bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgeon Skill and Perioperative Outcomes in Robot-Assisted Partial Nephrectomy
Authors: Wang Yuzhi , Wilder Samantha , Hijazi Mahmoud , Myles Marquisha D. , Mirza Mahin , Van Til Monica , Maatman Thomas , Ghani Khurshid R. , Lane Brian R. , Rogers Craig G. ,   Michigan Urological Surgery Improvement Collaborative
Published: July 2024

Importance

Technical skill in complex surgical procedures may affect clinical outcomes, and there is growing interest in understanding the clinical implications of surgeon proficiency levels.

Objectives

To determine whether surgeon scores representing technical skills of robot-assisted kidney surgery are associated with patient outcomes.

Design, Setting, and Participants

This quality improvement study included 10 urological surgeons participating in a surgical collaborative in Michigan from July 2021 to September 2022. Each surgeon submitted up to 7 videos of themselves performing robot-assisted partial nephrectomy. Videos were segmented into 6 key steps, yielding 127 video clips for analysis. Each video clip was deidentified and distributed to at least 3 of the 24 blinded peer surgeons from the collaborative who also perform robot-assisted partial nephrectomy. Reviewers rated technical skill and provided written feedback. Statistical analysis was performed from May 2023 to January 2024.

Main Outcomes and Measures

Reviewers scored each video clip using a validated instrument to assess technical skill for partial nephrectomy on a scale of 1 to 5 (higher scores indicating greater skill). For all submitting surgeons, outcomes from a clinical registry were assessed for length of stay (LOS) greater than 3 days, estimated blood loss (EBL) greater than 500 mL, warm ischemia time (WIT) greater than 30 minutes, positive surgical margin (PSM), 30-day emergency department (ED) visits, and 30-day readmission.

Results

Among the 27 unique surgeons who participated in this study as reviewers and/or individuals performing the procedures, 3 (11%) were female, and the median age was 47 (IQR, 39-52) years. Risk-adjusted outcomes were associated with scores representing surgeon skills. The overall performance score ranged from 3.5 to 4.7 points with a mean (SD) of 4.1 (0.4) points. Greater skill was correlated with significantly lower rates of LOS greater than 3 days (−6.8% [95% CI, −8.3% to −5.2%]), EBL greater than 500 mL (−2.6% [95% CI, −3.0% to −2.1%]), PSM (−8.2% [95% CI, −9.2% to −7.2%]), ED visits (−3.9% [95% CI, −5.0% to −2.8%]), and readmissions (−5.7% [95% CI, −6.9% to −4.6%]) (P < .001 for all). Higher overall score was also associated with higher partial nephrectomy volume (β coefficient, 11.4 [95% CI, 10.0-12.7]; P < .001).

Conclusions and Relevance

In this quality improvement study on video-based evaluation of robot-assisted partial nephrectomy, higher technical skill was associated with lower rates of adverse clinical outcomes. These findings suggest that video-based evaluation plays a role in assessing surgical skill and can be used in quality improvement initiatives to improve patient care.
Defining Levels of US Hospitals’ Pediatric Capabilities
Authors: Michelson Kenneth A. , Alpern Elizabeth R. , Remick Katherine E. , Cash Rebecca E. , Kemal Samaa , Wolk Courtney Benjamin , Camargo Carlos A. , Samuels-Kalow Margaret E.
Published: July 2024

Importance

Classifying hospitals across a wide range of pediatric capabilities, including medical, surgical, and specialty services, would improve understanding of access and outcomes.

Objective

To develop a classification system for hospitals’ pediatric capabilities.

Design, Setting, and Participants

This cross-sectional study included data from 2019 on all acute care hospitals with emergency departments in 10 US states that treated at least 1 child per day. Statistical analysis was performed from September 2023 to February 2024.

Exposure

Pediatric hospital capability level, defined using latent class analysis. The latent class model parameters were the presence or absence of 26 functional capabilities, which ranged from performing laceration repairs to performing organ transplants. A simplified approach to categorization was derived and externally validated by comparing each hospital’s latent class model classification with its simplified classification using data from 3 additional states.

Main Outcomes and Measures

Health care utilization and structural characteristics, including inpatient beds, pediatric intensive care unit (PICU) beds, and referral rates (proportion of patients transferred among patients unable to be discharged).

Results

Using data from 1061 hospitals (716 metropolitan [67.5%]) with a median of 2934 pediatric ED encounters per year (IQR, 1367-5996), the latent class model revealed 4 pediatric levels, with a median confidence of hospital assignment to level of 100% (IQR, 99%-100%). Of 26 functional capabilities, level 1 hospitals had a median of 24 capabilities (IQR, 21-25), level 2 hospitals had a median of 13 (IQR, 11-15), level 3 hospitals had a median of 8 (IQR, 6-9), and level 4 hospitals had a median of 3 (IQR, 2-3). Pediatric level 1 hospitals had a median of 66 inpatient beds (IQR, 42-86), level 2 hospitals had a median of 16 (IQR, 9-22), level 3 hospitals had a median of 0 (IQR, 0-6), and level 4 hospitals had a median of 0 (IQR, 0-0) (P < .001). Level 1 hospitals had a median of 19 PICU beds (IQR, 10-28), level 2 hospitals had a median of 0 (IQR, 0-5), level 3 hospitals had a median of 0 (IQR, 0-0), and level 4 hospitals had a median of 0 (IQR, 0-0) (P < .001). Level 1 hospitals had a median referral rate of 1% (IQR, 1%-3%), level 2 hospitals had a median of 25% (IQR, 9%-45%), level 3 hospitals had a median of 70% (IQR, 52%-84%), and level 4 hospitals had a median of 100% (IQR, 98%-100%) (P < .001).

Conclusions and Relevance

In this cross-sectional study of hospitals from 10 US states, a system to classify hospitals’ pediatric capabilities in 4 levels was developed and was associated with structural and health care utilization characteristics. This system can be used to understand and track national pediatric acute care access and outcomes.
Use of Massage Therapy for Pain, 2018-2023
Authors: Mak Selene , Allen Jennifer , Begashaw Meron , Miake-Lye Isomi , Beroes-Severin Jessica , De Vries Gerardo , Lawson Emily , Shekelle Paul G.
Published: July 2024

Importance

Massage therapy is a popular treatment that has been advocated for dozens of painful adult health conditions and has a large evidence base.

Objective

To map systematic reviews, conclusions, and certainty or quality of evidence for outcomes of massage therapy for painful adult health conditions.

Evidence Review

In this systematic review, a computerized search was conducted of PubMed, the Allied and Complementary Medicine Database, the Cumulated Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews, and Web of Science from 2018 to 2023. Included studies were systematic reviews of massage therapy for pain in adult health conditions that formally rated the certainty, quality, or strength of evidence for conclusions. Studies of sports massage therapy, osteopathy, dry cupping or dry needling, and internal massage therapy (eg, for pelvic floor pain) were ineligible, as were self-administered massage therapy techniques, such as foam rolling. Reviews were categorized as those with at least 1 conclusion rated as high-certainty evidence, at least 1 conclusion rated as moderate-certainty evidence, and all conclusions rated as low- or very low–certainty evidence; a full list of conclusions and certainty of evidence was collected.

Findings

A total of 129 systematic reviews of massage therapy for painful adult health conditions were found; of these, 41 reviews used a formal method to rate certainty or quality of evidence of their conclusions and 17 reviews were mapped, covering 13 health conditions. Across these reviews, no conclusions were rated as high certainty of evidence. There were 7 conclusions that were rated as moderate-certainty evidence; all remaining conclusions were rated as low- or very low–certainty evidence. All conclusions rated as moderate certainty were that massage therapy had a beneficial associations with pain.

Conclusions and Relevance

This study found that despite a large number of randomized clinical trials, systematic reviews of massage therapy for painful adult health conditions rated a minority of conclusions as moderate-certainty evidence and that conclusions with moderate- or high-certainty evidence that massage therapy was superior to other active therapies were rare.
From Pixels to Information: Artificial Intelligence in Fluorescence Microscopy
Authors: Han Seungjae , You Joshua Yedam , Eom Minho , Ahn Sungjin , Cho Eun‐Seo , Yoon Young‐Gyu
Published: July 2024

This review explores how artificial intelligence (AI) is transforming fluorescence microscopy, providing an overview of its fundamental principles and recent advancements. The roles of AI in improving image quality and introducing new imaging modalities are discussed, offering a comprehensive perspective on these changes. Additionally, a unified framework is introduced for comprehending AI‐driven microscopy methodologies and categorizing them into linear inverse problem‐solving, denoising, and nonlinear prediction. Furthermore, the potential of self‐supervised learning techniques that address the challenges associated with training the networks are explored, utilizing unlabeled microscopy data to enhance data quality and expand imaging capabilities. It is worth noting that while the specific examples and advancements discussed in this review focus on fluorescence microscopy, the general approaches and theories are directly applicable to other optical microscopy methods.
Photoresponsive Multirole Nanoweapon Camouflaged by Hybrid Cell Membrane Vesicles for Efficient Antibacterial Therapy of Pseudomonas aeruginosa‐Infected Pneumonia and Wound
Authors: Liu Hening , Tang Lu , Yin Yue , Cao Yuqi , Fu Cong , Feng Jingwen , Shen Yan , Wang Wei
Published: July 2024

Exploring effective antibacterial approaches for targeted treatment of pathogenic bacterial infections with reduced drug resistance is of great significance. Combinational treatment modality that leverages different therapeutic components can improve the overall effectiveness and minimize adverse effects, thus displaying considerable potential against bacterial infections. Herein, red blood cell membrane fuses with macrophage membrane to develop hybrid cell membrane shell, which further camouflages around drug‐loaded liposome to fabricate biomimetic liposome (AB@LRM) for precise antibacterial therapy. Specifically, photoactive agent black phosphorus quantum dots (BPQDs) and classical antibiotics amikacin (AM) are loaded in AB@LRM to accurately target the inflammatory sites through the guidance of macrophage membrane and long residence capability of red blood cell membrane, eventually exerting efficacious antibacterial activities. Besides, due to the excellent photothermal and photodynamic properties, BPQDs act as an efficient antibacterial agent when exposed to near‐infrared laser irradiation, dramatically increasing the sensitivity of bacteria to antibiotics. Consequently, the synergistic sterilizing effect produced by AB@LRM further restricts bacterial resistance. Upon laser irradiation, AB@LRM shows superior anti‐inflammatory and antibacterial properties in models of P. aeruginosa‐infected pneumonia and wounds. Hence, this light‐activatable antibacterial nanoplatform with good biocompatibility presents great potential to advance the clinical development in the treatment of bacterial infections.
Investigating upland cotton (Gossypium hirsutum L.) varietal performance in alternative row arrangements in Georgia
Authors: Hall Jordon M. , Lawton Caitlyn B. , Snider John L. , Roberts Phillip M. , Hand Lavesta C.
Published: July 2024

With grower interest in skip and wide row cotton systems, varietal performance in such systems has become a major question. An experiment was conducted in 2022 and 2023 in Tifton and Midville, GA, evaluating three row arrangements (standard 91‐cm row spacing, 2 × 1 skip row, and 183‐cm row spacing or wide row) and four commercially available varieties (Stoneville [ST] 5091 Bollgard 3 Xtendflex [B3XF], Phytogen [PHY] 400 Widestrike 3 Roundup Flex Enlist [W3FE], DynaGro [DG] 3799 B3XF, and Deltapine [DP] 1840 B3XF). There were no interactions between variety and row arrangement for any response variable, indicating the best variety for standard row spacings would also be the best variety in alternative row arrangements. Plant populations were reduced 32% and 53% in 2 × 1 skip‐row and wide‐row systems, respectively, compared to standard row arrangements, which accomplishes the major goal of these systems in reducing seed cost. Boll rot and hard lock were reduced in wide row treatments only, which could benefit cotton growers in the lower Southeast. However, reductions in lint yield were associated with 2 × 1 skip row (all site years) and wide row arrangements (three out of four site‐years) compared to the grower standard. Differences among varieties were observed in plant heights, lint yield, and fiber quality, which is to be expected. These results confirm much of the work conducted on skip and wide row cotton systems and indicate that for growers in the lower Southeast to achieve maximum lint yields, standard row arrangements are superior to alternative row arrangements.
Enhancing Sensitivity across Scales with Highly Sensitive Hall Effect‐Based Auxetic Tactile Sensors
Authors: Yun Youngheon , Lee Dongchan , Lee Soyeon , Pané Salvador , Puigmartí‐Luis Josep , Chun Sungwoo , Jang Bumjin
Published: July 2024

The research addresses the limitations inherent in conventional Hall effect‐based tactile sensors, particularly their restricted sensitivity by introducing an innovative metastructure. Through meticulous finite element analysis optimization, the Hall effect‐based auxetic tactile sensor (HEATS), featuring a rotating square plate configuration as the most effective auxetic pattern to enhance sensitivity, is developed. Experimental validation demonstrates significant sensitivity enhancements across a wide sensing range. HEATS exhibits a remarkable 20‐fold and 10‐fold improvement at tensile rates of 0.9% and 30%, respectively, compared to non‐auxetic sensors. Furthermore, comprehensive testing demonstrates HEATS’ exceptional precision in detecting various tactile stimuli, including muscle movements and joint angles. With its unparalleled accuracy and adaptability, HEATS offers vast potential applications in human–machine and human–robot interaction, where subtle tactile communication is a prerequisite.
Unravelling the Optoelectronic and Biological Properties of Phenanthroimidazo [1,2‐c] Quinazoline‐Based Donor‐Acceptor Materials
Authors: Ganesan Prabhu , Ranganathan Revathi , Vijay Solomon Rajadurai , Muhamed Noorani Peer , Ganesan Paramaguru , Thajuddin Nooruddin , Venkattappan Anbazhagan , Rajalingam Renganathan , Gao Peng
Published: July 2024

Imidazo[1,2‐c]quinazoline, a class of fused imidazole and quinazoline acceptor units, is widely established as biologically and broadly spectral active materials, while their optoelectronic properties were seldom investigated in the literature. In this context, this research work introduced two donors of varying strength, such as triphenylamine (TP) and phenothiazine (PZ) units, into the phenanthroimidazo [1,2‐c] quinazoline acceptor unit to form donor‐acceptor type luminescence materials such as TPQZ and PZQZ, respectively and were characterized by NMR and mass spectroscopy. Both these materials exhibited intramolecular charge transfer (ICT) type absorption (∼380–450 nm) and emission (∼540–600 nm) characteristics, which attributed to the electronic transition occurring from the HOMO of the TP/PZ donor to the LUMO+1 and LUMO+2 of the imidazo [1,2‐c] quinazoline acceptor unit, as predicted using DFT calculations. Increasing the electron donor strength was not only limited to fine‐tuning the π→π* based localized (∼400–450 nm) to ICT (∼450–650 nm) emission characteristics in both the solution and solid‐state conditions but also found to improve the zone of inhibition to 16 mm against Staphylococcus aureus/Bacillus subtilis bacterial species. The scope of realizing the luminescence nature of this acceptor unit is further expanded towards tagging biological samples such as E. coli. Overall, this work opens up a new paradigm in developing luminescent materials utilizing imidazo[1,2‐c]quinazoline acceptor unit for optoelectronic and biological applications.
Reversible switching of supramolecular self‐assembly between nanofibers and nanorings based on perylene‐terminated star elastomers
Authors: Deng Haoyun , Zhou Mengzhen , Li Shunli , Yang Zhixiong , Wei Jiao , Ou Encai , Xu Weijian
Published: July 2024

Perylene‐terminated star elastomers (PSE) containing the diblock copolymers of polystyrene (PS) and polyisoprene (PI) segments were designed and synthesized by anionic polymerization. The PSE exhibits good fluorescence performances in solution, self‐assembled aggregates, and solid state. Different supramolecular self‐assemblies in tetrahydrofuran (THF) solution based on the π−π stacking of perylene and interactions in PS can be observed from nanofibers to twisted multi‐nanoropes. Moreover, the twisted nanoropes under ultrasonic can transform spontaneously into nanorings in the stationary state, and reversibly switch between twisted nanoropes and nanorings via the manipulation of ultrasonic force. The terminating methods will offer considerable scope for the design and synthesis of new star elastomers. Meanwhile, a new insight into π−π stacking and interactions is provided for understanding multistep and cooperative self‐assembly in supramolecular self‐assembly.
Memory strategies in autistic and older adults
Authors: Torenvliet C. , Groenman A. P. , Van der Burg E. , Charlton R. C. , Hamilton C. J. , Geurts H. M.
Published: July 2024

Memory strategies in autistic adults seem to mimic strategies at older age, as both younger autistic and older non‐autistic individuals use fewer semantic features in visual memory tasks. Therefore, the current study aims to investigate whether early differences in memory strategies lead to altered age‐related effects in autism, particularly whether initial difficulties in strategy use become advantageous at older age (i.e., “protective aging”). A total of 147 participants across four groups (autistic younger/older, non‐autistic younger/older) completed an online assessment. This assessment included a recognition version of the Visual Patterns Test (VPT) to evaluate semantic strategy use in visual memory, the Just Noticeable Difference (JND) size task for assessing visual processing, and the Multifactorial Memory Questionnaire to evaluate subjective memory functioning and strategy use (MMQ). Unexpectedly, all groups benefited from semantic features on the VPT, although the older groups performed less accurately and slower than the younger groups. The JND Size task showed no group differences. Autistic adults rated their MMQ memory as worse than non‐autistic adults, despite reporting greater strategy use. These results indicate that cognitive strategies might be more similar between younger/older and autistic/non‐autistic people than previously expected, although notable discrepancies between objective and subjective measures were present. They also substantiate previously reported parallel (i.e., similar) age‐related effects between autistic and non‐autistic people.
Defined folding pattern of poly(rG) supports inherent ability to encode biological information
Authors: Kankia Nickolas , Lomidze Levan , Stevenson Skylar , Musier‐Forsyth Karin , Kankia Besik
Published: July 2024

The RNA World hypothesis posits that RNA can represent a primitive life form by reproducing itself and demonstrating catalytic activity. However, this hypothesis is incapable of addressing several major origin‐of‐life (OoL) questions. A recently described paradox‐free alternative OoL hypothesis, the Quadruplex (G4) World, is based on the ability of poly(dG) to fold into a stable architecture with an unambiguous folding pattern using G‐tetrads as building elements. Because of the folding pattern of three G‐tetrads and single‐G loops, dG15 is programmable and has the capability to encode biological information. Here, we address two open questions of the G4 World hypothesis: (1) Does RNA follow the same folding pattern as DNA? (2) How do stable quadruplexes evolve into the present‐day system of information transfer, which is based on Watson‐Crick base pair complementarity? To address these questions, we systematically studied the thermodynamic and optical properties of both DNA and RNA G15‐ and G3T (GGGTGGGTGGGTGGG)‐derived sequences. Our study revealed that similar to DNA sequences, RNAs adopt quadruplexes with only three G‐tetrads. Thus, both poly(dG) and poly(rG) possess inherent ability to fold into 3D quadruplex architecture with strictly defined folding pattern. The study also revealed that despite high stability of both DNA and RNA quadruplexes, they are vulnerable to single‐nucleotide substitutions, which drop the thermal stability by ~40°C and can facilitate introduction of the complementarity principle into the G4 World.
Hierarchical Self‐Assembly of Hyperbranched Polymer‐Based Topological Supramolecular Amphiphiles
Authors: Zhang Han , Pan Yi , Li Yinghua , Li Chen , Wang Yuling , Jiang Wenfeng , Xu Fugui , Mai Yiyong , Zhou Yongfeng
Published: July 2024

Supramolecular polymers (SPs) are constructed through non‐covalent interactions. The dynamic or reversible nature of SPs endows them unique physical and chemical properties, such as self‐adaptive and stimuli‐response abilities. The topological structures of SPs play an important role in determining the physicochemical properties and functionality. Hyperbranched polymers (HBPs) are highly branched 3D macromolecules with linear, dendritic, and terminal units, which makes them versatile candidates for the construction of SPs with fascinating architectures. The resultant HBP‐based SPs perfectly integrated the dynamic/reversible nature of SPs and the 3D topological features and multifunctionality of HBP polymers. To date, various types of HBP‐based SPs and their assemblies have been constructed, and their potential applications have been explored as well. This article overviews the current progress on self‐assembly of HBP‐based SPs. The strategies for construction of HBP‐based SPs and their assemblies are discussed. Typical potential applications of the assemblies of HBP‐based SPs are also introduced.
Insight from Electrochemical Analysis in the Radical Cation State of a Monopyrrolotetrathiafulvalene‐Based [2]Rotaxane
Authors: Neumann Mathias S. , Flood Amar H. , Jeppesen Jan O.
Published: July 2024

Mechanically interlocked molecules are a class of compounds used for controlling directional movement when barriers can be raised and lowered using external stimuli. Applied voltages can turn on redox states to alter electrostatic barriers but their use for directing motion requires knowledge of their impact on the kinetics. Herein, we make the first measurements on the movement of cyclobis(paraquat‐p‐phenylene) (CBPQT4+) across the radical‐cation state of monopyrrolotetrathiafulvalene (MPTTF) in a [2]rotaxane using variable scan‐rate electrochemistry. The [2]rotaxane is designed in a way that directs CBPQT4+ to a high‐energy co‐conformation upon oxidation of MPTTF to either the radical cation (MPTTF⋅+) or the dication (MPTTF2+). 1H NMR spectroscopic investigations carried out in acetonitrile at 298 K showed direct interconversion to the thermodynamically more stable ground‐state co‐conformation with CBPQT4+ moving across the oxidized MPTTF2+ electrostatic barrier. The electrochemical studies revealed that interconversion takes place by movement of CBPQT4+ across both the MPTTF•+ (19.3 kcal mol−1) and MPTTF2+ (18.7 kcal mol−1) barriers. The outcome of our studies shows that MPTTF has three accessible redox states that can be used to kinetically control the movement of the ring component in mechanically interlocked molecules.
Out‐of‐pocket costs for diagnostic testing following abnormal prostate cancer screening among privately insured men
Authors: Srivastava Arnav , Tilea Anca , Kim David D. , Dalton Vanessa K. , Fendrick A. Mark
Published: July 2024

Objective

Prostate cancer is the most common malignancy among men and following a positive prostate‐specific antigen (PSA) screening test, patients may undergo more expensive diagnostic testing. However, testing‐related out‐of‐pocket costs (OOPCs), which may preclude patients from completing the screening process, have not been previously quantified. OOPCs for follow‐up diagnostic testing (i.e., prostate biopsy and/or magnetic resonance imaging [MRI]) in patients with private insurance undergoing prostate cancer screening were estimated.

Methods

Men ages 55 to 69 years old who underwent PSA‐based prostate cancer screening from 2010 to 2020 from the IBM Marketscan database were identified. The number of patients undergoing follow‐up diagnostic testing within 12 months of screening was tabulated, dividing patients into three groups: (1) biopsy only, (2) MRI only, and (3) MRI + biopsy. Over the study period, patients with nonzero cost‐sharing and calculated inflation‐adjusted OOPCs, adding copayment, coinsurance, and deductible payments, for each group were identified.

Results

Among screened patients (n = 3,075,841) from 2010 through 2020, 91,850 had a second PSA test and an elevated PSA level, of which 40,329 (43.9%) underwent subsequent diagnostic testing. More than 75% of these patients experienced cost‐sharing, and median OOPCs rose substantially over the study period for patients undergoing biopsy only ($79 to $214), MRI only ($81 to $490), and MRI and biopsy ($353 to $620).

Conclusions

OOPCs from diagnostic testing after prostate cancer screening are common and rising. This work aligns with the recent position statement from the American Cancer Society, that payers should eliminate cost‐sharing, which may undermine the screening process, for diagnostic testing following cancer screening.
A GSO‐based multi‐objective technique for performance optimization of blockchain‐based industrial Internet of things
Authors: Zanbouri Kouros , Darbandi Mehdi , Nassr Mohammad , Heidari Arash , Navimipour Nima Jafari , Yalcın Senay
Published: July 2024

The latest developments in the industrial Internet of things (IIoT) have opened up a collection of possibilities for many industries. To solve the massive IIoT data security and efficiency problems, a potential approach is considered to satisfy the main needs of IIoT, such as high throughput, high security, and high efficiency, which is named blockchain. The blockchain mechanism is considered a significant approach to boosting data protection and performance. In the quest to amplify the capabilities of blockchain‐based IIoT, a pivotal role is accorded to the Glowworm Swarm Optimization (GSO) algorithm. Inspired by the collaborative brilliance of glowworms in nature, the GSO algorithm offers a unique approach to harmonizing these conflicting aims. This paper proposes a new approach to improve the performance optimization of blockchain‐based IIoT using the GSO algorithm due to the blockchain's contradictory objectives. The proposed blockchain‐based IIoT system using the GSO algorithm addresses scalability challenges typically associated with blockchain technology by efficiently managing interactions among nodes and dynamically adapting to network demands. The GSO algorithm optimizes the allocation of resources and decision‐making, reducing inefficiencies and bottlenecks. The method demonstrates considerable performance improvements through extensive simulations compared to traditional algorithms, offering a more scalable and efficient solution for industrial applications in the context of the IIoT. The extensive simulation and computational study have shown that the proposed method using GSO considerably improves the objective function and blockchain‐based IIoT systems' performance compared to traditional algorithms. It provides more efficient and secure systems for industries and corporations.
Reconfigurable fractal antennas for future wireless applications: A comprehensive review
Authors: Patel Khushbu , Behera Santanu Kumar
Published: July 2024

Reconfigurable fractal antenna (RFA) design is always necessary for the continued development of wireless communication systems as the antenna is playing a vital part in device performance. The need for efficient radiators that are compact, low‐profile, inexpensive, and low weight has attracted scientists for their research works. As a result, numerous ideas were put forward by the researchers to attempt to resolve these problems by utilizing various kinds of fractal and reconfigurable antennas as well as their combinations. However, it is challenging to have a clear and transparent review of the various works with a large variety of solutions and their uniqueness. The advanced RFA design for wireless applications is reviewed in this study together with its most recent and pertinent counterparts. In Koch RFA, bandwidths enable selective bands spanning 1–6 GHz frequency range. Further, in band RFA design, the overall bandwidth ranges from 1.45 to 4.52 GHz (103%) with low gain; on the other hand, the crescent RFA achieves 5.67 dBi peak gain. Furthermore, in polarization RFA, the ARBWs are 17.61% (2.2–2.62 GHz) and 8.69% (2.91–3.18 GHz). The Hilbert RFA operates at 0.9 and 2.45 GHz with gains of 3.1 and 7 dBi, respectively. This article investigates a comprehensive review of the requirements for RFAs for wireless applications. Furthermore, a comparative study on different reconfigurability with switching techniques, fractal geometries, various RFA design approaches to enhance device performance, and their significance is discussed. Existing research challenges and future directions are also discussed as part of this article.
Unilateral drainage and chemotherapy prolong the patency of a plastic stent placed above the sphincter of Oddi in patients with malignant hilar biliary obstruction
Authors: Tomooka Fumimasa , Kitagawa Koh , Mitoro Akira , Fujinaga Yukihisa , Nishimura Norihisa , Namisaki Tadashi , Akahane Takemi , Kaji Kosuke , Asada Shohei , Sato Shinya , Hanatani Jun‐Ichi , Mori Hitoshi , Motokawa Yuki , Iwata Tomihiro , Kachi Hiroki , Osaki Yui , Yoshiji Hitoshi
Published: July 2024

Objectives

To evaluate the results of inside stent therapy for unresectable malignant hilar biliary obstruction and identify factors related to stent patency duration.

Methods

Of 44 patients who underwent initial inside‐stent placement above the sphincter of Oddi from April 2017 to December 2022, 42 with the resolution of jaundice (clinical success rate, 95.5%) were retrospectively analyzed. Univariate and multivariate logistic regression analysis identified factors associated with stent patency duration.

Results

Univariate analysis revealed significant differences in the drainage method (406 days for unilateral drainage vs. 305 days for bilateral drainage of the right and left liver lobes, p = 0.022) with or without chemotherapy (406 days with vs. 154 days without, p = 0.038). Multivariate analysis (Cox proportional hazards analysis) revealed similar results, with unilateral drainage (p = 0.031) and chemotherapy (p = 0.048) identified as independent factors associated with prolonged stent patency. Early adverse events were observed in two patients (4.8%; one cholangitis, one pancreatitis).

Conclusions

Inside‐stent therapy was safely performed in patients with malignant hilar biliary obstruction. Simple unilateral drainage and chemotherapy may prolong stent patency.
Late Positive Potential Elicited by Monetary Reward Feedback Predicts Changes of Disordered Eating From Age 11 to Age 12 in Community‐Dwelling Girls
Authors: Liu Pan , Tan Jaron X. Y.
Published: July 2024

Objective

Early adolescence is marked by elevated psychopathology, including disrupted eating attitudes and behaviors. Reward processing is an identified mechanism in portending eating pathology, that is, aberrant reward responsivity may contribute to disrupted reward‐seeking behaviors (e.g., food consuming). This literature has focused on adults or mid‐to‐late adolescents, with little work done on early adolescence. We examined the linkages between reward feedback processing, indexed by event‐related potentials (ERPs), and changes of emerging disordered eating in community‐dwelling early adolescents.

Method

At T1, 115 youths (66 girls, mean/SD age = 11.00/1.16 years) completed an EEG monetary reward Doors task. Youths completed the Eating Disorder Examination‐Questionnaire Short at T1 and ~6 months (T2) and ~12 months (T3) after T1. In the ERP data, we isolated a reward positivity (RewP) and a late positive potential (LPP) via principal component analysis. We applied multilevel modeling to examine whether baseline ERPs interacted with Time in predicting disordered eating and whether these interactions varied by sex.

Results

We found a significant Time × LPP interaction in girls but not boys. Among girls, only those with a smaller LPP toward the losses (versus wins), which might reflect suboptimal evaluation and regulatory processes in undesired situations, showed increases in disordered eating from T1 to T3.

Discussion

We provided preliminary yet novel evidence concerning the prospective associations between reward processing and changes of disordered eating in early adolescents. Future studies along this line will be critical for understanding the early mechanisms of eating pathology, identifying youths at risk, and developing prevention strategies.
Overwintering under ice: A novel observation for an Australian freshwater turtle
Authors: Dowling James , Bower Deborah S. , Nordberg Eric J.
Published: July 2024

Frozen water bodies provide a physiological challenge to fauna by physically limiting access to atmospheric oxygen. To tolerate low temperatures, reptiles use brumation as a physiological strategy in winter. Cryptodira vary in their tolerance to freezing conditions but the extent of tolerance in pleurodirans is largely unknown. Australia's freshwater turtles inhabit warmer regions with less severe winters and have well‐developed mechanisms to cope with high temperatures and drying waterbodies, rather than extreme cold tolerance. Chelodina longicollis is a widespread Australian freshwater turtle species that tolerates high temperatures and desiccation during hot, dry periods while also undergoing brumation during winter months. Despite extensive research, limited observations exist on their behaviour during severe winter periods at the extremes of their range. In an 11‐month tracking study, we monitored adult C. longicollis, noting their movements, locations, and temperature weekly. We observed an adult female C. longicollis which, during a seven‐month period within a single creek pool, survived brumation in extreme cold water including a 15‐day period of total freezing of the surface water. After the ice melted following a rain event, the turtle was recaptured alive. This marks the first observation of brumation for an Australian chelid species under ice.
Stable body sizes in soil nematodes across altitudes: The role of intrageneric variation in community assembly
Authors: Li Teng , Li Xianping , Zheng Lingyun , Li Huixin
Published: July 2024

Animal body size exhibits rapid responses to environmental variations and displays considerable variability across ecological scales, significantly influencing ecological community assembly. However, our understanding of the extent of body size variation and its responses to environmental differences within soil fauna remains limited, impeding a comprehensive grasp of soil fauna's functional ecology. Here, we aim to investigate the magnitude of intrageneric body size variation and its implications for soil nematode community assembly along an altitudinal gradient. We examined soil nematode body size responses along an altitudinal gradient spanning from 3136 to 4128 m in an alpine mountain region of the eastern Tibetan Plateau. We assessed the contributions of intra‐ and intergeneric variations in body size, both within and among communities, using individual body size values. The implications of these variations for community assembly processes were determined through phenotypic variance ratios employing permutation tests. Our analyses did not reveal statistically significant correlations between altitude and the community‐weighted mean body mass, regardless of considering intrageneric trait variation (IGTV). Approximately 15% of the variation in body size among communities and a substantial 72% of the variation in body size within communities can be attributed to IGTV. Altitude did not significantly affect IGTV within or among communities. Furthermore, our results underscored the dominant role of internal filtering within the community in governing nematode community assembly, with external filtering outside the community playing a limited role within our altitudinal range. Our findings emphasize the dominant role of body size variation within communities rather than among communities, attributable to strong internal filtering processes. These findings advance our understanding of body size variation in soil nematodes across ecological scales and highlight the pivotal role of intrageneric variation in shaping the functional ecology of soil fauna.
Energy and exergy analysis of drying terebinth in a far infrared‐rotary dryer using response surface methodology
Authors: Kaveh Mohammad , Abbaspour‐Gilandeh Yousef , Nowacka Malgorzata , Kalantari Davood , El‐Mesery Hany S. , Taghinezhad Ebrahim
Published: July 2024

Water shows a strong tendency to absorb the energy of wavelengths of 3 and 6 µm, which are in the infrared (IR) range. Therefore, IR dryers are used to dry food and fruits that have a high‐water content. Thus, modeling and optimizing energy and exergy parameters of terebinth drying in an IR–rotary drum (RD) dryer were evaluated using the response surface methodology. Independent factors included IR power and rotary rotation speed, and response factors were specific energy consumption (SEC), energy efficiency (EFF), exergy efficiency (EXEFF), specific exergy loss (EXLOSS), and exergy improvement potential (EIP). According to the obtained results, the range of EFF and EXEFF was between 28.93%–9.11% and 0.88%–6.62%, respectively. As IR power and RD speed increased, SEC (123.75–39.21 MJ/kg), EXLOSS (3.97–2.97 MJ/kg), and EIP (3.62–1.009 MJ/kg) decreased, while EFF and EXEFF increased. The results obtained in this study showed that the optimal IR drying power is 616.39 W, and the optimal rotary rotation speed is 13.46 rpm.
Fabrication of chitin‐fibrin hydrogels to construct the 3D artificial extracellular matrix scaffold for vascular regeneration and cardiac tissue engineering
Authors: Yang Pengcheng , Xie Fang , Zhu Lihang , Selvaraj Jonathan Nimal , Zhang Donghui , Cai Jie
Published: July 2024

As the cornerstone of tissue engineering and regeneration medicine research, developing a cost‐effective and bionic extracellular matrix (ECM) that can precisely modulate cellular behavior and form functional tissue remains challenging. An artificial ECM combining polysaccharides and fibrillar proteins to mimic the structure and composition of natural ECM provides a promising solution for cardiac tissue regeneration. In this study, we developed a bionic hydrogel scaffold by combining a quaternized β‐chitin derivative (QC) and fibrin‐matrigel (FM) in different ratios to mimic a natural ECM. We evaluated the stiffness of those composite hydrogels with different mixing ratios and their effects on the growth of human umbilical vein endothelial cells (HUVECs). The optimal hydrogels, QCFM1 hydrogels were further applied to load HUVECs into nude mice for in vivo angiogenesis. Besides, we encapsulated human pluripotent stem cell‐derived cardiomyocytes (hPSC‐CMs) into QCFM hydrogels and employed 3D bioprinting to achieve batch fabrication of human‐engineered heart tissue (hEHT). Finally, the myocardial structure and electrophysiological function of hEHT were evaluated by immunofluorescence and optical mapping. Designed artificial ECM has a tunable modulus (220–1380 Pa), which determines the different cellular behavior of HUVECs when encapsulated in these. QCFM1 composite hydrogels with optimal stiffness (800 Pa) and porous architecture were finally identified, which could adapt for in vitro cell spreading and in vivo angiogenesis of HUVECs. Moreover, QCFM1 hydrogels were applied in 3D bioprinting successfully to achieve batch fabrication of both ring‐shaped and patch‐shaped hEHT. These QCFM1 hydrogels‐based hEHTs possess organized sarcomeres and advanced function characteristics comparable to reported hEHTs. The chitin‐derived hydrogels are first used for cardiac tissue engineering and achieve the batch fabrication of functionalized artificial myocardium. Specifically, these novel QCFM1 hydrogels provided a reliable and economical choice serving as ideal ECM for application in tissue engineering and regeneration medicine.
CD66b+/CD68+ circulating extracellular vesicles, lactate dehydrogenase and neutrophil‐to‐lymphocyte ratio can differentiate coronavirus disease 2019 severity during and after infection
Authors: Suades Rosa , Greco Maria Francesca , Prieto Paula , Padró Teresa , Devaux Yvan , Domingo Pere , Badimon Lina
Published: July 2024

Coronavirus disease 2019 (COVID‐19) has been a major public health burden. We hypothesised that circulating extracellular vesicles (cEVs), key players in health and disease, could trace the cell changes during COVID‐19 infection and recovery. Therefore, we studied the temporal trend of cEV and inflammatory marker levels in plasma samples of COVID‐19 patients that were collected within 24 h of patient admission (baseline, n = 80) and after hospital discharge at day‐90 post‐admission (n = 59). Inflammatory markers were measured by standard biochemical methods. cEVs were quantitatively and phenotypically characterized by high‐sensitivity nano flow cytometry. In patients recovered from COVID‐19 lower levels of inflammatory markers were detected. cEVs from vascular (endothelial cells) and blood (platelets, distinct immune subsets) cells were significantly reduced at day‐90 compared to admission levels, a pattern also observed for cEVs from progenitor, perivascular and epithelial cells. The best discriminatory power for COVID‐19 severity was found for inflammatory markers lactate dehydrogenase and neutrophil‐to‐lymphocyte ratio and for granulocyte/macrophage‐released CD66b+/CD68+‐cEVs. Albeit inflammatory markers were good indicators of systemic inflammatory response and discriminators of COVID‐19 remission, they do not completely reveal cell stress and organ damage states. cEVs reaching baseline pre‐infection levels at 90 days post‐infection in recovered patients discriminate parental cells affected by disease.
Longitudinal monitoring of Torque Teno virus DNAemia in kidney transplant recipients correlates with long‐term complications of inadequate immunosuppression
Authors: Chauvelot Luc , Barba Thomas , Saison Carole , Siska Evangelia , Kulifaj Dorian , Bakker Stephan J. L. , Koenig Alice , Rabeyrin Maud , Buron Fanny , Picard Cécile , Dijoud Frédérique , Manière Louis , Lina Bruno , Morelon Emmanuel , Dubois Valerie , Thaunat Olivier
Published: July 2024

Optimization of individual immunosuppression, which reduces the risks of both graft loss and patients' death, is considered the best approach to improve long‐term outcomes of renal transplantation. Torque Teno Virus (TTV) DNAemia has emerged as a potential biomarker reflecting the depth of therapeutic immunosuppression during the initial year post‐transplantation. However, its efficacy in long‐term monitoring remains uncertain. In a cohort study involving 34 stable kidney transplant recipients and 124 healthy volunteers, we established lower and upper TTV DNAemia thresholds (3.75–5.1 log10 cp/mL) correlating with T‐cell activatability, antibody response against flu vaccine, and risk for subsequent serious infections or cancer over 50 months. Validation in an independent cohort of 92 recipients confirmed that maintaining TTV DNAemia within this range in >50% of follow‐up time points was associated with reduced risks of complications due to inadequate immunosuppression, including de novo DSA, biopsy‐proven antibody‐mediated rejection, graft loss, infections, or cancer. Multivariate analysis highlighted “in‐target” TTV DNAemia as the sole independent variable significantly linked to decreased risk for long‐term complications due to inadequate immunosuppression (odds ratio [OR]: 0.27 [0.09–0.77]; p = 0.019). Our data suggest that the longitudinal monitoring of TTV DNAemia in kidney transplant recipients could help preventing the long‐term complications due to inadequate immunosuppression.
Rosacea fulminans: An anti‐inflammatory‐based therapeutic approach
Authors: Handgretinger Gabi , Saur Alexandra , Wolff Isabel , Schaller Martin
Published: July 2024

Background

The treatment of rosacea fulminans still poses a significant challenge in daily clinical practice. The pronounced centrofacial inflammation accompanied by severe pustulation, pain and high psychological stress, mostly affecting young women, requires an appropriate fast‐acting treatment regimen. A major difficulty here is that if isotretinoin is recommended for therapy, sufficiently reliable contraception is absolutely necessary and not always given. So far, alternative therapies have not been extensively studied.

Objectives

Our goal is to show the efficacy of a treatment regimen with macrolide antibiotics (azithromycin) without the need for initial systemic isotretinoin or corticosteroids.

Methods

We present six female patients in our outpatient clinic treated with a combination of azithromycin and topical ivermectin reaching rapid inflammation control.

Subsequently, maintenance with ultra‐low dose isotretinoin was initiated in 66% of cases. The patients were monitored for a median follow‐up time of 15.5 months [1–51 months].

Results

We can show rapid improvement of inflammation under antibiotic‐treatment with azithromycin (500 mg 3x weekly for 4 weeks, 2x weekly for 4 weeks, 1x weekly 4 weeks) followed by ultra‐low dose isotretinoin maintenance treatment with minimal side effects. Topical ivermectin was administered additionally.

Conclusions

Macrolides, in particular azithromycin, pose an alternative treatment method when retinoids are contraindicated extending the treatment regimen of rosacea fulminans. They are a fast‐acting and safe alternative to retinoids without the need for initial contraception. The antibiotic‐based approach is particularly suited to the control of inflammation.