bluuebunny/crossref_metadata_2025 huggingface dataset:
Preprocessing vannamei skeleton image for feature classification
Authors: Mariam  , Gaffar Ismail , Makkulawu Andi Ridwan , Ardiansyah
Published: January 2025

The use of visual imaging technology on underwater objects is still being developed, one of which is vaname shrimp (Litopenaeus vannamei). It is one type of shrimp that is popularly consumed by the world community. Super intensive shrimp pond farming can produce high amounts of production, but sometimes farmers also find very low production or in this case, harvest failure. It is influenced by many factors, one of which is the supervision of post-molting shrimp that require stable calcium levels in water to form new shells. This is done to keep soft shrimp without skin (post-molting) from dying due to cannibalism. Handling this requires monitoring using underwater imaging. The purpose of this research is to interpret the image of vaname shrimp molting underwater. The method used is image processing which consists of: Resize image, grayscale, thresholding, erosion and skeleton techniques. Skeleton features are well used for prediction of molting and not molting vanamei shrimp, where the prediction accuracy value using Support Vector Machine (SVM) classification Linear model shows an accuracy value of 71.43%.
Plasma mediated water splitting for hydrogen production
Authors: Cook M J , Nott T , Trompetter W J , Futter J , Bumby C W , Kennedy J V
Published: January 2025

This review explores the potential of enhancing hydrogen production energy efficiency through plasma-mediated water-splitting methods. A variety of plasma types have been explored in the literature for this purpose, including dielectric barrier discharge, microwave, radiofrequency, and gliding arc, with a large range of efficiencies in water splitting. The highest reported efficiencies of up to 80% have been achieved in systems using steam with argon as a carrier gas. The integration of steam in plasma reactors in place of room temperature liquid water contributes a remarkable 20%–50% increase to the overall energy efficiency while the additional energy required in converting water to steam only incurs a 16.4% energy cost to the overall process. Moreover, the addition of argon as a carrier gas in the plasma further enhances overall energy efficiency by an additional 25%–40%, bringing the energy efficiency of these systems up to 80% (based on plasma power). In addition, the use of steam proves advantageous as it prevents significant hydrogen peroxide production (a competing side reaction), and the unreacted steam can be readily condensed or frozen out to separate from the hydrogen and oxygen produced. These enhancements indicate that plasma-mediated water splitting has the potential to achieve similar efficiencies to conventional water electrolysis, with different benefits, paving the way for new applications of hydrogen technology. The disadvantage of plasma systems compared to polymer electrolyte membrane electrolysis is that the hydrogen and oxygen are produced together, however these gases can be readily separated using several technologies. While large-scale plasma systems for water splitting may not currently exist, the potential gains in energy efficiency open avenues for future research and implementation on a larger scale.
Investigation of tactile and strain sensing utilizing carbon-fiber network in silicone elastomer matrix
Authors: Lee Harry , Kim Garam , Barocio Eduardo
Published: January 2025

As the popularity of immersive and interactive technology continues to grow, there is demand for wearable or conformable tactile and strain sensors for human–computer-interaction. A major challenge in current conformable sensors is durability, tremendously limiting their applications in the market. This study utilizes long carbon-fiber networks in silicone elastomer matrix as electrodes for sensing, which consequently strengthens the sensors. Row and column pattern of long carbon-fiber was used to create projected capacitive touch sensors at every intersection and demonstrate multi-touch and spatial mapping capabilities. Similarly, these intersections were also demonstrated as piezoresistive force sensor where deformation from pressure on the intersection decreases the resistance between the row and column electrodes by altering the electrical network among the carbon-fibers. Lastly, piezoresistive strain sensors were manufactured by impregnating a pre-woven carbon-fiber fabric with silicone. Deformation in the 45-degree angle relative to the fabric caused changes in the electrical interactions between carbon-fibers and therefore the resistance along the sensor as well. These strain sensors showed an interesting behavior of increasing then decreasing resistance as the tensile load shifted from the silicone matrix to the carbon-fibers. The ultimate strength of properly bonded strain sensors using Smooth-On Sil-Poxy was significantly greater than the strength of pure two-part silicone. An intricately designed carbon-fiber network within a silicone matrix could combine these sensing mechanisms to potentially create a durable and compact multifunctional sensor that expands wearable sensing technology to rugged environments.
Synthesis of rice husk–based–mesoporous silica nanoparticles by facile calcination
Authors: Rumiyanti Leni , Garcia Shania , Istiqomah Nurul Imani , Manurung Posman , Firdaus Iqbal , Chotimah  , Suharyadi Edi
Published: January 2025

The growing industrial demand for mesoporous silica nanoparticles (MSNs) necessitates the exploration of alternative raw materials due to the limited availability of traditional sources. Rice husk, an environmentally sustainable by-product, offers a cost-effective solution with reduced environmental impact. This study investigates the synthesis of MSNs from rice husk using the sol–gel method, focusing on the effect of calcination temperature on their physical and chemical properties. Characterization confirmed the successful synthesis of MSNs. Fourier transform infrared spectroscopy identified siloxane groups in all samples, indicating silicate materials. Scanning electron microscopy-energy dispersive spectroscopy revealed a spherical-like morphology with silica as the primary component. Transmission electron microscopy measured the average particle sizes of control, 400 °C calcined, and 600 °C calcined MSNs as 50.5 nm, 49.3 nm, and 53.1 nm, respectively. X-ray diffraction analysis indicated the presence of silica phases in all samples. Surface area analysis showed a significant decrease in surface area (653 m2 g−1–113 m2 g−1) and pore volume (0.9 cm3 g−1–0.1 cm3 g−1) with increasing calcination temperature, while pore size slightly increased from 2.6 nm to 2.7 nm. Calcination temperature influences the removal of CTAB surfactants, enhances silicate bond strength, and increases silicon purity, resulting in reduced surface area and pore volume without altering the basic morphology or crystal structure of the MSNs. The synthesized MSNs, with their large surface area and unique properties, demonstrate potential for diverse applications, including their use as nanocontainers for corrosion inhibitors.
Impacts of drought on respiratory mortality in the upper midwest United States: a population subgroup assessment
Authors: Gwon Yeongjin , Ji Yuanyuan , Berman Jesse D , Abadi Azar M , Leeper Ronald D , Rennie Jared , Bell Jesse E
Published: January 2025

Drought is a complex climate phenomenon that varies regionally and temporally across the globe. Its frequency and intensity are expected to increase due to climate change, posing significant threats to human health. Despite these risks, there remains a notable gap in research on the health impacts of drought, particularly at the regional level within the United States. This study aims at assessing the risk of severe drought exposure to respiratory mortality in the Upper Midwest of the United States among the general population and at-risk subgroups from 2000 to 2018. Respiratory mortality was obtained for each county and month during study period based on the 10th International Classification of Disease codes. We used the Evaporative Demand Drought Index categorized into three levels and analyzed it at two timescales: 6 months and 12 months. A Bayesian two-stage time-series modeling approach was applied to estimate the county-level and overall risk along with the 95% Credible Intervals (Cr). Stratification analyses were conducted by age group, gender, race, urbanicity, and state within the region. Statistically significant associations were identified between respiratory mortality and the severe droughts. The estimated risks were 1.151 (95% Cr: 1.126–1.178) and 1.092 (95% Cr: 1.063–1.120) for the 6 and 12 month severe droughts. Our study suggests that the risks differs by subgroups: elevated risks in elderly (higher 14.4% and 9.8% for 6 and 12 month), White (15.1% and 9.0% higher for 6 and 12 month), males (12.7% and 5.1% higher for 6 and 12 month), females (15.8% and 11.1% higher for 6 and 12 month), urban 15.8% and 8.8% higher for 6 and 12 month), and rural (13.6% and 9.9% higher for 6 and 12 month) communities. Iowa showed the greatest increase (23.1%) in the 6 month severe drought, while Minnesota had the highest 20.3% in the 12 month severe drought. Our findings suggested that the elderly, both males and females, both rural and urban areas were the most affected subgroups. These findings demonstrate the need for policymakers and communities to adopt more effective drought mitigation strategies in this region.
On automorphism groups of smooth hypersurfaces
Authors: Yang Song , Yu Xun , Zhu Zigang
Published: January 2025

We show that smooth hypersurfaces in complex projective spaces with automorphism groups of maximum size are isomorphic to Fermat hypersurfaces, with a few exceptions. For the exceptions, we give explicitly the defining equations and automorphism groups.
Quantitative profiling pH heterogeneity of acidic endolysosomal compartments using fluorescence lifetime imaging microscopy
Authors: Deng Dinghuan , Guan Youchen , Mutlu Ayse Sena , Wang Baiping , Gao Shihong Max , Zheng Hui , Wang Meng C.
Published: January 2025

The endolysosomal system plays a crucial role in maintaining cellular homeostasis and promoting organism fitness. The pH of its acidic compartments is a crucial parameter for proper function, and it is dynamically influenced by both intracellular and environmental factors. Here, we present a method based on fluorescence lifetime imaging microscopy (FLIM) for quantitatively analyzing the pH profiles of acidic endolysosomal compartments in diverse types of primary mammalian cells and in live organism Caenorhabditis elegans. This FLIM-based method exhibits high sensitivity in resolving subtle pH differences, thereby revealing heterogeneity within a cell and across cell types. This method enables rapid measurement of pH changes in the acidic endolysosomal system in response to various environmental stimuli. Furthermore, the fast FLIM measurement of pH-sensitive dyes circumvents the need for transgenic reporters and mitigates potential confounding factors associated with varying dye concentrations or excitation light intensity. This FLIM approach offers absolute pH quantification and highlights the significance of pH heterogeneity and dynamics, offering a valuable tool for investigating lysosomal functions and their regulation in various physiological and pathological contexts.
Tetraspanins 10 and 15 support Venezuelan equine encephalitis virus replication in astrocytoma cells
Authors: Duven Mara , Friedrichs Alina , Tomlinson Michael G. , Steffen Imke , Gerold Gisa
Published: January 2025

Tetraspanins (Tspans) are transmembrane proteins that coordinate life cycle steps of viruses from distinct families. Here, we identify the human Tspan10 and Tspan15, both members of the TspanC8 subfamily, as replication factors for alphavirus Venezuelan equine encephalitis virus (VEEV) in astrocytoma cells. Pharmacological inhibition and small interfering RNA (siRNA)-mediated silencing of TspanC8 interactor a disintegrin and metalloproteinase 10 (ADAM10) reduced VEEV infection. Silencing of Tspan10, Tspan15, and ADAM10 did not affect VEEV entry but diminished viral genome replication. We report that Tspan10 is important for VEEV infection of several cell lines, while silencing of Tspan15 diminishes infection with several alphaviruses, but not flaviviruses, in astrocytoma cells. Conversely, we demonstrate that siRNA-mediated silencing of Tspan14, another member of the TspanC8 family, enhances infection with lentiviral pseudoparticles harbouring the envelope proteins of VEEV, identifying it as a restriction factor for VEEV entry. Silencing of ADAM10/Tspan15 substrate neuronal (N)-cadherin reduced VEEV infectivity, suggesting potential roles of ADAM10 substrates in VEEV infection. In sum, our study identifies three TspanC8s and ADAM10 as important modulators of VEEV infectivity.
Mechanism of chaperone recruitment and retention on mitochondrial precursors
Authors: Juszkiewicz Szymon , Peak-Chew Sew-Yeu , Hegde Ramanujan S.
Published: January 2025

Nearly all mitochondrial proteins are imported into mitochondria from the cytosol. How nascent mitochondrial precursors acquire and sustain import-competence in the cytosol under normal and stress conditions is incompletely understood. Here, we show that under normal conditions, the Hsc70 and Hsp90 systems interact with and redundantly minimize precursor degradation. During acute import stress, Hsp90 buffers precursor degradation, preserving proteins in an import-competent state until stress resolution. Unexpectedly, buffering by Hsp90 relies critically on a mitochondrial targeting signal (MTS), the absence of which greatly decreases precursor-Hsp90 interaction. Site-specific photo-crosslinking and biochemical reconstitution showed how the MTS directly engages co-chaperones of Hsc70 (St13 and Stip1) and Hsp90 (p23 and Cdc37) to facilitate chaperone retention on the mature domain. Thus, the MTS has a previously unappreciated role in regulating chaperone dynamics on mitochondrial precursors to buffer their degradation and maintain import competence, functions that may facilitate restoration of mitochondrial homeostasis after acute import stress.
Poor Narratives
Authors: Gentilini Ugo
Published: January 2025

The chapter connects poverty explanations and the design of cash transfers, including “individualistic” poverty perspectives (which ascribe poverty to effort, character, morality) and “structuralist” narratives (which describes poverty as the result of ingrained imbalances in societies’ economic organization and power distribution). Those views 22need not to be in competition and could be reconciled under a coherent poverty framework. The two extreme poles of thought have exerted significant influence on whether, why, and how cash transfers would pan out in practice. The pendulum has swung in both directions, but in the case of cash transfers it generally veered towards individualist explanations. After a brief excursus on the current state of the evidence, the chapter interrogates the origins of contemporary programs. It identifies ancestors of cash transfers interventions, with precursors being rooted in centuries-long practices (and in some cases stretching over millennia). The chapter concludes by discussing how, especially over the course of recent centuries, cash transfers were “indicted” by leading intellectuals. While not unanimous and original, their thinking shaped a mindset that would cast cash transfers as “part of the poverty problem.” Such rhetoric has persistent influence over space and time.
California
Authors: Albrecht Eduardo
Published: January 2025

This chapter includes interviews with Tracy Rosenberg of the citizens’ coalition group Oakland Privacy, and Jeremy Rud, a volunteer with community organization NorCal Resist. The chapter briefly explains the role and activities of these two grassroots groups, including Oakland Privacy’s work to ban facial recognition technology in parts of California, and NorCal’s lawsuit against Clearview AI. In Rosenberg’s interview she discusses the negative consequences of AI-based surveillance and the difficulty of holding these systems accountable. Rud explains his concerns about the use of AI to exclude those legally entitled to asylum, and the role of automated analysis in this process.
Fetal Positions
Authors: Adamczyk Amy
Published: January 2025

In many countries, abortion is a contentious public opinion issue. In nations like the United States, advocates on both sides of the debate have actively worked to amplify their voices and change legislation. In other parts of the world, abortion is not a major topic of discussion because people in many countries consider it a relatively settled issue. Why are there such big differences in how people view abortion? Fetal Positions around the Globe answers this question. Using data from over 200,000 people from 88 nations, I show that a handful of factors—overall levels of religious importance, Catholic proportion, economic and educational development, government history, and gender inequality—can explain differences in support. Dozens of interviews conducted in China and the United States offer insight into the processes shaping attitudes. Readers will be surprised to learn about the many similarities and differences in how Chinese and American residents view abortion. An analysis of over 800 newspaper articles from more than 40 countries provides additional clarity. Along with investigating why abortion disapproval varies so considerably across the world, Fetal Positions around the Globe also examines the forces shaping cross-national abortion rates and personal abortion decisions, analyzes the links between attitudes and laws, and unpacks the pathways through which personal and country-characteristics shape views. Fetal Positions around the Globe sheds light on one of the most important contemporary issues being discussed in many countries. The international focus provides fresh perspective on the abortion debate and offers important insight that can be gleaned only through a cross-national analysis.
Introduction
Authors: Adamczyk Amy
Published: January 2025

This book opens with an overview of the massive divide in public opinion about abortion across the world. The Introduction explains that isolating key societal characteristics is especially important for understanding differences across nations. Country-level effects, which can influence attitudes over and above personal characteristics, are discussed. World Values Survey data are introduced. While these survey data can provide insight into the major factors shaping attitudes, they obscure the processes through which they have an effect. Likewise, they do not consider each country’s unique history in shaping views. China and the United States are introduced as case study nations. Dozens of interviews were conducted with experts in these two countries. This Introduction explains why these two societies are especially suited for further investigation and complement the large cross-national survey analysis of abortion disapproval. This mixed-methods design is able to overcome the weaknesses of surveys or interviews alone.
Gender Equality, Social Movement Activity, and Race for Understanding Views about Abortion
Authors: Adamczyk Amy
Published: January 2025

This chapter examines how gender inequality and racial and ethnic differences shape abortion views. Across the world, gender inequality persists and affects the way many people view abortion. Even after accounting for their gender, people living in countries with higher levels of gender inequality are more opposed to abortion. Insight from the Chinese and American interviews helps unpack the various ways that gender inequality shapes disapproval. This chapter also examines the forces that gave rise to the overturning of Roe v. Wade, which removed American women’s constitutional right to an abortion. A significant contributor was social movement activity that helped perpetuate abortion 124as a critical issue for many conservative Americans. In the United States especially, the intersections of race and gender have informed views on both sides of the debate. The chapter ends with a discussion about how racial differences can shape abortion views.
Beyond Normativity
Authors: Finlay Stephen
Published: January 2025

Abstract

What is the future of normativity? What should that future be? This chapter employs the analogy of Samsara’s Wheel to characterize recent inquiry under the rubric ‘normativity’ as merely the latest epicycle in a futile circle of metaethical debate in which the same moves are reprised for different terms such as ‘ought’, ‘value’, ‘reasons’, ‘justification’, ‘authority’, ‘matters’, ‘fit’, et cetera. This futility is blamed on a four-way ambiguity running systematically throughout normative language. A two-dimensional, “perspectivist” diagnosis is provided of the difference between special (“robust”) and mundane (“merely formal”) normativity. By distinguishing between descriptive content and motivated perspective, the three major metaethical camps (noncognitivism, subjectivism, and objectivism) are explained as corresponding to the three possible ways of flattening two dimensions into one, depending on whose perspective (judge, subject, or theorist) is privileged. This reveals the errors characteristic of each camp and fragments “normativity” into multiple objects, denying the univocity of metaethical debate. Four obstacles to metaethical enlightenment are identified: illusion, attachment, charity, and forgetfulness.
Is the Unity of Normativity Safe?
Authors: Whiting Daniel
Published: January 2025

Abstract

A guiding assumption of much recent work on normativity is that it is uniform across domains. Normative notions are to be understood in the same way whether they concern moral, epistemic, prudential, aesthetic, and so on matters. This assumption is widespread but also contentious. In epistemology, it is commonplace to analyse knowledge and, more recently, justification by appeal to modal notions; that is, in terms of what is possible. Justification is a normative notion that applies across domains. Given the uniformity assumption, we should expect modal notions to appear in analyses of justification in, say, ethics. But that is not what we find. Instead, the tendency there is to explain justification in terms of reasons. While there are many theories of reasons in circulation, modal notions do not figure prominently, if at all, in them. So, there is a mismatch between the way in which normative notions are understood in epistemology and in ethics. This chapter tries to resolve this situation by developing a novel theory of reasons—specifically, of how fundamental reasons relate to derivative reasons—that makes central appeal to modal notions. In this way, the chapter suggests, we can reconcile the way ethicists and epistemologists understand reasons and, in turn, justification, thereby preserving the uniformity assumption.
n-1 Guilty Men
Authors: Dutant Julien , Littlejohn Clayton
Published: January 2025

Abstract

We argue that there is nothing that can do the work that normative reasons are expected to do. A currently popular view is that in any given situation, a set of normative reasons (understood as a set of facts, typically about the agent’s situation) always determines the ways we prospectively should or should not respond. We discuss an example that we think shows no such collection of facts could have this normative significance. A radical response might be to dispense with reasons and explain the facts about the ways we should respond using something else entirely (e.g., expected value). We think a more fruitful approach is to explore the possibility of using decision-theoretic tools in a reasons-centred framework.
Reasons from Identity
Authors: Heuer Ulrike
Published: January 2025

Abstract

Identities play a prominent role in many current discussions regarding nationality, gender, ethnicity, and religion. There is little doubt that these identities which are often based on social roles and are subject to social expectations are important for the ways in which people act and lead their lives. They certainly seem to have normative significance. This chapter explores why and when identities provide reasons. It examines Sartre’s well-known comments on bad faith as an objection that any account of reasons from identity must address. There are two roles that practical identities have been assigned in the explanation of normativity that can be seen as marking the ends of a spectrum: Korsgaard’s, who regards practical identities as the source of all normativity, and Scanlon’s, who doubts that identities have any direct role to play in the explanation of reasons. The chapter argues that between the all-encompassing and the skeptical, there is space for a direct role of identities in determining some practical reasons. It is not an idiosyncratic role but one that draws on a general value-based account of practical reasons, and it is not subject to the bad faith worry.
Atmospheric Emissions
Authors: Malcolm Rosalind , Pointing John
Published: January 2025

Section 79(1)(b) (smoke nuisance) is an early form of statutory nuisance, dating from 1866 in respect of dark smoke and 1875 in other cases. Section 79(1)(c) (fumes and gases), which applies only to domestic premises, originated in the EPA 1990. Smoke nuisances have also been controlled through other legislation in the past, notably the Clean Air Acts, and continue to fall subject to this statute and other environmental controls. Thus, primary controls over smoke are to be found in the Clean Air Act 1993 and Part I of the EPA 1990.2 The Clean Air Act 1993 regulates the emission of smoke from chimneys and some open sites. It prohibits the emission of dark smoke from chimneys.3
Implications of the Human Rights Act 1998
Authors: Malcolm Rosalind , Pointing John
Published: January 2025

The Human Rights Act 1998 (HRA 1998), which came into force in October 2000, incorporates into UK law the rights and freedoms set out in the European Convention on Human Rights.
Enforcement: Use of Abatement Notices
Authors: Malcolm Rosalind , Pointing John
Published: January 2025

The key procedural impact of the Environmental Protection Act 1990 (EPA 1990) was the introduction of the abatement notice as a method of controlling statutory nuisances through administrative action. The abatement notice, once served, requires the recipient to remedy the nuisance. At the centre of control is the local authority, which has a duty to inspect for statutory nuisances and to investigate complaints. Once the authority has formed the view that there is a statutory nuisance, it must serve a notice. The question of the extent to which the authority should consult with the recipient of the notice about its terms arises at this stage. Further, since the abatement notice exposes the recipient to the risk of prosecution, the notice itself must be carefully drawn within the powers of the local authority. Finally, it must be properly served.
Appeals Against Abatement Notices
Authors: Malcolm Rosalind , Pointing John
Published: January 2025

The recipient of an abatement notice may appeal to a magistrates’ court to have it quashed or to have the requirements varied to make them less onerous. The appeal is a civil matter which is commenced by way of making a complaint to the court. The grounds for appealing the notice need to be specified and are set down in the Statutory Nuisance (Appeals) Regulations 1995 (as amended). All relevant grounds of appeal should be included. If there is doubt as to whether a particular ground is relevant, it should be included. It can subsequently be withdrawn if the appellant decides not to pursue the point at the hearing, in which case it should be withdrawn as early as possible to avoid wasting legal costs or the court’s time.
Offences and Prosecution for Breach of an Abatement Notice
Authors: Malcolm Rosalind , Pointing John
Published: January 2025

Local authority prosecutions for breach of an abatement notice invoke the rules of evidence and procedures of the magistrates’ courts acting in their criminal capacity. These rules are more restrictive than those that apply to appeals against abatement notices under section 80(3) of the Environmental Protection Act 1990 (EPA 1990), where the rules and procedures are based on civil law.
Defences
Authors: Malcolm Rosalind , Pointing John
Published: January 2025

It also considers the defence of statutory authority and the impact of regulatory planning and environmental permissions on actions in statutory nuisance.
The UK-Irish Atopic eczema Systemic TherApy Register (A*STAR): baseline characteristics of the cohort
Authors: Gribaleva Elizaveta , Chan Kaitlyn , Chivardi Moreno Carlos , Prieto Merino David , Tsoi Man Fung , Carroll Rebecca , Coker Bolaji , De la Cruz Lilia , Baden Manisha , Beattie Paula E , Brown Sara , Burton Tim , Hearn Ross , Ingram John R , Irvine Alan D , Johnston Graham A , Man Irene , Ogg Graham , Wan Mandy , Warren Richard B , Woolf Richard T , Reynolds Nick J , Manca Andrea , Ardern Jones Michael R , Flohr Carsten ,   the A STAR Register Study Group, Ardern-Jones Michael R , Baldago Jerome , Bale Tracy , Beattie Paula , Brown Sara , Brown Victoria , Cork Michael J , Darné Sharmela , Fadhil May , Fahy Caoimhe , Ferguson Leila , Flohr Carsten , Hearn Ross , Ingram John R , Johnston Graham A , Ladoyanni Effi , Layton Alison , Leitch Claire , Lunt Mark , Man Irene , Moffit Deborah , Newell Louise , Ogg Graham , Paget Sophia , Petrof Gabriela , Popli Urvi , Rennie Catherine , Reynolds Nick , Rouhani Nasim , Sergeant Ann , Simpson Rosalind , Thompson Ben , Topliffe Joanne , Wahie Shyamal , Wainman Hannah , Warren Richard B , Wernham Aaron , Woolf Richard
Published: January 2025

A-STAR is a prospective, longitudinal register study aimed at evaluating short- and long-term effectiveness, safety, and cost-effectiveness of systemic treatments. This letter presents the baseline characteristics of the cohort and describes future directions of the register's development.
Real world clinical experience of using Brainomix e-CTA software in a medium size acute National Health Service Trust
Authors: Merchant Fraser , Choulerton James , James Richard , Pang Chun Lap
Published: January 2025

Objectives

Artificial intelligence (AI) software including Brainomix “e-CTA” which detect large vessel occlusions (LVO) have clinical potential. We hypothesized that in real world use where prevalence is low, its clinical utility may be overstated.

Methods

In this single centre retrospective service evaluation project, data sent to Brainomix from a medium size acute National Health Service (NHS) Trust hospital between January 3, 2022 and January 3, 2023 was reviewed. 584 intracranial computed tomography angiogram (CTA) datasets were analysed for LVO by e-CTA. The e-CTA output and radiology report were compared to ground truth, defined by a consultant radiologist with fellowship neuroradiology training, with access to subsequent imaging and clinical notes. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.

Results

Of 584 cases (45% female, mean age 70 ± 16 years), 9% (n = 50) had LVO. e-CTA had a sensitivity of 0.78 (95% CI 0.64-0.88), specificity of 0.93 (0.9-0.95), PPV of 0.5 (0.42-0.58), and NPV of 0.98 (0.96-0.99). e-CTA had an error rate of 9% (52/584). Erroneous cases were categorized into causes for error. Common causes for false positives included incorrect anatomy (21%, 8/39) and other pathology (13%, 5/39), with several uncategorizable cases (39%, 15/39). Common causes for false negatives included LVO within the terminal internal carotid artery (ICA) (55%, 6/11) and uncategorizable (18%, 2/11).

Conclusions

We demonstrated that PPV of e-CTA is poor in consecutive cases in a real-world NHS setting. We advocate for local validation of AI software prior to clinical use.

Advances in knowledge

Common AI errors were due to anatomical misidentification, presence of other pathology, and misidentifying LVO in the terminal ICA.
When Itch Becomes Unbearable
Authors: Yong Ji Fung , Lai Fei , Hackett Caitriona , Tobin Anne-Marie
Published: January 2025

Itch, or pruritus, is a common and unpleasant sensation transmitted by both the peripheral and central nervous systems, sharing pathways with pain sensation. The itch pathway is complex, and itch is a perplexing symptom. This patient's case presentation following a spinal stroke highlights the potential mechanism of neuropathic itch, the challenges in managing chronic neuropathic itch and dysaesthesia, and the importance of a holistic approach in treating patients with this condition.
Synthesis of polycarbonates and polyesters via tetraalkylammonium salt-catalyzed ring-opening polymerization
Authors: Suzuki Ryota , Takagi Satoru , Matsuda Minori , Yamamoto Takuya , Tajima Kenji , Li Feng , Isono Takuya , Satoh Toshifumi
Published: January 2025

Tetraalkylammonium salt was found to be an effective catalyst for the ring-opening polymerization of cyclic carbonates and cyclic esters, yielding aliphatic polycarbonates and polyesters with narrow dispersities. An important feature of this catalytic system is its tunable catalytic ability, which was achieved by altering the alkyl substrates and counter anions. The catalytic mechanism was studied by 1H NMR spectroscopy.
The TOXIN knowledge graph: supporting animal-free risk assessment of cosmetics
Authors: Sepehri Sara , Heymans Anja , Win Dinja De , Maushagen Jan , Sanctorum Audrey , Debruyne Christophe , Rodrigues Robim M , Kock Joery De , Rogiers Vera , Troyer Olga De , Vanhaecke Tamara
Published: January 2025

The European Union’s ban on animal testing for cosmetic products and their ingredients, combined with the lack of validated animal-free methods, poses challenges in evaluating their potential repeated-dose organ toxicity. To address this, innovative strategies like Next-Generation Risk Assessment (NGRA) are being explored, integrating historical animal data with new mechanistic insights from non-animal New Approach Methodologies (NAMs). This paper introduces the TOXIN knowledge graph (TOXIN KG), a tool designed to retrieve toxicological information on cosmetic ingredients, with a focus on liver-related data. TOXIN KG uses graph-structured semantic technology and integrates toxicological data through ontologies, ensuring interoperable representation. The primary data source is safety information on cosmetic ingredients from scientific opinions issued by the Scientific Committee on Consumer Safety between 2009 and 2019. The ToxRTool automates the reliability assessment of toxicity studies, while the Simplified Molecular Input Line Entry System (SMILES) notation standardizes chemical identification, enabling in silico prediction of repeated-dose toxicity via the implementation of the Organization for Economic Co-operation and Development Quantitative Structure–Activity Relationship Toolbox (OECD QSAR Toolbox). The ToXic Process Ontology, enriched with relevant biological repositories, is employed to represent toxicological concepts systematically. Search filters allow the identification of cosmetic compounds potentially linked to liver toxicity. Data visualization is achieved through Ontodia, a JavaScript library. TOXIN KG, filled with information for 88 cosmetic ingredients, allowed us to identify 53 compounds affecting at least one liver toxicity parameter in a 90-day repeated-dose animal study. For one compound, we illustrate how TOXIN KG links this observation to hepatic cholestasis as an adverse outcome. In an ab initio NGRA context, follow-up in vitro studies using human-based NAMs would be necessary to understand the compound’s biological activity and the molecular mechanism leading to the adverse effect. In summary, TOXIN KG emerges as a valuable tool for advancing the reusability of cosmetics safety data, providing knowledge in support of NAM-based hazard and risk assessments.

Database URL: https://toxin-search.netlify.app/
Natural shear wave imaging outperforms conventional echocardiographic parameters in detecting elevated left ventricular filling pressures
Authors: Youssef A , Desmet W , Castaldi G , Frederiks P , Dhooge J , Voigt J U
Published: January 2025

Background

Current conventional echocardiographic assessment of diastolic function relies on predicting left ventricular (LV) filling pressure as a surrogate of diastolic function. However, the current guidelines algorithm for estimation of LV filling pressures is complex. High frame rate (HFR) Shear wave (SW) imaging is emerging as a novel parameter for assessing myocardial stiffness, a key determinant of diastolic function. Natural SW can be induced, e.g., by mitral valve closure (MVC) and their propagation speed is directly related to myocardial stiffness. Little is known, however, to what extent SW after MVC can reflect diastolic LV filling pressures.

Purpose

We aimed at investigating the relationship between natural SW and LV diastolic filling pressures in comparison to conventional echocardiographic parameters.

Methods

Thirty patients (mean age 68.4±9.9 years) scheduled for clinically indicated left heart catheterization were prospectively recruited irrespective of diastolic function status. Conventional as well as HFR echocardiography (ca. 1200 frames/second) was performed immediately after the catheterization. We tracked SW occurring after MVC along the ventricular septum in the parasternal long axis view using an anatomical M-mode from base to apex colour coded for tissue acceleration. SW appeared immediately after as tilted green bands and their propagation velocity was measured semi-automatically (Figure 1).

Results

In our cohort, the LV mid-diastolic pressure (LVMDP) ranged from 5 to 19 mmHg, while the LV end-diastolic pressure (LVEDP) ranged from 7.5 to 29.5 mmHg. LV filling pressures were considered elevated if exceed 15 mmHg for LVMDP and 16 mmHg for LVEDP. Out of the conventional echocardiographic parameters, only mitral inflow to mitral relaxation velocity ratio (E/e’) correlated moderately with LV filling pressures (r=0.47, p=0.009 for LVMDP; and r=0.49, p=0.006 for LVEDP) (Figure 2 A,B). The accuracy of the conventional E/e’ cut-off value of 14 to predict elevated LV filling pressure is 76% for LVMDP and 70% for LVEDP (Figure 2C). SW velocities after MVC correlated strongly with diastolic LV pressures (r=0.65, p<0.001 for LVMDP; r=0.78, p<0.001 for LVEDP) (Figure 2 D,E). Interestingly, a cut-off value for SW velocity of 5.8 m/s showed an excellent ability to discriminate raised LVMDP (AUC: 0.93; sensitivity: 80%, specificity: 80%, accuracy: 80%) and elevated LVEDP (AUC: 0.96 ; Sensitivity: 89%, specificity: 95%, accuracy: 93%) (Figure 2F).

Conclusions

Our preliminary data showed that SW velocities at end-diastole are strongly related to LV filling pressures and can predict elevated LV filling pressures more accurately than conventional echocardiographic parameters. This ongoing study shows the potential of natural shear wave imaging as a promising innovative tool for assessment of diastolic function.

Figure 1

Figure 2
External validation of automated deep-learning based echocardiogram analysis
Authors: Merin R , Gvili-Perelman M , Tzuberi M , Merin H , Topilsky Y , Flint N
Published: January 2025

Background

The use of artificial intelligence (AI) in echocardiography is constantly expanding. Several AI algorithms now enable fully automated measurement of echocardiographic parameters, which can potentially reduce measurement variability and increase efficiency. These AI algorithms have demonstrated accuracy comparable to conventional human-based measurements. However, to adopt automated AI echocardiography analysis for routine use, we need a deeper understanding of its performance compared with that of human expert readers.

Purpose

This study aims to perform a real-world external validation of a commercial, fully automated AI algorithm by comparing its performance standard to echocardiographic measurements done by human experts.

Methods

We retrospectively analyzed 889 consecutive hospitalized patients who underwent a clinically indicated transthoracic echocardiographic study. Each study was performed by experienced cardiac sonographers and reviewed by expert echo cardiologists. All studies were also analyzed by a commercial, fully automated AI software (Us2.AI). We analyzed the correlation between standard echocardiographic parameters measured by human experts to those measured by the AI algorithm.

Results

Of the 889 patients, 731 (82%) had sufficient echocardiographic data to be included in the analysis (mean age 68±16, 46% Female). As shown in Table 1, the measures with the strongest correlation were E wave velocity (r=0.96, P<0.001), E/e' ratio (r=0.86, P<0.001), and systolic pulmonary artery pressure (r=0.88, P<0.001) whereas posterior wall thickness and left ventricular ejection fraction (LVEF) had lower correlation coefficients (r=0.52 and r=0.61, respectively, both P<0.001). On Bland-Altman plot (Figure 1), mean AI-obtained LVEF values were significantly higher compared to human-estimated LVEF values with a mean difference of 5.8. This discrepancy was specifically evident in cases where the human-based LVEF was 45% or higher.

Conclusion

In this external validation study, AI-based echocardiographic measurements showed a strong correlation with human-based measurements. LVEF values obtained by AI tended to be higher than human LVEF estimation.

Correlation of echocardiographic measure

Bland Altman for LV EF
How can we more efficiently train new users of echocardiography?
Authors: Stowell C , Lane B , Francis D , Shun-Shin M
Published: January 2025

Background/Introduction

Improving uptake and accessibility of echocardiography necessitates more efficient training. Current training programmes are focused around expert mentorship, clinical practicals, and lectures. All of these are resource-intensive, and difficult to scale.

Research into the way humans learn has consistently found that techniques such as spaced testing and interleaving of subjects, deliver superior retention - even of complex topics. These can be most easily and cost-effectively delivered online.

Purpose

To test how quickly students learn using an online platform, utilising contemporary teaching methods, made freely available to individuals within the NHS.

Methods

We designed our platform to facilitate interactive questioning of medical images, and performing interpretive and measurement tasks within echocardiography (Picture 1).

We piloted it in two phases. In phase one, to establish the acquisition of knowledge and skills without our platform, we recruited non-cardiology trainee doctors with daily access to a handheld cardiac ultrasound device, but without formal teaching. They received 5 consecutive 21-question quizzes, delivered by email and text at weekly intervals. Each quiz was balanced to include knowledge questions, such as anatomy identification; and interpretive questions, including grading ventricular function, chamber size, and valve disease severity. No feedback was provided. To provide a benchmark, 3 experts undertook the same quizzes.

In phase two, we opened up to anyone interested in learning echocardiography. In addition to the optimised quizzes, these participants received daily 21-question training modules.

Results

7 participants enrolled in phase one. They showed no improvement in test performance across the 5 weeks (+2% per week, 95% CI -2% to 6%, p=0.33). Questions which proved to be properly constructed (scores of 100% for experts) yet "too easy" (scores of 90% or higher for learners) were eliminated, and not used for the testing phase.

12 participants enrolled in phase two. All worked through the modules at their own pace (of those who did all 19 quizzes, time taken ranged from 6.6 to 15.6 weeks; median 14.3 weeks). Participants showed significant improvement over time (+11% per week, 95% CI, p<0.001). Those who took the quizzes later into any training programmes they were undertaking in parallel did not outperform those who took them earlier (p=0.89).

For LV function, participants showed little improvement over time (+9% per week, 95% CI -13% to +51%, p=0.23); but after undertaking a 5-quiz module on LV function, test scores increased 36% (95% CI 0% to 74%, p=0.05) from the previous week.

Conclusions

Our findings suggest that key skills in echocardiography can be efficiently learnt outside of the lecture theatre or clinical environment. Furthermore, precious time spent in the echo lab or on clinical placement might be more efficiently utilised by completing our online modules ahead of time.
Clinical validation of a novel fully automated measurement method for echocardiographic mechanical dispersion using deep learning
Authors: Melichova D , Nyberg J , Nguyen T M , Salte I M , Brunvand H , Haugaa K H , Edvardsen T , Dalen H , Lovstakken L , Ostvik A , Grenne B
Published: January 2025

Background

Evaluation of left ventricular (LV) function by strain echocardiography and mechanical dispersion (MD) has demonstrated improved prediction of ventricular arrhythmia in patients with heart failure (HF) and reduced ejection fraction. However, analyzing MD is both time consuming and operator dependent, thus its clinical use remains limited. Fully automated measurements of MD using a novel deep learning (DL) method may be a solution to facilitate clinical implementation.

Purpose

We aimed to validate a novel DL based method for fully automated measurements of MD, by evaluating its correlation and agreement with manual reference measurements in a large cohort of patients with heart failure and left ventricular ejection fraction (LVEF) <40%.

Methods

In this prospective multicenter follow-up study, we consecutively included patients with recently diagnosed heart failure of all causes with LVEF ≤ 40%. All patients were treated according to contemporary guidelines with optimal medical therapy and revascularization if necessary. Two experienced cardiologists recorded all echocardiograms using Vivid E9 or E95 scanners (GE HealthCare, Horten, Norway). Measurements of MD were performed both by an experienced cardiologist using a commercial semi-automatic method, and an in-house developed fully automated deep learning-based method.

Results

MD was measured in 200 patients (73 ± 14 years old, 33% females). Mean LVEF was 32% ± 6. Mean MD by reference measurements was 61 ± 17ms and by the deep learning method 63 ± 19 ms . Deep learning-based measurements of MD had excellent agreement with reference, with bias of 2ms and Limits of Agreement only 28ms (Figure 1). The correlation between methods was good, with R2 46%, p<0.001. Calculation time for automated measurements of MD per patient was only 6.4 ± 2.5 seconds per echocardiogram.

Conclusion

The novel fully automated deep learning-based method provides rapid measurements of MD and excellent agreement with manual reference measurements, and may thus facilitate clinical implementation of MD for improved risk stratification in patients with HF.