bluuebunny/crossref_metadata_2025 huggingface dataset:
Mathematical investigation of nanoparticle aggregation and heat transfer on mixed convective stagnation point flow of nanofluid over extendable vertical Riga plate
Authors: Mahmood Zafar , Khan Umar
Published: June 2023

The purpose of this study is to evaluate the effects that aggregation of nanoparticles has on mixed convective stagnation point flow and porous media across a permeable stretched vertical Riga plate in the occurrence of a heat source or sink for ethylene glycol-based nanofluids. It is possible to evaluate nanoparticle aggregation with modified versions of the Krieger-Dougherty and Maxwell-Bruggeman models. To obtain numerical solutions to the mathematical model of the present issue, the Runge–Kutta (RK-IV) with shooting technique in Mathematica was used. Figures in the proposed mixed convection and suction variables along a boundary surface in the stagnation point flow towards a permeable extending Riga plate identify and explain heat transfer processes and interrupted flow occurrences. By combining titania (TiO
2) nanoparticles with ethylene glycol as the base fluid, improved heat transmission is possible. The effects of different inputs on temperature and velocity profiles, skin friction coefficient, and local Nusselt number were graphically shown using tables and graphs. The heat transmission and skin friction rates both increased when the suction parameter was given larger values. Increases in both skin friction and the Nusselt number may be attributed to variations in the volume percentage of nanoparticles. Heat source parameter increased the temperature profile and reduced the Nusselt number. Aggregation models provide more accurate velocity and skin fraction profiles than homogeneous models, which is why they are more often used. The findings were confirmed by comparing the most up-to-date research with previously published results for the same situation. Results indicated that the two sets of data were consistent with one another.
Full-flux-surface effects on electrostatic turbulence in Wendelstein 7-X-like plasmas
Authors: Wilms Felix , Bañón Navarro Alejandro , Jenko Frank
Published: June 2023

We present the first nonlinear, gyrokinetic, surface-global simulations of a Wendelstein 7-X-like stellarator with kinetic electrons. As a first application, we investigate the interplay between Ion Temperature Gradient (ITG) and Trapped Electron Mode (TEM) driven turbulence in a Full-Flux-Surface (FFS) approach, as well as the effect of a neoclassical radial electric field, something that escapes the capabilities of flux-tube simulations. We find that even in this more complex setup, ITG turbulence is stabilised through a finite density gradient while TEM turbulence remains relatively weak. Furthermore, we show that the effect of the radial electric field itself is small in comparison with the variation of the gradients. Nevertheless, we observe that for some of the cases shown here, there is not only quantitative but also qualitative disagreement between flux-tube and FFS simulations, in contrast to earlier studies with an adiabatic electron model. These results emphasise the potential importance of retaining geometrical variations on the flux-surface when describing stellarator turbulence under realistic conditions.
FPGA Implementation of Integer Loop Delay Estimation with Low Complexity in Undersampling Digital Predistortion System
Authors: Ye Jincai , Fu Zhanming , Liu Qinghua
Published: June 2023

In a digital predistortion (DPD) system, accurate loop delay estimation is one of the prerequisites for precise calculation of the DPD coefficient. Multiplications of plural numbers are needed in most of the conventional loop delay estimation algorithms. Based on the Euclidean loop delay estimation (ELDE) method, this paper proposes a simplified Euclidean loop delay estimation (SELDE) method that can avoid the operation of the multiplication of plural numbers. The ELDE and SELDE method are implemented in actual undersampling systems, separately. The results of the experiments prove the feasibility and effectiveness of the methods. Compared with the ELDE method, the hardware resource consumption of SELDE is decreased, mainly reflected in the reduction of registers and look-up tables by 41.26% and 42.84%, respectively.
Research on the line spectrum denoising detection based on multi-scale feature autoencoder
Authors: Yin Yaping , Dai Weiguo , Zhang Zongtang , Shi Yanzi , Sun Shilin
Published: June 2023

Line spectrum detection is an important research direction in the field of underwater acoustic target detection. The relevant features of the target can be obtained by using the target line spectrum in the signal power spectrogram, but the radiated noise signal is susceptible to the influence of external noise, which degrades the quality of the target line spectrum and thus affects the complete extraction of the line spectrum. A denoising method is proposed in this paper based on deep learning network architecture and classical filter to extract the target line spectrum from the power spectrogram with strong background noise while maintaining the continuity of the line spectrum and improving the efficiency of line spectrum detection. The simulated signal power spectrogram is used to train the multi-scale feature autoencoder to remove different scale noise interference in the line spectrum part and then pass the morphological attribute filter to remove the background noise further and keep the line spectrum continuity. The experimental analysis of the measured fishing vessel noise signal and the simulated signal shows that the algorithm proposed in this paper can effectively remove the line spectrum noise interference, improve the line spectrum signal-to-noise ratio quality, and realize the effective detection of the line spectrum.
Optimal Design of Antennas based on CNN and BLS
Authors: Wang Xiaoyan , Tian Yubo
Published: June 2023

Surrogate can greatly reduce the computing cost of full-wave electromagnetic simulation software in antenna design, and neural networks as a kind of surrogate have become very popular in recent years, among which the Convolutional Neural Network (CNN) is a very hot topic due to its better feature extraction and generalization capability. In this paper, Broad Learning System (BLS) is introduced to address the problems that CNN may fall into with local optimization and overfitting when dealing with antenna data. It provides a learning method to increase nodes in width for regression prediction, which has good generalization ability. Specifically, in antenna design, feature extraction is first applied using the convolution and pooling of CNN. The original dataset is combined with the extracted feature data to realize data augmentation, and then the BLS is used for regression training. Compared with the traditional deep CNN, this model uses lightweight convolutional layers, which is promising in solving the problem of the network falling into local optimum or overfitting. The simulation results show that the accuracy reaches 93.91% and 92.34% respectively on the Abalone benchmark and antenna data, proving the effectiveness of the proposed model in this paper.
Downlink channel estimation of intelligent reflective surface aided MU-MIMO system
Authors: Li Qingyun , Dou Zheng , Li Zhigang , Li Xinxiang
Published: June 2023

Obtaining channel status information (CSI) is one of the main problems of the intelligent reflective surface (IRS) assisted communication system. This is because IRS has only a large number of passive reflective components and cannot process signals. In this paper, we aim to estimate downlink channel of IRS assisted multi-user multiple-input multiple-output (MU-MIMO) communication system. In time division duplex (TDD) mode, the downlink channel is estimated according to the uplink pilot by using channel reciprocity. We propose a parallel factor analysis based on projection subspace (PSS-PARAFAC) channel estimation scheme. In the first step, the common sparsity among multiple users is used for signal subspace projection to reduce noise energy and complexity. The second step is to convert each user signal received of base station (BS) into the PARAFAC problem. The iterative method of alternating least squares (ALS) is used to solve this problem. From the analysis of simulation results, the channel estimation performance of the proposed algorithm is better.
A Broadband Optical Fiber Coupler Based on Dual-Hollow Core Fiber
Authors: Zhang Zili , Chen Huajin , Wang Changxu , Li Yuan
Published: June 2023

Hollow fiber has become a research hotspot in the field of special fibers for its excellent characteristics, such as low loss, low delay, low dispersion, and low nonlinear coefficient. Due to the lack of fiber coupler matching hollow core fiber, the application development of hollow core fiber in the all-fiber integrated system is greatly hindered. Dual-core fiber is widely used in the development of fiber couplers because it can choose optical power, wavelength, and polarization state by the coupling between the two cores. For the urgent need for hollow core fiber coupler, the design and research of wideband fiber coupler based on dual-hollow core fiber are carried out in this paper. Based on the coupled mode theory, the theoretical correlation between the structural parameters and the coupling length in the dual-hollow core anti-resonant fiber was analyzed by using the COMSOL simulation software system. On this basis, a 50:50 wideband fiber coupler was designed by adjusting the structural parameters to reduce the coupling length and introducing the sleeve into the cladding pipe to reduce the loss. The bandwidth of the coupler is up to 150 nm and the transmission loss is on the order of 10−2 dB/m.
Sulfur isotopes quantify the impact of anthropogenic activities on industrial-era Arctic sulfate in a Greenland ice core
Authors: Jongebloed Ursula A , Schauer Andrew J , Hattori Shohei , Cole-Dai Jihong , Larrick Carleigh G , Salimi Sara , Edouard Shana R , Geng Lei , Alexander Becky
Published: June 2023

Anthropogenic sulfate aerosols are estimated to have offset 60% of greenhouse-gas-induced warming in the Arctic, a region warming four times faster than the rest of the world. However, sulfate radiative forcing estimates remain uncertain because the relative contributions from anthropogenic versus natural sources to total sulfate aerosols are unknown. Here we measure sulfur isotopes of sulfate in a Summit, Greenland ice core from 1850 to 2006 CE to quantify the contribution of anthropogenic sulfur emissions to ice core sulfate. We use a Keeling plot to determine the anthropogenic sulfur isotopic signature (δ34Santhro = +2.9 ± 0.3 ‰), and compare this result to a compilation of sulfur isotope measurements of oil and coal. Using δ34Santhro, we quantify anthropogenic sulfate concentration separated from natural sulfate. Anthropogenic sulfate concentration increases to 67 ± 7% of non-sea-salt sulfate (65.1 ± 20.2 µg kg−1) during peak anthropogenic emissions from 1960 to 1990 and decreases to 45 ± 11% of non-sea-salt sulfate (25.4 ± 12.8 µg kg−1) from 1996 to 2006. These observations provide the first long-term record of anthropogenic sulfate distinguished from natural sources (e.g. volcanoes, dimethyl sulfide), and can be used to evaluate model characterization of anthropogenic sulfate aerosol fraction and radiative forcing over the industrial era.
Structural and critical properties of Pr0.5Sr0.5MnO3 nanoparticle
Authors: Thi Viet Chinh Nguyen , Linh Dinh Chi , Thi Dung Nguyen , Thanh Tran Dang
Published: June 2023

In this work, a sample of Pr0.5Sr0.5MnO3 nanoparticles with an average crystalline size of  = 58 ± 2 nm was prepared by a combination of reactive milling method for 6 h at room temperature and heat treatment at the 1100 °C for 0.5 h. The x-ray diffraction analysis revealed the existence of a Pr0.5Sr0.5MnO3 single phase with the tetragonal structure (I4/mcm space group). Temperature and magnetic field dependences of magnetisation measurements indicated a coexistence of two magnetic phase transitions. One is the antiferromagnetic-ferromagnetic transition at T
N = 150 K. The other is the second-order ferromagnetic-paramagnetic phase transition at T
C = 273.5 K. Using the modified Arrott plots and the Kouvel-Fisher methods, the critical isotherm analysis, and the scaling relation, the magnetic order in Pr0.5Sr0.5MnO3 nanoparticle sample has been pointed out. Accordingly, the critical exponents were found to be β = 0.486, γ = 1.181, and δ = 3.249. These values are quite close to the allowable exponents of the mean field model, suggesting an existence of the long-range ferromagnetic order. A slight deviation from the mean field model has been explained by the formation of the core/shell structure in Pr0.5Sr0.5MnO3 nanoparticle.
A systematic review of cardiac in-silico clinical trials
Authors: Rodero Cristobal , Baptiste Tiffany M G , Barrows Rosie K , Keramati Hamed , Sillett Charles P , Strocchi Marina , Lamata Pablo , Niederer Steven A
Published: June 2023

Computational models of the heart are now being used to assess the effectiveness and feasibility of interventions through in-silico clinical trials (ISCTs). As the adoption and acceptance of ISCTs increases, best practices for reporting the methodology and analysing the results will emerge. Focusing in the area of cardiology, we aim to evaluate the types of ISCTs, their analysis methods and their reporting standards. To this end, we conducted a systematic review of cardiac ISCTs over the period of 1 January 2012–1 January 2022, following the preferred reporting items for systematic reviews and meta-analysis (PRISMA). We considered cardiac ISCTs of human patient cohorts, and excluded studies of single individuals and those in which models were used to guide a procedure without comparing against a control group. We identified 36 publications that described cardiac ISCTs, with most of the studies coming from the US and the UK. In

75
%

of the studies, a validation step was performed, although the specific type of validation varied between the studies. ANSYS FLUENT was the most commonly used software in

19
%

of ISCTs. The specific software used was not reported in

14
%

of the studies. Unlike clinical trials, we found a lack of consistent reporting of patient demographics, with

28
%

of the studies not reporting them. Uncertainty quantification was limited, with sensitivity analysis performed in only

19
%

of the studies. In

97
%

of the ISCTs, no link was provided to provide easy access to the data or models used in the study. There was no consistent naming of study types with a wide range of studies that could potentially be considered ISCTs. There is a clear need for community agreement on minimal reporting standards on patient demographics, accepted standards for ISCT cohort quality control, uncertainty quantification, and increased model and data sharing.
Recent advances in nanofiber-based flexible transparent electrodes
Authors: Zhang Houchao , Zhu Xiaoyang , Tai Yuping , Zhou Junyi , Li Hongke , Li Zhenghao , Wang Rui , Zhang Jinbao , Zhang Youchao , Ge Wensong , Zhang Fan , Sun Luanfa , Zhang Guangming , Lan Hongbo
Published: June 2023

Flexible and stretchable transparent electrodes are widely used in smart display, energy, wearable devices and other fields. Due to the limitations of flexibility and stretchability of indium tin oxide electrodes, alternative electrodes have appeared, such as metal films, metal nanowires, and conductive meshes. However, few of the above electrodes can simultaneously have excellent flexibility, stretchability, and optoelectronic properties. Nanofiber (NF), a continuous ultra-long one-dimensional conductive material, is considered to be one of the ideal materials for high-performance transparent electrodes with excellent properties due to its unique structure. This paper summarizes the important research progress of NF flexible transparent electrodes (FTEs) in recent years from the aspects of NF electrode materials, preparation technology and application. First, the unique advantages and limitations of various NF materials are systematically discussed. Then, we summarize the preparation technology of various advanced NF FTEs, and point out the future development trend. We also discuss the application of NFs in solar cells, supercapacitors, electric heating equipments, sensors, etc, and analyze its development potential in flexible electronic equipment, as well as problems that need to be solved. Finally, the challenges and future development trends are proposed in the wide application of NF FTEs in the field of flexible optoelectronics.
Some stable plethysms
Authors: Law Stacey , Okitani Yuji
Published: June 2023

In this note, we prove some new stability results for plethysm coefficients. As special cases, we verify a conjecture of Wildon, and show the stability of sequences recently predicted by Bessenrodt, Bowman and Paget [Trans. Amer. Math. Soc. 375 (2022), pp. 5151–5194] to be weakly increasing.
Hilbert points in Hardy spaces
Authors: Brevig O. , Ortega-Cerdà J. , Seip K.
Published: June 2023

A Hilbert point in

H
p

(

T

d

)

H^p(\mathbb {T}^d)

, for

d
≥
1

d\geq 1

and

1
≤
p
≤
∞

1\leq p \leq \infty

, is a nontrivial function

φ
\varphi

in

H
p

(

T

d

)

H^p(\mathbb {T}^d)

such that
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="double-vertical-bar phi double-vertical-bar Subscript upper H Sub Superscript p Subscript left-parenthesis double-struck upper T Sub Superscript d Subscript right-parenthesis Baseline less-than-or-equal-to double-vertical-bar phi plus f double-vertical-bar Subscript upper H Sub Superscript p Subscript left-parenthesis double-struck upper T Sub Superscript d Subscript right-parenthesis">

‖
φ

‖

H
p

(

T

d

)

≤
‖
φ
+
f

‖

H
p

(

T

d

)

\| \varphi \|_{H^p(\mathbb {T}^d)} \leq \|\varphi + f\|_{H^p(\mathbb {T}^d)}

whenever

f
f

is in

H
p

(

T

d

)

H^p(\mathbb {T}^d)

and orthogonal to

φ
\varphi

in the usual

L
2

L^2

sense. When

p
≠
2

p\neq 2

,

φ
\varphi

is a Hilbert point in

H
p

(

T

)

H^p(\mathbb {T})

if and only if

φ
\varphi

is a nonzero multiple of an inner function. An inner function on

T

d

\mathbb {T}^d

is a Hilbert point in any of the spaces

H
p

(

T

d

)

H^p(\mathbb {T}^d)

, but there are other Hilbert points as well when

d
≥
2

d\geq 2

. The case of

1
1

-homogeneous polynomials is studied in depth and, as a byproduct, a new proof is given for the sharp Khinchin inequality for Steinhaus variables in the range

2
>
p
>
∞

2>p>\infty

. Briefly, the dynamics of a certain nonlinear projection operator is treated. This operator characterizes Hilbert points as its fixed points. An example is exhibited of a function

φ
\varphi

that is a Hilbert point in

H
p

(

T

3

)

H^p(\mathbb {T}^3)

for

p
=
2
,
4

p=2, 4

, but not for any other

p
p

; this is verified rigorously for

p
>
4

p>4

but only numerically for

1
≤
p
>
4

1\leq p>4

.
On the maximal ideal spaces of 𝐇^{∞} on coverings of bordered Riemann surfaces
Authors: Brudnyi A.
Published: June 2023

The paper describes the topological structure of the maximal ideal space of the algebra of bounded holomorphic functions on a covering of a bordered Riemann surface. Some applications of the obtained results to the theory of bounded operator-valued holomorphic functions on Riemann surfaces are presented.
Power dilation systems {𝑓(𝑧^{𝑘})}_{𝑘∈ℕ} in Dirichlet-type spaces
Authors: Dan H. , Guo K.
Published: June 2023

Power dilation systems

{
f
(

z
k

)

}

k
∈

N

\{f(z^k)\}_{k\in \mathbb {N}}

in Dirichlet-type spaces

D

t

 
(
t
∈

R

)

\mathcal {D}_t\ (t\in \mathbb {R})

are treated. When

t
≠
0

t\neq 0

, it is proved that a system of functions

{
f
(

z
k

)

}

k
∈

N

\{f(z^k)\}_{k\in \mathbb {N}}

is orthogonal in

D

t

\mathcal {D}_t

only if

f
=
c

z
N

f=cz^N

for some constant

c
c

and some positive integer

N
N

. Complete characterizations are also given of unconditional bases and frames formed by power dilation systems of Dirichlet-type spaces. Finally, these results are applied to the operator theoretic case of the moment problem on Dirichlet-type spaces.
Functions with small and large spectra as (non)extreme points in subspaces of 𝐻^{∞}
Authors: Dyakonov K.
Published: June 2023

Given a subset

Λ
\Lambda

of

Z

+

≔
{
0
,
1
,
2
,
…
}

\mathbb Z_+≔\{0,1,2,\dots \}

, let

H
∞

(
Λ
)

H^\infty (\Lambda )

denote the space of bounded analytic functions

f
f

on the unit disk whose coefficients

f
^

(
k
)

\widehat f(k)

vanish for

k
∉
Λ

k\notin \Lambda

. Assuming that either

Λ
\Lambda

or

Z

+

∖
Λ

\mathbb Z_+\setminus \Lambda

is finite, we determine the extreme points of the unit ball in

H
∞

(
Λ
)

H^\infty (\Lambda )

.
Multilinear oscillatory integrals and estimates for coupled systems of dispersive PDEs
Authors: Bergfeldt Aksel , Rodríguez-López Salvador , Rule David , Staubach Wolfgang
Published: June 2023

We establish sharp global regularity of a class of multilinear oscillatory integral operators that are associated to nonlinear dispersive equations with both Banach and quasi-Banach target spaces. As a consequence we also prove the (local in time) continuous dependence on the initial data for solutions of a large class of coupled systems of dispersive partial differential equations.
The Hybrid Technique for Autologous Gluteal Augmentation
Authors: Ghavami Ashkan , Halani Sameer H , Amirlak Bardia
Published: June 2023

This article accompanying these videos will describe the technique created and innovated by the senior author for gluteal augmentation with autologous fat transfer. While the principles of gluteal fat grafting originated with Pitanguy, Regnault, Gonazalez, and Spina, the nuances vary greatly from surgeon to surgeon. Although there is much controversy regarding gluteal fat grafting, the major principle of avoiding intramuscular injection is the central pillar of safe and effective augmentation today. The senior author fine-tuned his method to optimize patient outcomes over the past 14 years and demonstrated lasting, aesthetic results while maximizing patient safety with his technique. More recently, the senior surgeon has developed the Hybrid Technique, involving manual injection of fat through a syringe and a power-assisted cannula to maximize aesthetic outcomes while adhering to safety principles. This method follows the deep and moderate depth subcutaneous injection principle while respecting the muscular, neurovascular, and ligamentous anatomy of the buttock.

Level of Evidence: 4
Diagnostic performance of clinical likelihood models of obstructive coronary artery disease to predict myocardial perfusion defects
Authors: Rasmussen Laust Dupont , Albertsen Line Emilie Brøgger , Nissen Louise , Ejlersen June Anita , Isaksen Christin , Murphy Theodore , Søndergaard Hanne Maare , Kirk Jane , Brix Lau , Gormsen Lars Christian , Petersen Steffen E , Bøttcher Morten , Winther Simon
Published: June 2023

Aims

Clinical likelihood (CL) models are designed based on a reference of coronary stenosis in patients with suspected obstructive coronary artery disease. However, a reference standard for myocardial perfusion defects (MPDs) could be more appropriate. We aimed to investigate the ability of the 2019 European Society of Cardiology pre-test probability (ESC-PTP), the risk-factor-weighted (RF-CL) model, and coronary artery calcium score-weighted (CACS-CL) model to diagnose MPDs.

Methods and results

Symptomatic stable de novo chest pain patients (n = 3374) underwent coronary computed tomography angiography and subsequent myocardial perfusion imaging by single-photon emission computed tomography, positron emission tomography, or cardiac magnetic resonance. For all modalities, MPD was defined as coronary computed tomography angiography with suspected stenosis and stress-perfusion abnormality in ≥2 segments. The ESC-PTP was calculated based on age, sex, and symptom typicality, and the RF-CL and CACS-CL additionally included a number of risk factors and CACS. In total, 219/3374 (6.5%) patients had an MPD. Both the RF-CL and the CACS-CL classified substantially more patients to low CL (<5%) of obstructive coronary artery disease compared with the ESC-PTP (32.5 and 54.1 vs. 12.0%, P < 0.001) with preserved low prevalences of MPD (<2% for all models). Compared with the ESC-PTP [area under the receiver-operating characteristic curve (AUC) 0.74 (0.71–0.78)], the discrimination of having an MPD was higher for the CACS-CL model [AUC 0.88 (0.86–0.91), P < 0.001], while it was similar for the RF-CL model [AUC 0.73 (0.70–0.76), P = 0.32].

Conclusion

Compared with basic CL models, the RF-CL and CACS-CL models improve down classification of patients to a very low-risk group with a low prevalence of MPD.
Effect of stage shift and immunotherapy treatment on lung cancer survival outcomes
Authors: Patel Parth , Flores Raja , Alpert Naomi , Pyenson Bruce , Taioli Emanuela
Published: June 2023

OBJECTIVES

Non-small-cell lung cancer mortality has declined at a faster rate than incidence due to multiple factors, including changes in smoking behaviour, early detection which shifts diagnosis, and novel therapies. Limited resources require that we quantify the contribution of early detection versus novel therapies in improving lung cancer survival outcomes.

METHODS

Non-small-cell lung cancer patients from the Surveillance, Epidemiology, and End Results-Medicare data were queried and divided into: (i) stage IV diagnosed in 2015 (n = 3774) and (ii) stage I–III diagnosed in 2010–2012 (n = 15 817). Multivariable Cox-proportional hazards models were performed to assess the independent association of immunotherapy or diagnosis at stage I/II versus III with survival.

RESULTS

Patients treated with immunotherapy had significantly better survival than those who did not (HRadj: 0.49, 95% confidence interval: 0.43–0.56), as did those diagnosed at stage I/II versus stage III (HRadj: 0.36, 95% confidence interval: 0.35–0.37). Patients on immunotherapy had a 10.7-month longer survival than those who were not. Stage I/II patients had an average survival benefit of 34 months, compared to stage III. If 25%% of stage IV patients not on immunotherapy received it, there would be a gain of 22 292 person-years survival per 100 000 diagnoses. A switch of only 25% from stage III to stage I/II would correspond to 70 833 person-years survival per 100 000 diagnoses.

CONCLUSIONS

In this cohort study, earlier stage at diagnosis contributed to life expectancy by almost 3 years, while gains from immunotherapy would contribute ½ year of survival. Given the relative affordability of early detection, risk reduction through increased screening should be optimized.
Foxp3 and Bcl6 deficiency synergistically induces spontaneous development of atopic dermatitis-like skin disease
Authors: Tai Yuki , Sakaida Yuki , Kawasaki Riyo , Kanemaru Kaori , Akimoto Kazunori , Brombacher Frank , Ogawa Shuhei , Nakamura Yoshikazu , Harada Yohsuke
Published: June 2023

Atopic dermatitis (AD) is a common chronic skin disease caused by immune dysfunction, specifically the hyperactivation of Th2 immunity. AD is a complex disease with multiple factors contributing to its development; however, the interaction between these factors is not fully understood. In this study, we demonstrated that the conditional deletion of both the forkhead box p3 (Foxp3) and B-cell lymphoma 6 (Bcl6) genes induced the spontaneous development of AD-like skin inflammation with hyperactivation of type 2 immunity, skin barrier dysfunction, and pruritus, which were not induced by the single deletion of each gene. Furthermore, the development of AD-like skin inflammation was largely dependent on IL-4/13 signaling but not on immunoglobulin E (IgE). Interestingly, we found that the loss of Bcl6 alone increased the expression of thymic stromal lymphopoietin (TSLP) and interleukin (IL)-33 in the skin, suggesting that Bcl6 controls Th2 responses by suppressing TSLP and IL-33 expression in epithelial cells. Our results suggest that Foxp3 and Bcl6 cooperatively suppress the pathogenesis of AD. Furthermore, these results revealed an unexpected role of Bcl6 in suppressing Th2 responses in the skin.
Methane emissions and 13C composition from beef steers consuming binary C3–C4 diets
Authors: Jaramillo David M , Ruiz-Moreno Martin , Vendramini Joao M B , Sollenberger Lynn E , DiLorenzo Nicolas , Queiroz Luana M D , Santos Erick R S , Garcia Liza , Abreu Daciele S , Dubeux Jose C B
Published: June 2023

Improvements in forage nutritive value can reduce methane emission intensity in grazing ruminants. This study was designed to evaluate how the legume rhizoma peanut (Arachis glabrata; RP) inclusion into bahiagrass (Paspalum notatum) hay diets would affect intake and CH4 production in beef steers. We also assessed the potential to estimate the proportion of RP contribution to CH4 emissions using δ13C from enteric CH4. Twenty-five Angus-crossbred steers were randomly allocated to one of five treatments (five steers per treatment blocked by bodyweight): 1) 100% bahiagrass hay (0%RP); 2) 25% RP hay + 75% bahiagrass hay (25%RP); 3) 50% RP hay + 50% bahiagrass hay (50%RP); 4) 75% RP hay + 25% bahiagrass hay (75%RP); 5) 100% RP hay (100%RP). The study was laid out using a randomized complete block design, and the statistical model included fixed effect of treatment, and random effect of block. Methane emissions were collected using sulfur hexafluoride (SF6) technique, and apparent total tract digestibility was estimated utilizing indigestible neutral detergent fiber as an internal marker. A two-pool mixing model was used to predict diet source utilizing CH4 δ13C. Inclusion of RP did not affect intake or CH4 production (P > 0.05). Methane production per animal averaged 250 g CH4/d and 33 g CH4/kg dry matter intake, across treatments. The CH4 δ13C were −55.5, −60.3, −63.25, −63.35, and −68.7 for 0%RP, 25%RP, 50%RP, 75%RP, and 100%RP, respectively, falling within the reported ranges for C3 or C4 forage diets. Moreover, there was a quadratic effect (P = 0.04) on the CH4 δ13C, becoming more depleted (e.g., more negative) as the diet proportion of RP hay increased, appearing to plateau at 75%RP. Regression between predicted and observed proportions of RP in bahiagrass hay diets based on δ13C from CH4 indicate δ13C to be useful (Adj. R2 = 0.89) for predicting the contribution of RP in C3–C4 binary diets. Data from this study indicate that, while CH4 production may not always be reduced with legume inclusion into C4 hay diets, the δ13C technique is indeed useful for tracking the effect of dietary sources on CH4 emissions.
Leveraging Society Membership for Career Development
Authors: Destounis Stamatia
Published: June 2023

A breast radiologist who is early in their career will be faced with many opportunities that can be both challenging and rewarding. It is helpful to be aware of the resources available in the breast imaging field. Specialty society membership provides opportunities for personal and professional growth. Connections and relationships can be made with other breast radiologists at differing career stages, presenting opportunities to develop mentor-mentee relationships with experienced members and peer-to-peer relationships with colleagues who may have similar professional experiences. The resources available through society membership can assist in career development and help navigate academic and private practice settings.
Gallic acid: a polyphenolic compound potentiates the therapeutic efficacy of cisplatin in human breast cancer cells
Authors: Shruthi S , Mumbrekar Kamalesh D , Rao B S Satish , Shenoy Bhasker K
Published: June 2023

Gallic acid (GA) is a natural polyhydroxyphenolic compound with antioxidant, antimutagenic, anti-inflammatory, and antineoplastic activities. Cisplatin (CPT) is a platinum-based chemotherapeutic drug, and it is the treatment of choice for breast, ovarian, testicular, head, and neck cancers. However, the use of anticancer drugs has undesirable effects on patients due to associated toxicities. Thus, it is necessary to search for alternatives that reduce unintended side effects and enhance anticancer potential. The use of natural compounds with the conventional chemotherapeutic drug is a new aspect of cancer therapy. In the present study, we evaluated the ability of GA in the modulation of anticancer effects of CPT in human breast adenocarcinoma cells (MCF-7) by performing MTT, apoptosis, clonogenic cell survival, and micronucleus assays. GA and CPT showed significant cytotoxic activities in MCF-7 cells in a dose-dependent manner. In combination therapy (GA 2.5, 5.0, and 10 μg/mL + CPT10 μg/mL), GA synergistically reduced the MCF-7 cell viability in contrast to the individual therapies. Cancer cells death by GA is through the induction of apoptosis as observed in the acridine orange and ethidium bromide dual staining method. The frequency of micronuclei (MN) was decreased significantly (P < 0.001) in combinational therapy, possibly reducing the risk of chemotherapy-induced MN. Moreover, GA in mono or combinational therapy did not induce any cytotoxic effects in normal breast epithelial cells (MCF-10A). GA did not show any significant difference in colony inhibition compared to CPT. This outcome shows its differential effects in normal and cancerous cells. Hence, the combination GA with chemotherapeutic drugs could represent a promising alternative therapy in cancer treatment with minimal side effects.
Sortilin acts as an endocytic receptor for α‐synuclein fibril
Authors: Ishiyama Shun , Hasegawa Takafumi , Sugeno Naoto , Kobayashi Junpei , Yoshida Shun , Miki Yasuo , Wakabayashi Koichi , Fukuda Mitsunori , Kawata Yasushi , Nakamura Takaaki , Sato Kazuki , Ezura Michinori , Kikuchi Akio , Takeda Atsushi , Aoki Masashi
Published: June 2023

Cell‐to‐cell spreading of misfolded α‐synuclein (αSYN) is supposed to play a key role in the pathological progression of Parkinson's disease (PD) and other synucleinopathies. Receptor‐mediated endocytosis has been shown to contributes to the uptake of αSYN in both neuronal and glial cells. To determine the receptor involved in αSYN endocytosis on the cell surface, we performed unbiased, and comprehensive screening using a membrane protein library of the mouse whole brain combined with affinity chromatography and mass spectrometry. The candidate molecules hit in the initial screening were validated by co‐immunoprecipitation using cultured cells; sortilin, a vacuolar protein sorting 10 protein family sorting receptor, exhibited the strongest binding to αSYN fibrils. Notably, the intracellular uptake of fibrillar αSYN was slightly but significantly altered, depending on the expression level of sortilin on the cell surface, and time‐lapse image analyses revealed the concomitant internalization and endosomal sorting of αSYN fibrils and sortilin. Domain deletion in the extracellular portion of sortilin revealed that the ten conserved cysteines (10CC) segment of sortilin was involved in the binding and endocytosis of fibrillar αSYN; importantly, pretreatment with a 10CC domain‐specific antibody significantly hindered αSYN fibril uptake. The presence of sortilin in the core structure of Lewy bodies and glial cytoplasmic inclusions in the brain of synucleinopathy patients was confirmed via immunohistochemistry, and the expression level of sortilin in mesencephalic dopaminergic neurons may be altered with disease progression. These results provide compelling evidence that sortilin acts as an endocytic receptor for pathogenic form of αSYN, and yields important insight for the development of disease‐modifying targets for synucleinopathies.
Innovative Projects: A Unique Approach to Telehealth Education
Authors: Roberto Anka , O’Rourke Jenny , Khairat Saif , Gustin Tina , Rutledge Carolyn
Published: June 2023

During the COVID-19 pandemic, telehealth utilization grew astronomically, encouraging more institutions of higher education to become innovative and proactive in preparing health care providers to deliver high-quality telehealth care. Telehealth can be creatively implemented throughout health care curricula given the appropriate guidance and tools. This article speaks to the development of student telehealth projects as part of the work of a national taskforce funded by the Health Resources and Services Administration and charged with the development of a telehealth toolkit. Proposed telehealth projects allow students to take the lead in their innovative learning and allow faculty to facilitate project-based evidence-based pedagogy.
Surgeon Experience Influences Robotics Learning Curve for Minimally Invasive Lumbar Fusion
Authors: Shahi Pratyush , Subramanian Tejas , Maayan Omri , Korsun Maximilian , Singh Sumedha , Araghi Kasra , Singh Nishtha , Asada Tomoyuki , Tuma Olivia , Vaishnav Avani , Sheha Evan , Dowdell James , Qureshi Sheeraz , Iyer Sravisht
Published: June 2023

Study Design.

Retrospective review of prospectively collected data.

Objective.

To analyze the learning curves of three spine surgeons for robotic minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).

Summary of Background Data.

Although the learning curve for robotic MI-TLIF has been described, the current evidence is of low quality with most studies being single-surgeon series.

Materials and Methods.

Patients who underwent single-level MI-TLIF with three spine surgeons (years in practice: surgeon 1: 4, surgeon 2: 16, and surgeon 3: two) using a floor-mounted robot were included. Outcome measures were operative time, fluoroscopy time, intraoperative complications, screw revision, and patient-reported outcome measures. Each surgeon’s cases were divided into successive groups of 10 patients and compared for differences. Linear regression and cumulative sum (CuSum) analyses were performed to analyze the trend and learning curve, respectively.

Results.

A total of 187 patients were included (surgeon 1: 45, surgeon 2: 122, and surgeon 3: 20). For surgeon 1, CuSum analysis showed a learning curve of 21 cases with the attainment of mastery at case 31. Linear regression plots showed negative slopes for operative and fluoroscopy time. Both learning phase and postlearning phase groups showed significant improvement in patient-reported outcome measures. For surgeon 2, CuSum analysis demonstrated no discernible learning curve. There was no significant difference between successive patient groups in either operative time or fluoroscopy time. For surgeon 3, CuSum analysis demonstrated no discernible learning curve. Even though the difference between successive patient groups was not significant, cases 11 to 20 had an average operative time of 26 minutes less than cases 1–10), suggesting an ongoing learning curve.

Conclusions.

Surgeons who are well-experienced can be expected to have no or minimal learning curve for robotic MI-TLIF. Early attendings are likely to have a learning curve of around 21 cases with the attainment of mastery at case 31. Learning curve does not seem to impact clinical outcomes after surgery.

Level of Evidence.

Level 3.
International Analgesia and Sedation Weaning and Withdrawal Practices in Critically Ill Adults: The Adult Iatrogenic Withdrawal Study in the ICU*
Authors: Bolesta Scott , Burry Lisa , Perreault Marc M. , Gélinas Céline , Smith Kathryn E. , Eadie Rebekah , Carini Federico C. , Saltarelli Katrianna , Mitchell Jennifer , Harpel Jamie , Stewart Ryan , Riker Richard R. , Fraser Gilles L. , Erstad Brian L. ,   on behalf of the AduLt iatrogEnic withdRawal sTudy in the ICU (ALERT-ICU) Study Investigators
Published: June 2023

OBJECTIVES:

Iatrogenic withdrawal syndrome (IWS) associated with opioid and sedative use for medical purposes has a reported high prevalence and associated morbidity. This study aimed to determine the prevalence, utilization, and characteristics of opioid and sedative weaning and IWS policies/protocols in the adult ICU population.

DESIGN:

International, multicenter, observational, point prevalence study.

SETTING:

Adult ICUs.

PATIENTS:

All patients aged 18 years and older in the ICU on the date of data collection who received parenteral opioids or sedatives in the previous 24 hours.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

ICUs selected 1 day for data collection between June 1 and September 30, 2021. Patient demographic data, opioid and sedative medication use, and weaning and IWS assessment data were collected for the previous 24 hours. The primary outcome was the proportion of patients weaned from opioids and sedatives using an institutional policy/protocol on the data collection day. There were 2,402 patients in 229 ICUs from 11 countries screened for opioid and sedative use; 1,506 (63%) patients received parenteral opioids, and/or sedatives in the previous 24 hours. There were 90 (39%) ICUs with a weaning policy/protocol which was used in 176 (12%) patients, and 23 (10%) ICUs with an IWS policy/protocol which was used in 9 (0.6%) patients. The weaning policy/protocol for 47 (52%) ICUs did not define when to initiate weaning, and the policy/protocol for 24 (27%) ICUs did not specify the degree of weaning. A weaning policy/protocol was used in 34% (176/521) and IWS policy/protocol in 9% (9/97) of patients admitted to an ICU with such a policy/protocol. Among 485 patients eligible for weaning policy/protocol utilization based on duration of opioid/sedative use initiation criterion within individual ICU policies/protocols 176 (36%) had it used, and among 54 patients on opioids and/or sedatives ≥ 72 hours, 9 (17%) had an IWS policy/protocol used by the data collection day.

CONCLUSIONS:

This international observational study found that a small proportion of ICUs use policies/protocols for opioid and sedative weaning or IWS, and even when these policies/protocols are in place, they are implemented in a small percentage of patients.
Orthokeratology for Slowing Myopia Progression in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Tang Kai , Si Junkang , Wang Xingrong , Lu Xiuzhen , Bi Hongsheng
Published: June 2023

Objective:

To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) on the effects of orthokeratology for slowing myopia progression in children.

Methods:

We performed a specific search on PubMed, Embase, Cochrane Library, Clinical Trials, CNKI, SinoMed, and Wanfang Data for RCTs conducted up to October 1, 2022. We pooled the weighted mean difference (WMD) between the orthokeratology and control groups for axial length (AL) elongation and the odds ratio (OR) for rates of adverse events and dropout.

Results:

Seven RCTs involving 655 eyes were included. There were significant differences in the effects of orthokeratology versus control in slowing AL elongation with WMD of −0.11 mm (95% confidence interval (CI), −0.13 to −0.08; P<0.01) at 6 months, −0.16 mm (95% CI, −0.18 to −0.13; P<0.01) at 12 months, −0.23 mm (95% CI, −0.29 to −0.18; P<0.01) at 18 months, and −0.28 mm (95% CI, −0.38 to −0.19; P<0.01) at 24 months, respectively. Myopia control rate declined, with 64%, 53%, 50%, and 47% recorded for 6, 12, 18, and 24 months, respectively. There was no statistical significance for adverse events between orthokeratology and control groups (OR=2.63, 95% CI, 0.72–9.61; P=0.11).

Conclusion:

Orthokeratology can effectively slow myopia progression in children, and the efficacy of myopia control decreases with time.
Blood–Brain Barrier Dysfunction and Exposure to Head Impacts in University Football Players
Authors: Jones Casey M. A. , Kamintsky Lyna , Parker Ellen , Kureshi Nelofar , Audas Lorelei , Wilson Lisa , Champagne Allen A. , Boulanger Marie-Michelle , DiStefano Vincent , Fenerty Lynne , Bowen Chris , Beyea Steven , Atkinson Christina , Clarke David B. , Friedman Alon
Published: June 2023

Objective:

To investigate the link between dysfunction of the blood–brain barrier (BBB) and exposure to head impacts in concussed football athletes.

Design:

This was a prospective, observational pilot study.

Setting:

Canadian university football.

Participants:

The study population consisted of 60 university football players, aged 18 to 25. Athletes who sustained a clinically diagnosed concussion over the course of a single football season were invited to undergo an assessment of BBB leakage.

Independent variables:

Head impacts detected using impact-sensing helmets were the measured variables.

Main outcome measures:

Clinical diagnosis of concussion and BBB leakage assessed using dynamic contrast-enhanced MRI (DCE-MRI) within 1 week of concussion were the outcome measures.

Results:

Eight athletes were diagnosed with a concussion throughout the season. These athletes sustained a significantly higher number of head impacts than nonconcussed athletes. Athletes playing in the defensive back position were significantly more likely to sustain a concussion than remain concussion free. Five of the concussed athletes underwent an assessment of BBB leakage. Logistic regression analysis indicated that region-specific BBB leakage in these 5 athletes was best predicted by impacts sustained in all games and practices leading up to the concussion—as opposed to the last preconcussion impact or the impacts sustained during the game when concussion occurred.

Conclusions:

These preliminary findings raise the potential for the hypothesis that repeated exposure to head impacts may contribute to the development of BBB pathology. Further research is needed to validate this hypothesis and to test whether BBB pathology plays a role in the sequela of repeated head trauma.
Modern approaches to treating Zenker's diverticulum
Authors: Fair Lucas , Ward Marc A.
Published: June 2023

Purpose of review

Zenker's diverticulum is the most common hypopharyngeal diverticulum. Patients with Zenker's diverticulum may require surgical treatment, which can be performed via an open surgical or endoscopic approach. A new endoscopic technique that is now being used for Zenker's diverticulum is Zenker Per Oral Endoscopic Myotomy (ZPOEM). ZPOEM has demonstrated promising results, and may have certain advantages over the other endoscopic treatments. The purpose of this review article is to evaluate the various surgical and endoscopic treatment options for Zenker's diverticulum, while specifically focusing on ZPOEM.

Recent findings

Endoscopic approaches have become the first-line therapy for Zenker's diverticulum, replacing the traditional open approach, because of the less invasive nature of the endoscopic procedures, improved rates of morbidity, and quicker recovery times. Recent studies evaluating ZPOEM have demonstrated that it is technically feasible and highly efficacious. In addition, it has a low rate of clinical recurrence and adverse events. When compared with other endoscopic techniques for treating Zenker's diverticulum, ZPOEM appears to have improved outcomes.

ZPOEM has been recently implemented in the algorithm of Zenker's diverticulum management. Further comparative and prospective studies focusing on long-term follow-up are still needed; however, ZPOEM appears to be an excellent option for patients suffering from Zenker's diverticulum.
A Case Report of Mediastinal Teratoma in a Pediatric Patient With Nephrotic Syndrome: Paraneoplastic Syndrome or Incidental Finding?
Authors: Alva Heather L. , Ahn Haejun , Zhao Xixi , Obeidat Mohammad , Charu Vivek , Crane Jacquelyn N. , Marsenic Olivera
Published: June 2023

A 12-year-old female presented with weight gain, edema, and shortness of breath. Laboratory and urine studies confirmed nephrotic syndrome and presence of a mediastinal mass, identified as a mature teratoma after resection. Nephrotic syndrome persisted despite resection and renal biopsy confirmed minimal change disease, which ultimately responded to steroid treatment. She had two relapses of nephrotic syndrome after vaccination administration, both of which occurred within eight months of tumor resection and were responsive to steroids. Autoimmune and infectious workup for other causes of nephrotic syndrome was negative. This is the first reported case of nephrotic syndrome associated with mediastinal teratoma.