 100 patients, deep learning started to significantly outperform linear regression when trained on 900 patients. Average prediction performance improved by ∼20% when increasing the sample size 9× [maximum for 100 patients: 0.279 ± 0.005 (R2, 95% confidence interval), 900 patients: 0.337 ± 0.006]. In summary, for sample sizes of 900 patients, deep learning showed a higher prediction performance than typically employed linear methods. These findings suggest the existence of non-linear relationships between lesion location and stroke severity that can be utilized for an improved prediction performance for larger sample sizes.