bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulation for the test mass charging rate in the Tianqin orbit
Authors: Lei Chi , Su Wei , Hong Wei , Li Honggang , Zhao Menghao , Chen Bingxue , Chu Liangyu , Li Qingqing , Bai Yanzheng , Zhou Zebing
Published: November 2023

For the purpose of detecting gravitational waves from space, high-energy particles will infiltrate the satellite’s structure and accumulate charges on the test mass, consequently diminishing detection performance. Present investigations into the charging rate of the test mass typically rely on the particle distribution of Earth orbit. However, the influence of the Earth’s magnetosphere needs to be considered for the Tianqin detector because of its geocentric orbit. In this paper, artificial neural network is used to fuse satellite data and the galactic cosmic rays model to give the distribution of high-energy particles in the Tianqin orbit. And then, the charging rate is estimated by Monte Carlo simulation. The simulation results show that the flux of hundreds of MeV particles is a little higher than that in Earth orbit, which lead to

3
−
4

 e s−1 higher than LISA, i.e. the charging rate of approximately 43 e s−1 during periods of solar minimum and 19 e s−1 during periods of solar maximum. These findings hold substantial implications for guiding the design of the charge management system.
Anti-reflection metasurface synergizing plasma and lattice modes: an efficient route to wideband electromagnetic transparency under extreme angles
Authors: Li Tiefu , Ma Jiachen , Chu Zuntian , Yan Mingbao , Jiang Jinming , Wang Jiafu , Feng Cunqian , Han Yajuan , Qu Shaobo
Published: November 2023

All-angle wideband electromagnetic (EM) transparency for dual polarizations is desired for many practical applications. Conventionally, surface-mount anti-reflection materials or films are usually used to reduce the reflection and thus enhance transparency. In this paper, we propose to achieve wideband EM transparency under extreme angles for both TE- and TM-polarizations using embedded anti-reflection metasurface. The metasurface is composed of a pair of long and short metallic strips, which can introduce both plasma and lattice modes into the original half-wave wall. The plasma mode can create an angle-stable transmission peak at a lower frequency while the lattice mode renders a transmission peak under extreme angles at a higher frequency due to scattering cancellation between short strips and the substrate. By synergizing the plasma, half-wave, and lattice modes consecutively, wide-band transparency can be achieved under extreme angles for TE polarization. Due to the anisotropy of the metasurface, wideband transparency under TM-polarization is maintained. This finally enables us to obtain wideband EM transparency for dual polarizations under extreme angles. More importantly, the metasurface can also be customized to operate best under any given incident angle. Prototypes were designed, fabricated, and measured. Both the simulation and experiment results verify our method. This work provides an efficient route to wideband EM transparency under extreme angles and may find wide applications in communication, radar, and others.
Deep particle diffusometry: convolutional neural networks for particle diffusometry in the presence of flow and thermal gradients
Authors: Sardana Pranshul , Wereley Steven T
Published: November 2023

Diffusion coefficient measurement is a helpful tool in revealing various properties of a fluid such as viscosity and temperature. However, determining the diffusion coefficient often requires specialized equipment. Particle-based techniques allow the use of conventional cameras to determine flow properties without any specialized measurement devices. However, the performance of existing methods such as single-particle and correlation-based measurements degrade drastically in the presence of real-world scenarios such as flow and thermal gradients. This work introduces a new method of estimating diffusion coefficient in the presence of flow and thermal gradients named deep particle diffusometry (DPD). The technique uses temporally averaged particle images as inputs and uses convolutional neural networks to predict the underlying diffusion coefficient. The results show that a high fit coefficient R
2 value of 0.99 was achieved with no or known fluid flow conditions and an R
2 value of 0.95 was achieved if the fluid had an arbitrary flow. Next, the generalization ability of the network was shown by training the DPD models on no gradient datasets and testing on datasets with a diffusion coefficient gradient. The networks maintained comparably high R
2 values of 0.96. Next, the DPD models were tested against three conventional methods on various simulated datasets, showing their superior performance in situations where an arbitrary flow was present along with diffusion. Finally, the networks were tested on experimental data and the predictions were compared with conventional methods which resulted in R2 values of 0.97 under the no-flow condition. The results show that the proposed method provides performance similar to existing methods on datasets with no flow or with a known flow and can surpass their performance on datasets that have an arbitrary flow.
Time-resolved electrostatic force microscopy under base-bias-level control
Authors: Sato Jo , Ishibashi Ryota , Takahashi Takuji
Published: November 2023

We propose a base-bias-level control method, in which the contact potential difference is always compensated in a similar way to Kelvin probe force microscopy, applicable to time-resolved electrostatic force microscopy using the pump–probe method. We experimentally acquired temporal waveforms of the electrostatic force signal on two SiO2/n-type Si samples, one of which was as-grown and the other was treated by forming gas annealing. Consequently, the effectiveness of the proposed method was confirmed.
Embedded measurement of process monitoring in melt-cast explosive based on distributed optical fiber sensing and numerical verification
Authors: Deng Pengfei , Sun Jie , Guo Penglin , Fu Tao
Published: November 2023

The solidification sequence during the solidification of fusion-cast explosives is an important parameter for the optimization of the manufacturing process, which can be analyzed by using numerical simulation experiments. However, the numerical simulations are not totally reliable due to the inherent errors in the algorithms and parameters. To address this issue, a measurement method is proposed to monitor the solidification process based on the embedded method of distributed fiber optic sensing. And a method is developed to identify the solid–liquid phase change interface region, which can be effectively demodulated and analyzed for sensing data. The experimental results were verified by using numerical simulations based on casting simulation software and compared. It can be found that the total solidification time and pattern of both are relatively consistent. However, some of the solidification characteristics in the numerical simulation are lack of precision due to the inaccuracy of the heat transfer parameters.
Experimental study on acoustic signal characteristic analysis and time delay estimation of pipeline leakage in boilers
Authors: Luo Pei , Yang Wenkai , Sun Mingyang , Shen Guoqing , Zhang Shiping
Published: November 2023

Acoustic signal detection technology has significant advantages in detecting the leakage and bursting of heat exchange pipes in boilers. To address the current lack of sound signal data for steam medium leakages and the problem of large errors in the complex sound field environment of power plants, we performed an innovative experimental comparative analysis of leakage acoustic signals under a dual medium of compressed air and steam to provide a reference for detecting leakage acoustic signals. During the experiment, the time and frequency domains were analyzed by changing the pressure of the leakage pipeline and aperture of the leakage hole, and the spectrogram and power spectrum of the leakage acoustic signal were obtained using fast Fourier transform and autocorrelation analysis. The results showed that the signal value of the leakage medium increased with increasing pipeline pressure and leakage aperture and that the energy of the steam leakage acoustic signal was greater than that of compressed air under the same pressure and aperture because of its larger specific heat capacity. In addition, the complete empirical mode decomposition of adaptive noise (CEEMDAN) algorithm was introduced into the denoising decomposition of the leakage sound signal in the furnace, and the average error of the time delay value of the leakage acoustic signal calculated using the CEEMDAN algorithm was observed to be within 5%.
Is muscle localized phase angle an indicator of muscle power and strength in young women?
Authors: Oliveira Núbia Maria , Fukuoka Aryanne Hydeko , Matias Catarina Nunes , Guerra-Júnior Gil , Gonçalves Ezequiel Moreira
Published: November 2023

Objective. This study aimed to investigate the capacity of the bioelectrical muscle localized phase angle (ML-PhA) as an indicator of muscle power and strength compared to whole body PhA (WB-PhA). Approach. This study assessed 30 young women (22.1 ± 3.2 years) for muscle power and strength using the Wingate test and isokinetic dynamometer, respectively. Bioimpedance analysis at 50 kHz was employed to assess WB-PhA and ML-PhA. Lean soft tissue (LST) and fat mass (FM) were quantified using dual x-ray absorptiometry. Performance values were stratified into tertiles for comparisons. Regression and mediation analysis were used to test WB-PhA and ML-PhA as performance predictors. Main results. Women in the second tertile of maximum muscle power demonstrated higher ML-PhA values than those in first tertile (13.6° ± 1.5° versus 11.5° ± 1.5°, p = 0.031). WB-PhA was a predictor of maximum muscle power even after adjusting for LST and FM (β = 0.40, p = 0.039). ML-PhA alone predicted average muscle power (β = 0.47, p = 0.008). FM percentage was negatively related to ML-PhA and average muscle power, and it mediated their relationship (b = 0.14; bias-corrected and accelerated 95% confidence interval: 0.007–0.269). Significance. PhA values among tertiles demonstrated no differences and no correlation for strength variables. The results revealed that both WB and ML-PhA may be markers of muscle power in active young women.
Cross-subject emotion recognition using hierarchical feature optimization and support vector machine with multi-kernel collaboration
Authors: Pan Lizheng , Tang Ziqin , Wang Shunchao , Song Aiguo
Published: November 2023

Objective. Due to individual differences, it is greatly challenging to realize the multiple types of emotion identification across subjects. Approach. In this research, a hierarchical feature optimization method is proposed in order to represent emotional states effectively based on peripheral physiological signals. Firstly, sparse learning combined with binary search is employed to achieve feature selection of single signals. Then an improved fast correlation-based filter is proposed to implement fusion optimization of multi-channel signal features. Aiming at overcoming the limitations of the support vector machine (SVM), which uses a single kernel function to make decisions, the multi-kernel function collaboration strategy is proposed to improve the classification performance of SVM. Main results. The effectiveness of the proposed method is verified on the DEAP dataset. Experimental results show that the proposed method presents a competitive performance for four cross-subject  types of emotion identification with an accuracy of 84% (group 1) and 85.07% (group 2). Significance. The proposed model with hierarchical feature optimization and SVM with multi-kernel function collaboration demonstrates superior emotion recognition accuracy compared to state-of-the-art techniques. In addition, the analysis based on DEAP dataset composition characteristics presents a novel perspective to explore the emotion recognition issue more objectively and comprehensively.
Availability and reactivity of N2(v) for NH3 synthesis by plasma catalysis
Authors: Bayer Brian N , Raskar Sai , Adamovich Igor V , Bruggeman Peter J , Bhan Aditya
Published: November 2023

Production of vibrationally excited N2 (N2(v)) in atmospheric pressure nonthermal plasma and loss of N2(v) by gas-phase reactions and reactions on catalytic surfaces are analyzed to examine the role of N2(v) in NH3 formation by plasma catalysis. Vibrational state-to-state kinetic models complemented with molecular beam mass spectrometry (MBMS) measurements demonstrate that N2(v> 0) is produced with densities 100× greater than the density of N radicals by a radiofrequency atmospheric pressure plasma jet. The experimentally measured loss of N2(v) corresponds with a state-to-state kinetic model that describes loss of N2(v) by surface-mediated vibrational relaxation without consideration of reactions that convert N2(v) to NH3 over the catalyst surface. Rate constants for vibrational relaxation of N2(v) on catalyst surfaces exceed upper bounds on proposed rate constants for NH3 formation reactions from N2(v) over Fe when v < 9, Ni when v < 18, and Ag when v < 39, which indicates that only higher vibrational levels can possibly contribute to catalytic NH3 formation faster than they undergo vibrational relaxation on the surface. Densities of N2(v> 8), vibrational levels that can possibly react over Fe to form NH3 faster than they undergo vibrational relaxation, are less than or similar to N densities at the inlet of the catalyst bed and measured NH3 formation for the investigated conditions in this work, while densities of N2(v> 17) and N2(v> 38) are orders of magnitude below the N density at the inlet of the catalyst bed and the measured NH3 formation. The loss of N2(v) by vibrational relaxation on the surface limits the ability of N2(v) to contribute to catalytic NH3 formation and explains why N2(v) does not produce NH3 in quantities that are comparable to NH3 formation from N even though N2(v > 0) is more abundantly produced by the plasma.
Advancements in wearable ammonia sensors using polypyrrole/MWCNT coated yarn
Authors: Maity Debasis , Rajendra Kumar Ramasamy Thangavelu
Published: November 2023

In this study, we utilized a dip coating method to modify insulating yarn with polypyrrole and multiwall carbon nanotubes (MWCNTs) to convert it into a conductive yarn. The resulting fabricated conducting yarn underwent thorough characterization through scanning electron microscope, x-ray diffraction pattern, and thermal gravimetric analysis. Subsequently, we examined the ammonia sensing properties of the modified yarn at various stages of its development. Our findings revealed that the combination of MWCNTs followed by polypyrrole modification significantly enhanced the ammonia sensing capabilities compared to using MWCNTs or polypyrrole-coated yarn individually. Specifically, the MWCNTs followed by polypyrrole modified yarn demonstrated an excellent sensing response, remarkable repeatability (up to 24 continuous cycles), quick response time (11 ± 2 s), and recovery time (34 ± 5 s). Additionally, the sensor exhibited good linearity in detecting ammonia vapor concentrations within the range of 20–100 ppm. We also assessed the sensor’s performance with diverse vapors at room temperature, revealing its high selectivity for ammonia. Furthermore, the sensor’s response correlated linearly with yarn length. Remarkably, it demonstrated minimal sensitivity to humidity and exceptional stability over fifty days. These results have the potential to lead to the development of wearable room temperature ammonia sensors, suitable for use in agricultural and industrial chemistry, as well as in environmental, automotive, and medical applications.
Screening significant properties of macro-fiber composite laminate substrate anisotropy with viscoelastic and thermal considerations at the quasi-static level
Authors: Tran Brandon , Ifju Peter G
Published: November 2023

A macro-fiber composite (MFC) is a class of smart material actuator that employs piezoceramic fibers to extend or contract under an applied electric field. When embedded on a thin substrate, actuated MFCs induce surface pressure, resulting in out-of-plane motion. Design characteristics of the substrate, such as anisotropy, give rise to unique bend/twist behavior. Previous studies on MFC applications have focused on optimizing patch location in relation to the local design to achieve optimal bend/twist motion. However, the resolution to these approaches is restricted to the design space of the application, presenting an absence in piezoelectric laminate design intuition. This research aims to streamline the initial optimization process by analyzing the significant material properties associated with substrate design. To accomplish this, a viscoelastic piezoelectric plate theory model is developed to accurately capture the displacement behavior of the MFC laminate for any given substrate design. Experimental data is used to validate and refine the model, ensuring it closely represents real-world physics. A 2k fractional factorial design of experiments approach is used to identify significant substrate properties per MFC laminate configuration, assigning each material property a two-level coding system. Three configurations are observed, with each exhibiting distinct significant properties and effects compared to others. Furthermore, the study explores the impact of thermal factors on substrate behavior for these MFC laminates, highlighting how significant properties can be temperature dependent. The contributions to the kinematic response due to substrate property perturbation varies uniquely per material property and MFC laminate configuration. Statistical evidence supports the notion that the hysteretic behavior of a material is unaffected by thermal influences and is solely determined by the elastic constants of the substrate. The maximum remanent hysteretic response is shown to be proportional to the maximum actuation response at near room temperature.
Multi-taper-based automatic correction of non-anechoic antenna measurements
Authors: Dzwonkowski Mariusz , Waladi Vorya , Bekasiewicz Adrian
Published: November 2023

Prototype measurements belong to the key steps in the development of antenna structures. Although accurate validation of their far-field performance can be realized in dedicated facilities, such as anechoic chambers, the high cost of their construction and maintenance might not be justified if the main goal of measurements is to support teaching or low-budget research. Instead, they can be performed in non-anechoic conditions and then refined using appropriate correction algorithms. Unfortunately, the existing post-processing methods suffer from multiple challenges that include manual setup of parameters as well as validation of performance in idealized conditions. In this communication, a multi-taper-based framework for correction of antenna characteristics obtained in non-anechoic environments has been proposed. The algorithm augments one-shot measurements of the structure under test in order to extract the line-of-sight responses while attenuating the interferences pertinent to multi-path propagation and noise from external sources of radiation. The performance of the proposed correction routine has been demonstrated in two test sites using a geometrically small Vivaldi radiator and validated against state-of-the-art techniques from the literature. The uncertainty budget for the measurements performed using the approach amounts to 0.26 dB, which is low given challenging propagation conditions considered for experiments.
Pupil-linked arousal correlates with neural activity prior to sensorimotor decisions
Authors: Koorathota Sharath , Ma Jia Li , Faller Josef , Hong Linbi , Lapborisuth Pawan , Sajda Paul
Published: November 2023

Objective. Sensorimotor decisions require the brain to process external information and combine it with relevant knowledge prior to actions. In this study, we explore the neural predictors of motor actions in a novel, realistic driving task designed to study decisions while driving. Approach. Through a spatiospectral assessment of functional connectivity during the premotor period, we identified the organization of visual cortex regions of interest into a distinct scene processing network. Additionally, we identified a motor action selection network characterized by coherence between the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC). Main results. We show that steering behavior can be predicted from oscillatory power in the visual cortex, DLPFC, and ACC. Power during the premotor periods (specific to the theta and beta bands) correlates with pupil-linked arousal and saccade duration. Significance. We interpret our findings in the context of network-level correlations with saccade-related behavior and show that the DLPFC is a key node in arousal circuitry and in sensorimotor decisions.
Giant cell tumor of the clivus misdiagnosed as calcifying fibrous tumor
Authors: Lack M , Usman A , Hamza A , Meyer A R , Stevens T
Published: November 2023

Introduction/Objective

Giant cell tumors of bone (GCTs) are generally benign, locally aggressive lesions accounting for approximately 4% of primary bone tumors. GCTs of the skull are rare and constitute <1% of all reported GCTs as they typically occur in the epiphysis of long bones. Specifically, in the clivus location, these tumors are exceedingly rare with fewer than 10 articles in English literature. The purpose of this report is to describe a case of GCT in this unusual location that was misdiagnosed as giant cell reparative granuloma on biopsy and subsequently calcifying fibrous tumor on resection.

Methods/Case Report

A 34-year-old male presented with history of headache, visual disturbance, epistaxis, and nausea. MRI demonstrated a large soft tissue mass eroding the clivus. A biopsy was interpreted at an outside institution as giant cell reparative granuloma. The patient was treated with denosumab and subsequently underwent resection of the mass due to worsening symptoms. Post-treatment pathology was interpreted as calcifying fibrous tumor. The patient presented to our institution for further management and outside pathology was reviewed.

Histologically, the initial tumor was composed of a bland spindle cell proliferation with admixed osteoclast-type giant cells. In this location, the differential diagnosis includes Brown tumor, giant cell reparative granuloma, and, rarely, GCT. HG34W immunostain was positive in the tumor cells confirming the diagnosis of GCT. The post-therapy specimen showed abundant woven bone formation and a lack of giant cells. Post-denosumab GCT are known to show these features. Follow up imaging showed a slow growing moderately enhancing mass at the resection site. Patient is alive with disease 36 months after initial diagnosis.

Results (if a Case Study enter NA)

NA

Conclusion

With rare exceptions, bone tumors frequently follow generalized patterns of involvement. Pathologists need to be aware of these exceptions. Appropriate panel of immunohistochemical stains help clinching the right diagnosis, especially in unusual clinical settings.
Impact of HER2 assay sensitivity on the ability to detect tumors with low to ultra-low HER2 expression: A TMA study on more than 10,000 tumors from more than 100 tumor entities
Authors: Lennartz M , Blessin N C , Dum D , Höflmayer D , Weidemann S , Sauter G , Clauditz T S , Simon R , Steurer S , Burandt E , Marx A H
Published: November 2023

Introduction/Objective

Detection of low level HER2 expression is important for therapy with new HER2 inhibitors in breast cancer. HER2 assays with high sensitivity are therefore needed. These may identify low level HER2 expression in various types other than breast cancer.

Methods/Case Report

A tissue microarray containing >10,000 tissue samples from more than 100 different tumor types and subtypes was analyzed for immunohistochemical expression of HER2 using different immunohistochemistry protocols and anti-HER2 antibodies, including the HercepTest and laboratory developed tests designed for high sensitivity. HER2 IHC evaluation included the recording of HER2 low (1+), ultralow (any staining, less than 1+), and 0 (negative).

Results (if a Case Study enter NA)

Irrespective of the assay sensitivity all assays showed the expected/tolerable association with HER2 FISH data in 308 breast cancers. In non-breast cancers, the use of different assays yielded variable rates of low or ultra-low HER2 expression in different tumor entities. For example, low (1+) and ultra-low (+) expression was observed in 7-24% (1+) and 11-28% (+) of serous ovarian cancers, 6.2-24% (1+) and 3.4-19% (+) of endometrioid endometrial cancers, 5.5-14% (1+) and 7.7-13% (+) of intestinal gastric cancers, 1.8-9.2% (1+) and 4.5- 11% (+) of ductal adenocarcinomas of the pancreas, 19-33% (1+) and 5.5-11% (+) of muscle invasive urinary bladder cancers, 2.9-16% (1+) and 4.3-12% (+) of adenocarcinomas of the colon.

Conclusion

Low level HER2 expression occurs commonly in many cancer types. The rate of identifiable tumors with HER2 low or HER2 ultra-low expression varies depending on assay parameters that can easily be modified.

Irrespective of assay sensitivity, our data identify various tumor entities with significant fractions of “HER2-low” cases that might benefit from therapy with new antibody drug conjugates.
Interpace, Affirma, and Thyroseq Performance Characteristics in 341 Bethesda Category III/IV Thyroid Nodules
Authors: Connelly C F , Cimic A , Baskota S
Published: November 2023

Introduction/Objective

Multiple FDA-approved molecular testing platforms are used by our institution for evaluating genomic characteristics of thyroid nodules. We aim to correlate molecular results and final histopathology (HPE) of thyroid nodules with cytologic diagnosis of The Bethesda System (TBS) Category III or IV.

Methods/Case Report

We included 341 cases of thyroid nodules diagnosed as TBS-III or TBS-IV with subsequent molecular analysis performed on 1 of 5 platforms (Interpace ThyraMIR Thyroid miRNA Classifier, Afirma Genomic Sequencing Classifier, Thyroseq Genomic Classifier, Next-Generation Sequencing (NGS) Fusion Panel, or RosettaGX Reveal Thyroid miRNA Classifier). All findings reported on molecular analysis and all benign or malignant neoplasms diagnosed on final HPE were considered “significant findings.” Performance characteristics of all 5 molecular platforms were analyzed.

Results (if a Case Study enter NA)

Of 341 cases, 80.1% (n=273) were classified as TBS-III and 19.9% (n=68) were classified as TBS-IV. The overall concordance of molecular and final HPE when available was 60.9% (n=28).

Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) are respectively 75.0%, 60.0%, 75.0%, and 60.0% for Interpace; 65.0%, 60.0%, 85.0%, and 33.0% for Afirma; and 75.0%, 50.0%, 75.0%, and 50.0% for Thyroseq platforms.

Of TBS-III cases, 66.3% (n=181), 25.6% (n=70), 4.8% (n=13), 1.5% (n=4), and 1.8% (n=5) underwent molecular testing via Interpace, Afirma, Thyroseq, NGS, and Rosetta platforms, respectively. Only 9.2% (n=25) of TBS-III cases had subsequent HPE. Concordance of molecular and final HPE for TBS-III cases was 52.0% (n=13) with a PPV of 75.0% and NPV of 40.0%. Concordances of molecular and final HPE according to molecular platform are: 57.1% (n=4) on Interpace, 53.3% (n=8) on Afirma, and 50.0% (n=1) on Thyroseq.

Of TBS-IV cases, 52.9% (n=36), 36.8% (n=25), 5.9% (n=4), 2.9% (n=2), and 1.5% (n=1) underwent molecular testing via Interpace, Afirma, Thyroseq, NGS, and Rosetta platforms, respectively. Only 30.9% (n=21) of TBS-IV cases had subsequent HPE. Concordance of molecular and final HPE for TBS-IV cases was 71.4% (n=15) with a PPV of 86.0% and NPV of 43.0% Concordances of molecular and final HPE according to molecular platform are: 71.4% (n=5), 66.7% (n=6), and 75.0% (n=3) on Interpace, Afirma, and Thyroseq respectively.

Conclusion

Our study reports similar performance characteristics of 3 commonly used molecular platforms (Interpace, Afirma, and Thyroseq) for genomic evaluation of thyroid nodules.
Diffusely Invasive Mucormycosis of the Small Bowel in a Patient with Microbiologic Cultures and Tissue Biopsies Negative for Fungal Organisms
Authors: Chiu R , Lee J , Salahi W
Published: November 2023

Introduction/Objective

Invasive mucormycosis can be a swiftly fatal medical emergency occurring in patients with uncontrolled diabetes. This angioinvasive fungus causes tissue necrosis, hemorrhage, and thrombosis and often develops in the sinonasal cavities where it can extend directly to the CNS or spread systemically to visceral sites like the GI tract. Here, we describe a patient whose small bowel resection shortly before death, revealed diffusely invasive mucormycosis despite that blood and body fluid cultures and tissue biopsies were negative for fungal organisms.

Methods/Case Report

Our patient is a 39 year old male with a history of uncontrolled diabetes, brought to our hospital in cardiac arrest and found to have fentanyl in his system. His labs showed severe metabolic and electrolyte derangements including diabetic ketoacidosis. His blood cultures revealed bacteremia but no fungal growth, and he was placed on antibiotics for sepsis. The patient developed compartment syndrome of his bilateral forearms, which were amputated and showed necrotic skeletal muscle but no fungal infection. The patient also developed facial necrosis concerning for mucormycosis, but nasal endoscopic and facial skin biopsies were negative for mucor.

However, his abdominal CT showed diffuse mural thickening of his small bowel concerning for bowel ischemia, which prompted an exploratory laparotomy that revealed large segments of necrotic jejunum and ileum. While peritoneal fluids collected during the surgery yielded no fungal growth on culture, resected segments of necrotic small bowel showed massive presence of mucor with broad, pauci-septate, ribbon-like hyphae branching at right angles. Small bowel and mesenteric vessels showed angioinvasion by mucor with vasculitis and fibrin thrombi causing ischemic enteritis. Mucor was also noted diffusely invading small bowel muscularis propria, adventitia, and mesenteric fat, and small bowel also showed ulceration, hemorrhage, and transmural and mesenteric fat necrosis. Unfortunately, a few days after his surgery, the patient expired from multi-organ failure and septic shock before he could receive anti-fungal therapy for mucormycosis.

Results (if a Case Study enter NA)

NA

Conclusion

Mucormycosis is a rapidly growing, angioinvasive, and potentially lethal fungal infection that must be promptly recognized. This report documents an unusual case of invasive mucormycosis of the small bowel that went undetected in a severely ill patient whose blood and peritoneal cultures and tissue biopsies were all negative for fungal organisms.
Intraepithelial CD8+ cytotoxic T-cells are the main component of the immune tumor microenvironment that drive prognosis in muscle-invasive bladder cancer
Authors: Debatin N F , Bady E , Mandelkow T , Sauter G , Blessin N C , Samtleben H , Horst D , Marx A H , Fisch M , Slojewski M , Ecke T , Koch S , Zecha H , Schlomm T , Adamini N
Published: November 2023

Introduction/Objective

Quantity and the spatial relationship of individual immune cell (sub)types can provide prognostic information in muscle-invasive bladder cancer.

Methods/Case Report

To study the prognostic role of different immune cell subpopulations in muscle-invasive bladder cancer, we stained 521 muscle-invasive urothelial bladder carcinomas with 21 antibodies using BLEACH&STAIN multiplex fluorescence immunohistochemistry (mfIHC) in a tissue microarray format. A framework of neuronal networks was trained and used for image analysis.

Results (if a Case Study enter NA)

The identification of more than 300 different immune cell subpopulations and the characterization of their spatial relationship resulted in numerous spatial interaction patterns. 40 immune parameters

showed prognostic significance in univariate analyses of which 15 were independent from pT, pN, and histologic grade. The strongest association to clinical outcome was identified for intraepithelial CD8+cytotoxic T-cells (tAUC:

0.70) compared to all other 15 independent prognosis parameters (AUC: ≤0.68, p=0.039). Deeper spatial analysis revealed an increased expression levels of TIM3, CTLA-4 and PD-1 on CD8+ T cells that were located in the intraepithelial compartment. Furthermore, the cell-to-cell interaction profile of intraepithelial CD8+ T-cells was dominated by intraepithelial dendritic cells as well as intraepithelial M1-macrophages.

Conclusion

The intraepithelial CD8+T-cells that showed the highest expression level of TIM-3, PD-1 and CTLA-4 and were strongly interacting with M1-macrophages as well as dendritic cells and represented the strongest prognostic parameter in muscle-invasive bladder cancer. This can be explained by the fact that tumor cell destruction by CD8+ cytotoxic T-lymphocytes through direct cell-to-cell-contacts represents the “terminal-end-route” of anti-tumor immunity. The strongest prognostic immune-factor – intraepithelial CD8+T-cells – can be measured straightaway in routine pathology as the CD8-labelling index using conventional bright field immunohistochemistry.
Neurovascular Structure-adjacent Frozen-section Examination (NeuroSAFE) increases Nerve-sparing Frequency and reduces Positive Surgical Margins in open and Robot-assisted Laparoscopic Radical Prostatectomy: Experience After 486 Consecutive Patients
Authors: Soeder S J , Kaltenhaeuser S , Fuhrich N , Marx A H , Rossner L M , Jeziorowski A , Blana A , Samtleben H
Published: November 2023

Introduction/Objective: Introduction

Intraoperative frozen-section analysis allows real-time histologic assessment of surgical margins (SMs) and identification of candidates for nerve-sparing (NS) procedures in radical prostatectomy (RP).

Objective: To examine the efficacy of a systematic neurovascular structure-adjacent frozen-section examination (NeuroSAFE) during open and robotic assisted radical prostatectomy (RARP).

Methods/Case Report

From January 2019 to December 2020, 486 consecutive RPs were performed at the academic hospital Fuerth. Of these, 289 (59 %) were conducted with NeuroSAFE.

Surgical procedure: NeuroSAFE included the whole laterorectal circumference of the prostate corresponding to the neurovascular bundle to determine the SM status.

Outcome measurements and statistical analysis: The impact of NeuroSAFE on NS frequency and SM status was analyzed by chi-square test in matched cohorts. Data obtained from 289 RPs performed with NeuroSAFE were compaired to those from 197 RP without NeuroSAFE.

Results (if a Case Study enter NA)

In NeuroSAFE RPs, frequency of NS was significantly higher in lower pT stages (pT2 and pT3a: 78 % vs 68%, 58% vs 51%, p < 0.0001, p = 0.047, respectively), whereas in stage ≥ pT3b, there was no significant difference in NS rate (53% vs 34%; p = 0.14). PSM rates were significantly lower only in pT2 tumors (all stages: 35% vs 24%, p=0.06; pT2: 12% vs 15%; p=0.02; pT3a: 36% vs 35%; p=0.6 and ≥pT3b: 39% vs 52%, p=0.3) compared with the matched non-NeuroSAFE RPs. Positive SMs (PSMs) were leading to a secondary resection of the ipsilateral neurovascular tissue. Secondary wide resection resulted in conversion to a definitive negative SM (NSM) status in 85 % of the patients.

Conclusion

NeuroSAFE enables real-time histologic monitoring and oncologic safety of a NS procedure. Systematic NeuroSAFE significantly increases NS frequencies and reduces PSMs in stage pT2 tumors. Patients with a NeuroSAFE-detected PSM could be converted to a prognostically more favorable NSM status by secondary wide resection.
Therapy-Related Acute Myeloid Leukemia After Chemotherapy For Osteosarcoma: Report of 2 Cases and Review of The Literature
Authors: Hwang C , Medeiros D , Kyono W , Thompson K
Published: November 2023

Introduction/Objective

Therapy-related acute myeloid leukemia (t-AML) and myelodysplastic syndrome (t-MDS) are rare but well-established late complications of chemotherapeutic agents or radiation therapy used to treat various malignancies. Many cases of t-AML/t-MDS have been described secondary to Hodgkin, non-Hodgkin lymphoma, and other solid tumors. However, only a few cases of t-AML and t-MDS have been reported following osteosarcoma treatment. We describe two patients diagnosed with osteosarcoma who developed t-AML after receiving multiple chemotherapeutic agents.

Methods/Case Report

A 12-year-old male with Li-Fraumeni syndrome was diagnosed with osteosarcoma of the left ilium and sacrum with pulmonary metastases. Despite multiple lines of chemoradiation therapy including doxorubicin and ifosfamide, tumor progressed at the primary tumor site. The patient subsequently presented with altered mental status and pancytopenia. Bone marrow biopsy demonstrated AML. He died despite supportive care.

A 14-year-old female was diagnosed with left tibial osteosarcoma with bony and pulmonary metastases. She was treated on standard osteosarcoma chemotherapy including doxorubicin, cisplatin, methotrexate, ifosfamide and etoposide, surgery, and radiation. 1 year following therapy, she had local recurrence of osteosarcoma without progression despite not starting chemotherapy. However, 3 years later, she developed pancytopenia, and immature white blood cells were identified on peripheral smear. Bone marrow biopsy revealed AML-M7. Despite supportive care and zoledronic acid, she ultimately died from sepsis and disseminated intravascular coagulation.

Results (if a Case Study enter NA)

NA

Conclusion

With improved therapy and survival for osteosarcoma patients, these patients should be monitored for secondary malignancies. T-AML is rare following osteosarcoma treatment, but outcome remains poor, despite treatment. Underlying Li-Fraumeni syndrome may influence the risk of development of secondary malignant neoplasms. Literature review of types and prognosis of t-AML following osteosarcoma will be reviewed and compared to our cases, including related genetic predisposing factors and chemotherapeutic agents. Our second patient is the first reported case of AML-M7 secondary to osteosarcoma treatment.
Benign High Prevalence Antibody Yta
Authors: Ngo N , Abdelmonem M , Cabungan M , Cai W , Virk M S , Chang S , Papakonstantino K , Jurado C , Shan H , Yunce M
Published: November 2023

Introduction/Objective

The Yt system, also known as the Cartwright system, discovered in 1964, consists of five antigens encoded by the ACHE gene on chromosome 7. Yta and Ytb are antithetical antigens on the GPI – linked red cell glycoprotein, acetylcholinesterase (AChE). About 8-10% of individuals of European ancestry are Yt(b+); Yta is highly prevalent in all populations. The other three high-prevalence antigens, YTEG, YTLI, and YTOT, were added to this system in 2018. Yta is not affected by trypsin but is destroyed by α-chymotrypsin treatment of reagent red cells. Yta and Ytb are sensitive to disulfide bond-reducing agents 2-aminoethylisothiouronium bromide (AET) and dithiothreitol (DTT). Yt antibodies are mostly IgG and require Indirect Antiglobulin Test (IAT) for detection. Yt antibodies are not clinically significant, although anti-Yta may cause accelerated destruction of Yt(a+) transfused red cells. Monocyte Monolayer Assay (MMA) is often used to determine whether the anti-Yta is predicted to cause destruction of transfused Yt(a+) red cells.

Methods/Case Report

A 50 year old female of Hispanic/Latino descent with a BRCA2 mutationand a history of scoliosis and severe migraineswas admitted for robotic-assisted bilateral salpingo-oophorectomy, cystoscopy, and dilation and curettage. A type and screen was ordered preoperatively, and her antibody screen was positive. In her profile, the origin of anti-Yta was identified from an outside facility since 2008, but written documentation of anti-Yta identification could not be located. On antibody identification, the patient’s plasma was reactive with all cells (1+ AHG in PEG) except the auto control. Rare frozen anti-Yta antisera were used for phenotyping the patient for Yta and she was found to be Yta negative. Yta antigens are sensitive or weakened by DTT, so DTT-treated panel screen cells were used to rule out all clinically significant alloantibodies except for the Kell system. Anti-K and anti-k were ruled out by testing the patient’s plasma against SCARF (Serum, Cells, and Rare Fluid Exchange) Yta negative with homozygous K positive and homozygous k positive cells. Anti-Yta was reconfirmed at our facility.

Results (if a Case Study enter NA)

NA

Conclusion

Yta-negative blood is so rare that anti-Yta reacts > 99.8% of most populations. In some cases, autologous transfusion may be recommended for a patient. However, anti-Yta is often benign, and antigen-negative blood may not need to be transfused. The patient had uncomplicated procedures, and blood transfusion was not indicated at that time.
Radiofrequency thalamotomy for tremor produces focused and predictable lesions shown on magnetic resonance images
Authors: Ishihara Bryony K , Hart Michael G , Barrick Thomas R , Howe Franklyn A , Morgante Francesca , Pereira Erlick A
Published: December 2023

Radiofrequency thalamotomy is a neurosurgical management option for medically-refractory tremor. In this observational study, we evaluate the MRI features of the resultant lesion, their temporal dynamics, and how they vary depending on surgical factors. We report on lesion characteristics including size and location, as well as how these vary over time and across different MRI sequences. Data from 12 patients (2 essential tremor, 10 Parkinson’s disease) who underwent unilateral radiofrequency thalamotomy for tremor were analysed. Lesion characteristics were compared across five structural sequences. Volumetric analysis of lesion features was performed at early (<5 weeks) and late (>5 months) timepoints by manual segmentation. Lesion location was determined after registration of lesions to standard space. All patients showed tremor improvement (clinical global impressions scale) postoperatively. Chronic side-effects included balance disturbances (n = 4) and worsening mobility due to parkinsonism progression (n = 1). Early lesion features including a necrotic core, cytotoxic oedema and perilesional oedema were best demarcated on T2-weighted sequences. Multiple lesions were associated with greater cytotoxic oedema compared with single lesions (T2-weighted mean volume: 537 ± 112 mm³ versus 302 ± 146 mm³, P = 0.028). Total lesion volume reduced on average by 90% between the early and late scans (T2-weighted mean volume: 918 ± 517 versus 75 ± 50 mm³, t = 3.592, P = 0.023, n = 5), with comparable volumes demonstrated at ∼6 months after surgery. Lesion volumes on susceptibility-weighted images were larger than those of T2-weighted images at later timepoints. Radiofrequency thalamotomy produces focused and predictable lesion imaging characteristics over time. T2-weighted scans distinguish between the early lesion core and oedema characteristics, while lesions may remain more visible on susceptibility-weighted images in the months following surgery. Scanning patients in the immediate postoperative period and then at 6 months is clinically meaningful for understanding the anatomical basis of the transient and permanent effects of thalamotomy.
Sitravatinib combined with PD-1 blockade enhances cytotoxic T-cell infiltration by M2 to M1 tumor macrophage repolarization in esophageal adenocarcinoma
Authors: Sweeney Ryan , Omstead Ashten N , Fitzpatrick John T , Zheng Ping , Gorbunova Anastasia , Grayhack Erin E , Goel Arul , Khan Alisha F , Kosovec Juliann E , Wagner Patrick L , Jobe Blair A , Kelly Ronan J , Zaidi Ali H
Published: November 2023

Esophageal adenocarcinoma (EAC) is a leading cause of cancer-related mortality. Sitravatinib is a novel multi-gene tyrosine kinase inhibitor (TKI) that targets tumor-associated macrophage (TAM) receptors, VEGF, PDGF and c-Kit. Currently, sitravatinib is actively being studied in clinical trials across solid tumors and other TKIs have shown efficacy in combination with immune checkpoint inhibitors (ICI) in cancer models. In this study, we investigated the anti-tumor activity of sitravatinib alone and in combination with PD-1 blockade in an EAC rat model. Treatment response was evaluated by mortality, pre- and post-treatment MRI, gene expression, immunofluorescence and immunohistochemistry. Our results demonstrated adequate safety and significant tumor shrinkage in animals treated with sitravatinib, and more profoundly, sitravatinib and PD-1 inhibitor, AUNP-12 (P < 0.01). Suppression of TAM receptors resulted in increased gene expression of pro-inflammatory cytokines and decreased expression of anti-inflammatory cytokines, enhanced infiltration of CD8+ T cells, and M2 to M1 macrophage phenotype repolarization in the tumor microenvironment of treated animals (P < 0.01). Moreover, endpoint immunohistochemistry staining corroborated the anti-tumor activity by downregulation of Ki67 and upregulation of Caspase-3 in the treated animals. Additionally, pretreatment gene expression of TAM receptors and PD-L1 were significantly higher in major responders compared with the non-responders, in animals that received sitravatinib and AUNP-12 (P < 0.02), confirming that TAM suppression enhances the efficacy of PD-1 blockade. In conclusion, this study proposes a promising immunomodulatory strategy using a multi-gene TKI to overcome developed resistance to an ICI in EAC, establishing rationale for future clinical development.
Emergence of dense scale-free networks and simplicial complexes by random degree-copying
Authors: Esquivel-Gómez J , Barajas-Ramírez J G
Published: December 2023

Many real-world networks exhibit dense and scale-free properties, that is, the amount of connections among the nodes is large and the degree distribution follows a power-law P(k)∼k−γ. In particular, for dense networks γ∈(1,2]. In the literature, numerous network growth models have been proposed with the aim to reproduce structural properties of these networks. However, most of them are not capable of generating dense networks and power-laws with exponents in the correct range of values. In this research, we provide a new network growth model that enables the construction of networks with degree distributions following a power law with exponents ranging from one to an arbitrary large number. In our model, the growth of the network is made using the well-known Barabási–Albert model, that is, by nodes and links addition and preferential attachment. The amount of connections with which each node is born, can be fixed or depending of the network structure incorporating a random degree-copying mechanism. Our results indicate that if degree-copying mechanism is applied most of the time, then the resulting degree distribution has an exponent tending to one. Also, we show that the resulting networks become denser as γ→1, in consequence their clustering coefficient increases and network diameter decreases. In addition, we study the emergence of simplicial complexes on the resulting networks, finding that largest simplicial dimension appears as γ decreases.