bluuebunny/crossref_metadata_2025 huggingface dataset:
SLUG and SNAIL as Potential Immunohistochemical Biomarkers for Renal Cancer Staging and Survival
Authors: Zivotic Maja , Kovacevic Sanjin , Nikolic Gorana , Mioljevic Ana , Filipovic Isidora , Djordjevic Marija , Jovicic Vladimir , Topalovic Nikola , Ilic Kristina , Radojevic Skodric Sanja , Dundjerovic Dusko , Nesovic Ostojic Jelena
Published: July 2023

Renal cell carcinoma (RCC) is the deadliest urological neoplasm. Up to date, no validated biomarkers are included in clinical guidelines for the screening and follow up of patients suffering from RCC. Slug (Snail2) and Snail (Snail1) belong to the Snail superfamily of zinc finger transcriptional factors that take part in the epithelial–mesenchymal transition, a process important during embryogenesis but also involved in tumor progression. We examined Slug and Snail immunohistochemical expression in patients with different stages of renal cell carcinomas with the aim to investigate their potential role as staging and prognostic factors. A total of 166 samples of malignant renal cell neoplasms were analyzed using tissue microarray and immunohistochemistry. Slug and Snail expressions were evaluated qualitatively (presence or absence), in nuclear and cytoplasmic cell compartments and compared in relation to clinical parameters. The Kaplan–Meier survival analysis showed the impact of the sarcomatoid component and Slug expression on the survival longevity. Cox regression analysis separated Slug as the only independent prognostic factor (p = 0.046). The expression of Snail was associated with higher stages of the disease (p = 0.004), especially observing nuclear Snail expression (p < 0.001). All of the tumors that had metastasized showed nuclear immunoreactivity (p < 0.001). In clear cell RCC, we showed a significant relationship between a high nuclear grade and nuclear Snail expression (p = 0.039). Our results suggest that Slug and Snail could be useful immunohistochemical markers for staging and prognosis in patients suffering from various RCCs, representing potential targets for further therapy strategies of renal cancer.
Transcriptomic Responses of Salvia hispanica to the Infestation of Red Spider Mites (Tetranychus neocaledonicus)
Authors: Lee May , Wang Le , Yue Gen Hua
Published: July 2023

Salvia hispanica (chia) is a highly nutritious food source and has gained popularity due to its high omega-3 fatty acid content. Red spider mites are a serious problem in the production of S. hispanica. However, no study has been conducted to analyze the defensive response to the infestation of red spider mites in S. hispanica. To elucidate the molecular mechanisms of the defensive response of S. hispanica to red spider mites, we performed a transcriptomic analysis of S. hispanica when infested by red spider mites. In the comparative assessment of leaf transcriptomes, a total of 1743 differentially expressed genes (DEGs) were identified between control and mite-infested S. hispanica. From these, 1208 (69%) transcripts were upregulated and 535 (31%) were downregulated. The DEGs included transcription factors, defense hormones, and secondary metabolites that were either suppressed or activated in response to spider mite herbivory. Gene Ontology (GO) enrichment analysis revealed that plant secondary metabolites, such as glucosinolates, and signaling pathways, including the jasmonic acid signaling pathway, may play an important role in the defense against red spider mites. This study provides novel insights into the defense response of S. hispanica to insect herbivory and could be a resource for the improvement of pest resistance in the chia.
Gene–Smoking Interaction Analysis for the Identification of Novel Asthma-Associated Genetic Factors
Authors: Cha Junho , Choi Sungkyoung
Published: July 2023

Asthma is a complex heterogeneous disease caused by gene–environment interactions. Although numerous genome-wide association studies have been conducted, these interactions have not been systemically investigated. We sought to identify genetic factors associated with the asthma phenotype in 66,857 subjects from the Health Examination Study, Cardiovascular Disease Association Study, and Korea Association Resource Study cohorts. We investigated asthma-associated gene–environment (smoking status) interactions at the level of single nucleotide polymorphisms, genes, and gene sets. We identified two potentially novel (SETDB1 and ZNF8) and five previously reported (DM4C, DOCK8, MMP20, MYL7, and ADCY9) genes associated with increased asthma risk. Numerous gene ontology processes, including regulation of T cell differentiation in the thymus (GO:0033081), were significantly enriched for asthma risk. Functional annotation analysis confirmed the causal relationship between five genes (two potentially novel and three previously reported genes) and asthma through genome-wide functional prediction scores (combined annotation-dependent depletion, deleterious annotation of genetic variants using neural networks, and RegulomeDB). Our findings elucidate the genetic architecture of asthma and improve the understanding of its biological mechanisms. However, further studies are necessary for developing preventive treatments based on environmental factors and understanding the immune system mechanisms that contribute to the etiology of asthma.
Silicon Accumulation in Leaves Reduces the Herbivory by Invasive Fall Armyworm Spodoptera frugiperda and Enhances the Yield of Maize
Authors: Nagaratna Wangi , Kalleshwaraswamy Chicknayakanahalli Marulasiddappa , Dhananjaya Bhakthanakatte Chandrappa , Prakash Nagabovanalli B. , Deshmukh Sharanabasappa S. , Sunil Chandrashekar , Hossain Mohammad Anwar , Mallikarjuna Hosamane Basvarajappa
Published: July 2023

Fall armyworm (FAW) Spodoptera frugiperda is currently being considered as a serious insect pest in maize that causes significant yield losses worldwide. Silicon (Si) and plant growth regulators (PGRs) are known to induce resistance against biotic and abiotic stresses thereby enhancing the yield. This study was conducted to determine the influence of Si and PGRs on the incidence and damage of FAW on maize (Zea mays L.) under field condition. The experiment was conducted in both Kharif and Rabi seasons using a randomized complete block design with three replications and treatments. Various combinations of foliar silicic acid (FSA) and two PGRs such as gibberelic acid (GA3) and jasmonic acid (JA) were tested to study their effects on FAW incidence and maize yield. The application of FSA at 2mL/plant + GA3 at 0.5 mg/plant recorded the lowest number of larvae per plant (0.39 larva/plant) with the lowest damage score of 2.55 (Davis scale). The percent infestation was also low for the same treatment, i.e., 34.14 percent infestation with the highest percent reduction over control (56.43%). The highest yield (58.39 q/ha) and cost–benefit ratio (1:2.34) was recorded for FSA at 2 mL/plant + GA3 at 0.5 mg/plant, which was considered as the best treatment. This study demonstrated that exogenous application of Si along with PGRs has significant negative effect on field incidence of FAW and enhanced the yield of maize.
Wander Effect on Pavement Performance for Application in Connected and Autonomous Vehicles
Authors: Pais Jorge , Pereira Paulo , Thives Liseane
Published: July 2023

Connected and Autonomous Vehicles (CAV) will change how road engineers design road pavements because they can position themselves within a traffic lane, keeping their position in the lane more precisely than human-driven vehicles. These vehicles will have lower lateral wandering, which can induce more damage to pavements, such as cracking and permanent deformation, than the conventional vehicles, with consequences for the infrastructures due to the increased cracking and reduced safety due to the rutting. Thus, it is essential to assess the wander effect on pavement performance to define policies for its implementation on CAV. This paper studies the impact of the lateral wander of the traffic on pavement performance, considering its fatigue and permanent deformation resistance. This impact can be used to define limits for the wander to minimize distresses on the pavement. The results of this study allow us to conclude that for a pavement with a 10 cm asphalt layer, the wander effect is more significant for fatigue life. A pavement life increase of 20% was observed for a wander of 0.2 m, while for 0.6 m, the fatigue life can increase up to 48%. For the permanent deformation, a pavement life increase of 2% for a wander of 0.2 m was observed, but for 0.6 m, the pavement life can be increased up to 34%.
Improved Alkali–Silica Reaction Forecast in Concrete Infrastructures through Stochastic Climate Change Impact Analysis
Authors: Rahman Md Asif , Lu Yang
Published: July 2023

The assessment of concrete infrastructures’ functionality during natural hazards is fundamental in evaluating their performance and emergency response. In this work, the alkali–silica reaction (ASR) in concrete is evaluated under the climate change impact. The ASR is greatly influenced by the weather parameters, such as temperature and humidity. Climate change has led the quickening of global warming and has caused extreme weather events in recent years. These events can create anomalies in weather and thus convey potential threats to the concrete infrastructures affected by the ASR. Capturing these extreme events is the key prerequisite for the precise quantification of the ASR chemophysics. This work develops a novel stochastic approach to understand the influence of stochastic temperature and humidity on ASR expansion. To assess the stochastic weather impacts on concrete, a physics-informed domain is developed by capturing the variably saturated porous medium of concrete. This is an effort to analyze ASR kinetics that integrates chemo-physical damage under extreme weather events. Results elucidate that the ASR-affected concrete would experience 83.33% more damage in 10 years than from seasonal change due to the stochastic weather impacts from climate change. This improved predictive model will guide the durable infrastructure materials design practices and enhance the resiliency of concrete infrastructures.
Synthesis of New Organoselenium-Based Succinanilic and Maleanilic Derivatives and In Silico Studies as Possible SARS-CoV-2 Main Protease Inhibitors
Authors: Shaaban Saad , Al-Faiyz Yasair S. , Alsulaim Ghayah M. , Alaasar Mohamed , Amri Nasser , Ba-Ghazal Hussein , Al-Karmalawy Ahmed A. , Abdou Aly
Published: July 2023

Herein we report the synthesis of organic selenide-based maleanilic and succinanilic acids in good yields (up to 95%). Their structural identities were elucidated by spectroscopic techniques (e.g., IR, 1H- & 13C-NMR, and MS). The ADMET analysis, molecule electrostatic potential map, DFT, and frontier molecular orbital were used to study the organoselenium compounds’ pharmacokinetics, drug-likeness characteristics, geometries, and chemical and electronic properties. Moreover, a molecular docking tool was employed to investigate the organic selenides’ ability to inhibit the SARS-CoV-2 Mpro target (PDB: 7BFB). Within this context, organic selenides exhibited promising binding affinities to the SARS-CoV-2 Mpro receptor in the following order (12 > 11 > 10 > 9 > 7 > 8). Furthermore, molecular dynamics simulations were also carried out for 200 ns to evaluate the exact behavior of the most active compound (12) within the Mpro binding pocket of SARS-CoV-2 compared with its co-crystallized inhibitor (Co).
TmCN@C82: Monometallic Clusterfullerene Encapsulating a Tm3+ Ion
Authors: Zhang Huichao , Xin Jinpeng , Jin Huaimin , Xiang Wenhao , Chen Muqing , Yao Yang-Rong , Yang Shangfeng
Published: July 2023

Metal cyanide clusterfullerenes (CYCFs) are formed via the encapsulation of a single metal atom and a cyanide unit inside fullerene cages, endowing them with excellent properties in various applications. In this work, we report the synthesis, isolation, and characterizations of the first cases of thulium (Tm)-based CYCFs with the popular C82 carbon cages. The structural elucidation of the two TmCN@C82 isomers was achieved via diverse analytical techniques, including mass spectrometry, Vis-NIR spectroscopy, single-crystal X-ray crystallography, and cyclic voltammetry. The crystallographic analyses unambiguously confirmed the molecular structures of the two TmCN@C82 isomers as TmCN@Cs(6)-C82 and TmCN@C2v(9)-C82. Both TmCN clusters adopt a well-established triangular configuration, with the Tm ion located on the symmetrical plane of the carbon cages. The electronic structures of both TmCN@C82 isomers adopt a Tm3+(CN)−@(C82)2− configuration, exhibiting characteristic spectral and electrochemical properties reminiscent of divalent endohedral metallofullerenes (EMFs). Intriguingly, unlike the divalent Tm2+ ion observed in the mono-metallofullerenes Tm@C2n, a higher oxidation state of Tm3+ is identified in the monometallic TmCN cluster due to bonding with the cyanide anion. This result provides valuable insight into the essential role of the non-metallic endo-units in governing the oxidation state of the metal ion and the electronic behaviors of EMFs.
Comparison of Three Attractants for the Effective Capture of Xylotrechus chinensis Adults in Multi-Funnel Traps
Authors: Kavallieratos Nickolas G. , Boukouvala Maria C. , Skourti Anna , Antonatos Spyridon , Petrakis Panos V. , Papachristos Dimitrios P. , Papadoulis Georgios Th.
Published: July 2023

The Asian coleopteran Xylotrechus chinensis (Chevrolat) (Cerambycidae: Cerambycinae) is an invasive species in several European countries, attacking mulberry trees. In the current research, we evaluated the performance of three mixtures consisting of pheromones and attractants for the monitoring of X. chinensis adults. Attractant 1 (i.e., geranyl acetone, fuscumol acetate, fuscumol, monochamol, 3-hydroxyhexan-2-one, 2-methyl-1-butanol, anti-2,3-hexanediol, prionic acid + ethanol), attractant 2 (i.e., geranyl acetone, fuscumol acetate, fuscumol, monochamol, 3-hydroxyhexan-2-one, 2-methyl-1-butanol, anti-2,3-hexanediol, prionic acid + α-pinene + ethanol) and attractant 3 (i.e., geranyl acetone, fuscumol acetate, fuscumol, monochamol, 3-hydroxyhexan-2-one, 2-methyl-1-butanol, anti-2,3-hexanediol, prionic acid + α-pinene + ipsenol + ethanol) were baited in multi-funnel traps and installed in mulberries for a two-year period in Athens (Greece). The flight activity of X. chinensis starts at the end of April and terminates at the end of October. The peaks of X. chinensis flight activity were observed on 16 August 2021 and on 6 July 2022. Attractant 3 proved to be the most effective blend, catching 953 adults, followed by attractant 2 (523 adults) and attractant 1 (169 adults), throughout the experimental period. It seems that the pest was not attracted to the basic part of the blend (i.e., pheromones + ethanol). The incorporation of α-pinene and ipsenol resulted in the elevated activity of the base lure. The elevated performance of attractant 3 may be attributed to only the α-pinene and the ipsenol, or possibly the α-pinene, ipsenol, and ethanol, because the pheromone blend did not contain any of the pheromone components of the target species. Overall, attractant 3 could be a useful tool to detect and track X. chinensis in new invasive areas, triggering early management strategies against further establishment of this species.
Long-Term Follow Up of Sexual Function and Steroid Levels in Women after Perimenopausal Hysterectomy with or without Concomitant Oophorectomy
Authors: Zimmerman Jonas , Brännström Mats , Bergdahl Cornelia , Aziz Adel , Hermansson Jonas
Published: July 2023

Hysterectomy, most often performed because of bleeding disorders or uterine leiomyoma, is one of the most common major surgical procedures in women and is usually performed during the perimenopausal period on ages 45–55 years. Hysterectomy may be combined with bilateral salpingo-oophorectomy, as a risk-reducing procedure to minimize the risk of ovarian cancer. An open question is whether concomitant oophorectomy, with cessation of ovarian androgen secretion, has any long-term effects on sexual function. In the present prospective cohort study of women undergoing benign hysterectomy, the long-term (10–12 years) effects on sexual function and changes in sex hormone levels were investigated in women having undergone perimenopausal hysterectomy, with or without concomitant bilateral salpingo-oophorectomy. Originally, 491 women (mean age around 50 years) were operated with (patient preference) either only hysterectomy (HYST) or hysterectomy plus bilateral salpingo-oophorectomy (HYST + BSO), and 441 women (90%; HYST; n = 271 and HYST + BSO; n = 170) completed a one-year survey. In the present study, 185 women (42%) of the cohort with one-year follow up participated in the long-term follow up after 10–12 years. Follow-up was with the 10-item McCoy Female Sex Questionnaire and blood analysis of levels of testosterone, estradiol and sexual-hormone-binding globulin. The results showed that specific aspects of sexual function were lower after HYST + BSO compared to HYST 10–12 years after surgery. These lowered items were frequency of sexual fantasies, enjoyment of sexual activity, sexual arousal, and orgasmic frequency. No long-term differences in sex hormone levels were found between the two groups. In conclusion, some items related to sexual function were lower after HYST + BSO in a long-term perspective study, although the levels of testosterone were unaltered. This finding may have implications for clinical recommendations concerning prophylactic salpingo-oophorectomy or for hysterectomy during the perimenopausal age.
Exploring Microbiota Diversity in Cervical Lesion Progression and HPV Infection through 16S rRNA Gene Metagenomic Sequencing
Authors: Stoian Irina Livia , Botezatu Anca , Fudulu Alina , Ilea Ciprian Gavrila , Socolov Demetra Gabriela
Published: July 2023

(1) Background: Cervical cancer is a significant health concern, with the main cause being persistent infection with high-risk Human Papillomavirus (hrHPV). There is still no evidence for why viral persistence occurs in some women, but recent studies have revealed the interplay between cervical microbiota and hrHPV. This research aimed to characterize the cervicovaginal microbiota in cervical lesion progression and HPV infection status. (2) Methods: This study included 85 cervical specimens from women from the north-eastern region of Romania. DNA was isolated from cervical secretion for HPV genotyping and 16S ribosomal RNA gene NGS sequencing. (3) Results: Our study revealed a distinct pattern within the studied group when considering Lactobacillus species, which differs from findings reported in other populations. Specifically, the presence of Lactobacillus iners coupled with the absence of Lactobacillus crispatus alongside Atopobium spp., Prevotella spp., and Gardnerella spp. could serve as defining factors for severe cervical lesions. The results also showed a significant association between microbiota diversity, HPV infection, and cervical lesion progression. (4) Conclusions: As the microbiota profile seems to vary among different populations and individuals, a deeper comprehension of its composition has the potential to develop personalized detection and treatment approaches for cervical dysplasia and cancer.
Endocuff Vision-Assisted Resection for Difficult Colonic Lesions—Preliminary Results of a Multicenter, Prospective Randomized Pilot Study
Authors: Palma Rossella , Andrisani Gianluca , Fanello Gianfranco , Lauro Augusto , Panetta Cristina , Eberspacher Chiara , Di Matteo Francesco , Vaccari Samuele , Zorzetti Noemi , D’Andrea Vito , Pontone Stefano
Published: July 2023

Background—Screening programs for colorectal cancer are implemented due to their ability to reduce mortality. The Endocuff Vision is a new endoscopic device that significantly improves the adenoma detection rate. The primary outcome was to assess the efficacy of ECV in improving stability and reducing operation time during difficult colon polypectomies in a multicenter randomized prospective study. Methods—In a randomized multicenter pilot study, two groups of patients who underwent difficult polypectomies with and without the assistance of Endocuff Vision were compared. Demographics and clinical characteristics of patients were obtained, and polyps’ size, morphology, site, and access (SMSA); polypectomy time; and endoscope stability were evaluated. Results—From October 2016 to April 2020, 32 patients were enrolled. In total, 12 patients underwent Endocuff Vision polypectomy, and 20 patients underwent standard polypectomy by using a computer-generated random number table. No statistical differences were found in clinical characteristics, SMSA, and polypectomy time. The most interesting findings were the positive correlations between shaking and SMSA (r = 0.55, p = 0.005) and shaking and polypectomy time (r = 0.745, p < 0.0001). Conclusion—Endocuff Vision seems to be adequately stable during difficult endoscopic resection procedures. The new parameter proposed that shaking is strongly correlated to the stability of the endoscope, the difficulty of the resection (SMSA), and the polypectomy time.
DOACs in the Anticoagulation of Mechanical Valves: A Systematic Review and Future Perspectives
Authors: Langenaeken Tom , Vanoppen Arnaud , Janssens Fien , Tanghe Loes , Verbrugghe Peter , Rega Filip , Meuris Bart
Published: July 2023

Valvular heart disease is a common disease often necessitating valve replacement. Mechanical heart valves (MHVs) are often used in younger patients because of their longer durability. Their main disadvantage is the need for lifelong anticoagulation. Warfarin is considered a standard treatment, but it is far from perfect. Direct oral anticoagulants (DOACs) are a new and more patient-friendly alternative to warfarin when anticoagulation is required, but have not yet been approved for the indication of mechanical valves. Evidence acquisition: A literature search of Pubmed, Embase, Web of Science (Core Collection), and Cochrane Library (from inception to May 2023) was performed using a search string that was well defined and not modified during the study. An extensive overview of the search terms used in each database can be found in the Appendix. Only prospective clinical trials were included in this review. A total of 10 publications were included in this review. Relevance to clinical practice: This systematic review summarizes the different types of DOACs and their possible use in the anticoagulation of mechanical valves. We aim to propose future directions in anticoagulation research for mechanical valves. Conclusions: DOAC use in MHVs has been halted due to the failure of both dabigatran and apixaban in two major clinical trials. However, rivaroxaban was successful in two small clinical trials. Ample research is still needed to explore new valve designs as well as new anticoagulation targets.
Short and Long-Term Outcomes of Lesion Index-Guided High-Power Short-Duration Approach for Atrial Fibrillation Ablation
Authors: Di Cori Andrea , Parollo Matteo , Gentile Francesco , Pistelli Lorenzo , Vitale Carlo , Della Volpe Salvatore , Giannotti Santoro Mario , Mazzocchetti Lorenzo , De Lucia Raffaele , Canu Antonio , Barletta Valentina , Grifoni Gino , Segreti Luca , Bongiorni Maria Grazia , Zucchelli Giulio
Published: July 2023

High-power short-duration (HPSD) ablation is an increasingly used ablation strategy for pulmonary vein isolation (PVI) procedures, but Lesion Index (LSI)-guided HPSD radiofrequency (RF) applications have not been described in this clinical setting. We evaluated the procedural efficiency and safety of an LSI-guided HPSD strategy for atrial fibrillation (AF) ablation. Paroxysmal and persistent AF patients scheduled for AF ablation were prospectively enrolled and divided into two groups, according to the ablation power used (≥45 W for the LSI-HP Group and ≤40 W for the LSI-LP group). All patients underwent only PVI LSI-guided ablation (5.5 to 6 anteriorly; 5 to 5.5 superiorly, 4.5 to 5 posteriorly) with a point-by-point strategy and an inter-lesion distance <6 mm. Forty-six patients with AF (25 in the LSI-HP Group vs 21 in the LSI-LP Group)—59% paroxysmal, 78% male, with low-intermediate CHA2DS2-Vasc scores (2 [1–3]), a preserved ejection fraction (65 ± 6%) and a mean left atrial index volume of 39 ± 13 mL/m2 were prospectively enrolled. Baseline clinical characteristics were comparable between groups. PVI was successful in all patients. The RF time (29 (23–37) vs. 49 (41–53) min, p < 0.001), total procedure time (131 (126–145) vs. 155 (139–203) min, p = 0.007) and fluoroscopy time (12 (10–18) vs. 21 (16–26) min, p = 0.001) were significantly lower in the LSI-HP Group. No complications or steam pops were seen in either group. LSI-HP AF ablation significantly improved procedural efficiency—reducing ablation time, total procedural duration, and fluoroscopy use, while maintaining a comparable safety profile to lower-power procedures.
Characterizing Sjögren-Associated Fatigue: A Distinct Phenotype from ME/CFS
Authors: Kim Laura , Kedor Claudia , Buttgereit Frank , Heidecke Harald , Schaumburg Desiree , Scheibenbogen Carmen
Published: July 2023

Fatigue is the most commonly reported and debilitating extraglandular symptom of primary Sjögren′s syndrome (pSS). Fatigue and exertional intolerance are hallmark symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We aimed to characterize fatigue and further symptoms among pSS patients and to determine whether there is a symptom overlap in pSS and ME/CFS. In 19 patients with pSS, we assessed pSS symptom severity and disease activity via questionnaires as well as the Canadian Consensus Criteria (CCC) for ME/CFS. Hand grip strength (HGS) and levels of α1-, α2-, β1-, β2-, M3- and M4-receptor-autoantibodies were measured. A subgroup of pSS patients exhibited severe fatigue and had higher severity of pain (p = 0.045), depression (p = 0.021) and sleep disturbances (p = 0.020) compared to those with less fatigue. Four of eighteen pSS patients fulfilled the CCC. HGS parameters strongly correlated with fatigue severity (p < 0.05), but strength fully recovered one hour after exertion in contrast to ME/CFS. Levels of β1-, β2- and M4-receptor-autoantibodies were elevated and correlated significantly with disease activity assessed by the ESSDAI (p < 0.05), but not fatigue severity. Only a minor subgroup of pSS patients fulfills the CCC, and post exertional malaise (PEM) is atypical, as it is primarily triggered by mental/emotional but not physical exertion. HGS assessment is an objective measure to assess overall fatigue severity.
Comparable and Complimentary Modalities for Treatment of Small-Sized HCC: Surgical Resection, Radiofrequency Ablation, and Microwave Ablation
Authors: Wicks Jeffrey S. , Dale Benjamin S. , Ruffolo Luis , Pack Ludia J. , Dunne Richard , Laryea Marie A. , Hernandez-Alejandro Roberto , Sharma Ashwani Kumar
Published: July 2023

Background: Over the past decade, there has been continual improvement in both ablative and surgical technologies for the treatment of hepatocellular carcinoma (HCC). The efficacy of ablative therapy compared to surgical resection for HCC has not been thoroughly evaluated using multiple large-scale randomized controlled trials. By international consensus, if a patient is eligible, surgery is the primary curative treatment option, as it is believed to confer superior oncologic control. Objective: to determine the efficacies of percutaneous ablative therapies and surgical resection (SR) in the treatment of HCC. Data sources, study appraisal, and synthesis methods: A meta-analysis using 5 online databases dating back to 1989 with more than 31,000 patients analyzing patient and tumor characteristics, median follow-up, overall survival, and complication rate was performed. Results: Ablative therapies are suitable alternatives to surgical resection in terms of survival and complication rates for comparable patient populations. For the entire length of the study from 1989–2019, radiofrequency ablation (RFA) produced the highest 5-year survival rates (59.6%), followed by microwave ablation (MWA) (50.7%) and surgical resection (SR) (49.9%). In the most recent era from 2006 to 2019, surgical resection has produced the highest 5-year survival rate of 72.8%, followed by RFA at 61.7% and MWA at 50.6%. Conclusions and key findings: Depending on the disease state and comorbidities of the patient, one modality may offer superior overall survival rates over the other available techniques. Interventional ablative methods and surgical resection should be used in conjunction for the successful treatment of small-sized HCC.
A Random Forest Model for Post-Treatment Survival Prediction in Patients with Non-Squamous Cell Carcinoma of the Head and Neck
Authors: Zhang Xin , Liu Guihong , Peng Xingchen
Published: July 2023

Background: Compared to squamous cell carcinoma, head and neck non-squamous cell carcinoma (HNnSCC) is rarer. Integrated survival prediction tools are lacking. Methods: 4458 patients of HNnSCC were collected from the SEER database. The endpoints were overall survivals (OSs) and disease-specific survivals (DSSs) of 3 and 5 years. Cases were stratified–randomly divided into the train & validation (70%) and test cohorts (30%). Tenfold cross validation was used in establishment of the model. The performance was evaluated with the test cohort by the receiver operating characteristic, calibration, and decision curves. Results: The prognostic factors found with multivariate analyses were used to establish the prediction model. The area under the curve (AUC) is 0.866 (95%CI: 0.844–0.888) for 3-year OS, 0.862 (95%CI: 0.842–0.882) for 5-year OS, 0.902 (95%CI: 0.888–0.916) for 3-year DSS, and 0.903 (95%CI: 0.881–0.925) for 5-year DSS. The net benefit of this model is greater than that of the traditional prediction methods. Among predictors, pathology, involved cervical nodes level, and tumor size are found contributing the most variance to the prediction. The model was then deployed online for easy use. Conclusions: The present study incorporated the clinical, pathological, and therapeutic features comprehensively and established a clinically effective survival prediction model for post-treatment HNnSCC patients.
Direct Anterior vs. Direct Lateral Approach Total Hip Arthroplasty for Displaced Femoral Neck Fracture
Authors: Ben Elyahu Ron , Ohana Nissim , Agabaria Eltaieb , Biadsi Ahmad , Segal David , Yaacobi Eyal , Palmanovich Ezequiel , Markushevich Michael , Brin Yaron Shraga
Published: July 2023

Background: This study compared outcomes of the direct anterior approach (DAA) and direct lateral approach (DLA) for treating displaced femoral neck fractures in active elderly patients. Methods: This retrospective study included active elderly patients who sustained a displaced femoral neck fracture and underwent a cementless total hip arthroplasty either with a supine DAA or a decubitus DLA. Patients were assessed using the Harris hip score at discharge and at a 6-week follow-up. Results: A total of 41 women and 18 men were included in the study. Of those, 22 underwent DLA and 37 received DAA, all performed by the same team. In both groups, 69% were women, mean age was 70 years, and mean BMI was 25.2. Mean hemoglobin loss was 2.3 g/dl between admission and the first post-operative day in both groups. Similar numbers in each cohort were discharged home rather than to a rehabilitation center. The patients who underwent the DAA experienced a 2-day reduction in their hospital stay compared to the DLA group (4.2 ± 1.9 vs. 6.8 ± 3.7, respectively; p < 0.001). The Harris hip score in the DAA group was significantly higher at the 6-week follow-up than in the DLA group (87.23 ± 7.75 vs. 81.23 ± 7.67, respectively; p < 0.031). Conclusions: The patients who underwent THA with the DAA demonstrated better short term outcomes compared to the alternative approach for displaced femoral neck fractures in active elderly patients. DAA helped patients regain independence faster and might decrease hospitalization and rehabilitation costs. Based on these results, we recommend using the DAA for active elderly patients with a displaced femoral neck fracture.
Racial and Ethnic Disparities in Opioid Prescriptions for Patients with Abdominal Pain: Analysis of the National Ambulatory Medical Care Survey
Authors: Ahmed Awais , McHenry Nicole , Gulati Shivani , Shah Ishani , Sheth Sunil G.
Published: July 2023

Background: Disparities in pain control have been extensively studied in the hospital setting, but less is known regarding the racial/ethnic disparities in opioid prescriptions for patients with abdominal pain in ambulatory clinics. Methods: We examined opioid prescriptions during visits by patients presenting with abdominal pain between the years of 2006 and 2015, respectively, in the National Ambulatory Medical Care Survey database. Data weights for national-level estimates were applied. Results: We identified 4006 outpatient visits, equivalent to 114 million weighted visits. Rates of opioid use was highest among non-Hispanic White patients (12%), and then non-Hispanic Black patients (11%), and was the lowest in Hispanic patients (6%). Hispanic patients had lower odds of receiving opioid prescriptions compared to non-Hispanic White patients (OR = 0.49; 95% CI, 0.31–0.77, p = 0.002) and all non-Hispanic patients (OR 0.48; 95% CI 0.30–0.75; p = 0.002). No significant differences were noted in non-opioid analgesia prescriptions (p = 0.507). A higher frequency of anti-depressants/anti-psychotic prescriptions and alcohol use was recorded amongst the non-Hispanic patients (p = 0.027 and p = 0.001, respectively). Conclusions: Rates of opioid prescriptions for abdominal pain patients were substantially lower for the Hispanic patients compared with the non-Hispanic patients, despite having a decreased rate of high-risk features, such as alcohol use and depression. The root cause of this disparity needs further research to ensure equitable access to pain management.
Short-Term and Medium-Term Radiological and Clinical Assessment of Patients with Symptomatic Flexible Flatfoot Following Subtalar Arthroereisis with Spherus Screw
Authors: Bobiński Andrzej , Tomczyk Łukasz , Reichert Paweł , Morasiewicz Piotr
Published: July 2023

Background: There have been no reports on arthroereisis screw insertion into the talus in patients with flexible flatfoot. We aimed to conduct a clinical and radiological assessment in patients with symptomatic pes planovalgus deformity treated with a talar screw. Methods: This study involved a prospective assessment of 27 patients treated surgically for symptomatic flexible flatfoot deformity in the period 2021–2022. The following parameters were assessed in this study: Meary’s angle, the Costa–Bartani angle, the calcaneal pitch angle, surgery duration, the length of hospital stay, patient satisfaction, patients’ retrospective willingness to consent to the treatment they received, postoperative complications, and the use of analgesics. Results: The mean follow-up period was 14.76 months. Meary’s angle decreased from 18.63° before surgery to 9.39° at follow-up (p = 0.004). The Costa–Bartani angle decreased significantly from 154.66° before surgery to 144.58° after surgery (p = 0.012). The calcaneal pitch angle changed from 16.21° before to 19.74°. Complications were reported in three patients (11.11%). The mean surgery duration was 32 min. The mean hospital stay was 2.2 days. Fourteen patients (51.85%) were highly satisfied with the treatment, and 12 patients (44.44%) were quite satisfied with treatment. Twenty-five (92.59%) of the evaluated patients would choose the same type of treatment again. Six patients (22.22%) needed to use analgesics prior to surgical treatment, whereas none of the patients needed to use them by the final follow-up. Conclusion: Spherus screw arthroereisis helps improve radiological parameters in patients with flexible flatfoot. We observed good clinical outcomes after treatment with a talar screw, with a majority of patients reporting moderate-to-high levels of satisfaction with treatment. Both short- and medium-term treatment outcomes of pes planovalgus treatment with the use of Spherus screw are good.
Reversing the Inflammatory Process—25 Years of Tumor Necrosis Factor-α Inhibitors
Authors: Muth Katharina N. , Rech Juergen , Losch Florian O. , Hoerning André
Published: July 2023

Immune-mediated inflammatory diseases, such as rheumatoid arthritis, psoriatic arthritis, peripheral and/or axial spondyloarthritis, Crohn’s disease, and ulcerative colitis, are characterized by molecular and cellular changes in the immune system. Due to the systemic nature of these diseases, organs such as the liver or cardiovascular system are often affected by the inflammatory process. Tumor necrosis factor-α inhibitor therapy reduces the activation of pro-inflammatory signaling cascades, mitigates the chronic inflammatory process by restoring cellular balance, and alleviates clinical consequences, such as pain and tissue damage.
An Exploratory Study Investigating Factors Influencing the Outpatient Delivery of Geriatric Rehabilitation
Authors: Prins Lidy A. P. , Gamble Chris J. , van Dam van Isselt Eléonore F. , Stammen Romy A. I. , Ettaibi Ahlam , Creemers Ilse A. M. , van Haastregt Jolanda C. M.
Published: July 2023

Background: Outpatient delivery of geriatric rehabilitation (GR) might contribute to preserving the accessibility and quality of GR, whilst dealing with an increasing demand for healthcare in an aging population. However, the application of outpatient GR differs between GR facilities. This study aimed to gain insight into factors influencing outpatient GR utilization. Methods: In this case study, 24 semi-structured interviews were conducted with physicians, physiotherapists, nurse practitioners, occupational therapists, and managers in GR. Interviews were transcribed and analyzed using summative content analysis. Results: Various patient-related barriers for using outpatient GR were mentioned including lacking social support and limited capacities and self-management skills. Additionally, professional-related barriers included a lack of awareness and consensus among care professionals regarding the possibilities and potential advantages of outpatient GR. Yet, most perceived barriers were related to efficiency and organization of outpatient GR (e.g., reimbursement system, lacking practical guidance). Still, most participants were in favor of increasing outpatient GR because of expected advantages for patients, GR organizations, and society. Conclusions: Despite experienced barriers, there seems to be agreement on the need to increase outpatient GR application. It is recommended to use the present findings to develop and evaluate new ways of organizing and reimbursing outpatient GR.
Post-Quantum Authentication in the MQTT Protocol
Authors: Samandari Juliet , Gritti Clémentine
Published: July 2023

Message Queue Telemetry Transport (MQTT) is a common communication protocol used in the Internet of Things (IoT). MQTT is a simple, lightweight messaging protocol used to establish communication between multiple devices relying on the publish–subscribe model. However, the protocol does not provide authentication, and most proposals to incorporate it lose their lightweight feature and do not consider the future risk of quantum attacks. IoT devices are generally resource-constrained, and postquantum cryptography is often more computationally resource-intensive compared to current cryptographic standards, adding to the complexity of the transition. In this paper, we use the postquantum digital signature scheme CRYSTALS-Dilithium to provide authentication for MQTT and determine what the CPU, memory and disk usage are when doing so. We further investigate another possibility to provide authentication when using MQTT, namely a key encapsulation mechanism (KEM) trick proposed in 2020 for transport level security (TLS). Such a trick is claimed to save up to 90% in CPU cycles. We use the postquantum KEM scheme CRYSTALS-KYBER and compare the resulting CPU, memory and disk usages with traditional authentication. We found that the use of KEM for authentication resulted in a speed increase of 25 ms, a saving of 71%. There were some extra costs for memory but this is minimal enough to be acceptable for most IoT devices.
Effects of Carbon Nanotubes on Thermal Behavior of Epoxy Resin Composites
Authors: Najmi Lida , Hu Zhong
Published: July 2023

Human society’s need to build low-weight, high-strength and durable structures has increased the demand for composite materials. In this case, composites are used where high mechanical strength, low weight, sound and thermal insulation properties are required. One of the most important issues now is designing materials and coatings aimed at reducing heat loss and resisting high temperatures. One way to address this problem is to develop a technique for preparing and applying composite materials that slow down their heating applied to a surface. In this study, carbon nanotubes (CNTs) reinforced composites were fabricated using silicone molding to be applied to honeycomb sandwich structures. To determine the effect of CNTs on the thermal behavior of the sandwich panels, different weight percentages of this material (0.025, 0.05. 0.075 wt.%) were added to the epoxy resin. The results showed that the thermal stability of the epoxy composites was directly related to the increase in the percentage of CNTs as the CNT content increased to 0.075 wt.%, and the thermal degradation temperature of the epoxy composites increased by 14 °C. In addition, the energy absorption increased by 4.6% with an increase in CNTs up to 0.075 wt.%. Density measurements showed that the density of the nanocomposite samples increased by adding CNTs to pure epoxy resin. The actual densities of the samples reinforced with 0.025, 0.05, and 0.075 wt.% CNTs are 0.925, 0.926, and 0.927 of the theoretical density, respectively. Since the CNT dispersion uniformity in the epoxy matrix can significantly affect the properties of the composites, in this study, a new method of dispersing CNTs in the epoxy resin matrix resulted in higher thermal conductivity while using lower amounts of CNTs compared to other studies. The storage modulus of the epoxy matrix composites reinforced with 0.05 wt.% in this study was 25.9% and 6.9% higher than that from the previous study reinforced with 0.1 wt.% and 0.25 wt.% CNTs, respectively. Furthermore, the tanδ and loss modulus of the composite reinforced with 0.05 wt.% CNTs in this study were 52% and 54.5% higher than that from the previous study with 0.1 wt.% CNTs, respectively. This study provided an optimal approach for designers and engineers who want to effectively design their composite honeycomb sandwich structure with better thermal properties.
Open-Set Recognition of Wood Species Based on Deep Learning Feature Extraction Using Leaves
Authors: Fang Tianyu , Li Zhenyu , Zhang Jialin , Qi Dawei , Zhang Lei
Published: July 2023

An open-set recognition scheme for tree leaves based on deep learning feature extraction is presented in this study. Deep learning algorithms are used to extract leaf features for different wood species, and the leaf set of a wood species is divided into two datasets: the leaf set of a known wood species and the leaf set of an unknown species. The deep learning network (CNN) is trained on the leaves of selected known wood species, and the features of the remaining known wood species and all unknown wood species are extracted using the trained CNN. Then, the single-class classification is performed using the weighted SVDD algorithm to recognize the leaves of known and unknown wood species. The features of leaves recognized as known wood species are fed back to the trained CNN to recognize the leaves of known wood species. The recognition results of a single-class classifier for known and unknown wood species are combined with the recognition results of a multi-class CNN to finally complete the open recognition of wood species. We tested the proposed method on the publicly available Swedish Leaf Dataset, which includes 15 wood species (5 species used as known and 10 species used as unknown). The test results showed that, with F1 scores of 0.7797 and 0.8644, mixed recognition rates of 95.15% and 93.14%, and Kappa coefficients of 0.7674 and 0.8644 under two different data distributions, the proposed method outperformed the state-of-the-art open-set recognition algorithms in all three aspects. And, the more wood species that are known, the better the recognition. This approach can extract effective features from tree leaf images for open-set recognition and achieve wood species recognition without compromising tree material.
An SOC-Based Bidirectional Virtual DC Machine Control for Energy Storage Systems in Offshore Isolated Island DC Microgrids
Authors: Wang Shuran , Wang Zhanshan , Liu Xiuchong , Ye Xiaolu
Published: July 2023

In order to achieve the state of charge (SOC) balance of distributed energy storage systems (ESSs) in offshore isolated island DC microgrids and enhance the inertia and damping characteristics of DC microgrids, an SOC-based bidirectional virtual DC machine (VDCM) control is presented. The control proposed has the following three improvements. Firstly, the improved VDCM control removes the power loop and torque loop on the basis of ensuring inertia and damping characteristics. Secondly, the inertia time constant and damping constant, which are related to the bus voltage difference and the change rate of bus voltage difference, are introduced to improve bus voltage dynamic performance. The proposed method overcomes the shortcoming in that traditional VDCM control cannot adaptively suppress bus voltage oscillation according to the bus voltage fluctuation amplitude. Thirdly, an improved SOC-based VDCM virtual armature resistance (VAR) is proposed to achieve rapid SOC balance. The improved SOC-based VDCM VAR is an SOC-related function added to the initial VAR. This enables the proposed VAR to have a certain adaptive ability, which can adjust the energy absorbed or released by energy storage units according to the SOC state. Compared with other controls, the control proposed takes less time to achieve SOC balance. Finally, the effectiveness and superiority of the scheme are proven by simulation cases.
Simulation of a Ship’s Block Panel Assembly Process: Optimizing Production Processes and Costs through Welding Robots
Authors: Wahidi Sufian Imam , Oterkus Selda , Oterkus Erkan
Published: July 2023

Conventional welding techniques for complex structures often rely on human involvement, which can be prone to errors when deviations from the planned process occur. In contrast, robotic welding is highly precise and effective, particularly in the assembly of complex structures such as double-bottom ships. Therefore, this paper presents a comprehensive technical and economic analysis comparing robotic welding to conventional welding in the assembly process of a ship’s block panels. The study aims to evaluate and compare the strategies employed in robotic welding and conventional welding, with a specific focus on the ship double-bottom context. Furthermore, an economic value analysis is conducted to assess the cost effectiveness of each approach. The analysis reveals that robotic welding can achieve a significantly faster welding speed, completing the process approximately 3.85 times quicker compared to conventional methods. Moreover, the ratio of electricity and man-hours between robot welding and conventional welding is 1:2.75. These findings highlight the potential for cost savings by implementing robotic welding processes. The analysis reveals a significant difference in operational costs, highlighting the efficiency and cost effectiveness of robotic welding compared to conventional methods.