bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Design Methods for Interactive Spaces in Schools for Children with Intellectual Disabilities Considering User Needs
Authors: Liu Hui , Zhu Jinhui , Ni Peng , Li Yujia , Li Shiyuan
Published: July 2024

To scientifically enhance user perception in decision-making for designing interactive spaces in schools for children with intellectual disabilities, we propose an innovative design model that integrates the Kano model, Analytic Hierarchy Process (AHP), and Axiomatic Design (AD) theories based on user needs. Initially, multi-method research was used to gather the original user requirements which were then refined through data cleaning to establish the initial user needs. The Kano model was then employed to categorize these initial user needs. AHP was then used to construct a hierarchical analysis model for the interactive spaces in schools for children with intellectual disabilities, creating a judgment matrix to accurately calculate demand weight values at each level. Subsequently, AHP was used to select the most important demand items. The independence axiom of AD theory was used to achieve a “Z”-shaped mapping between the functional requirements (FRs) and design parameters (DPs) for the interactive spaces in schools for children with intellectual disabilities. This mapping was analyzed using a matrix approach to assess the design rationality and optimize solutions, thereby transforming user needs into design parameters. Finally, the design parameters were used to create interactive spaces through computer-aided design, and the resulting design plans were evaluated. Experimental results indicate that this design scheme effectively translates subjective concepts into specific design parameters through a qualitative and quantitative approach. This significantly enhances the user needs of interactive spaces in schools for children with intellectual disabilities and provides a scientific basis for the architectural design of these schools.
Impact of Robotic Assistance on Minimally Invasive Surgery for Type II Endometrial Cancer: A National Cancer Database Analysis
Authors: Lamiman Kelly , Silver Michael , Goncalves Nicole , Kim Michael , Alagkiozidis Ioannis
Published: July 2024

The objective of this study is to compare the overall survival (OS) and surgical outcomes between conventional laparoscopy and robot-assisted laparoscopy (RAL) in women with type II endometrial cancer. We identified a large cohort of women who underwent hysterectomy for type II endometrial cancer between January 2010 and December 2014 using the National Cancer Database (NCDB). The primary outcome was to compare the OS of conventional laparoscopy versus RAL. Secondary outcomes included the length of hospital stay, 30-day readmission rate, 90-day mortality, rates of lymph node retrieval, rates of node positivity, and rates of conversion to laparotomy. Cohorts were compared and multivariable logistic regression was used to determine characteristics with statistically significant predictors of outcome. We identified 7168 patients with stage I–III type II endometrial cancer who had minimally invasive surgery as primary treatment between 2010 and 2014. A total of 5074 patients underwent RAL. Women who underwent RAL were less likely to have stage III disease (26.4% vs. 29.9%, p = 0.008) and had smaller primary tumors (4.6 vs. 4.1 cm, p < 0.001). In a multivariable model, there was no difference in OS between conventional laparoscopy and RAL. With regard to postoperative outcomes, RAL was associated with a decreased risk for conversion to laparotomy (2.7% vs. 12%, p < 0.001), a shorter hospital stay (1 vs. 2 days, p < 0.001), a decreased 90-day mortality (1.3% vs. 2.2%, p = 0.004), and an increased number of lymph nodes sampled (14 vs. 12, p < 0.001). In multivariable analysis, the use of RAL was independently associated with a reduced rate of conversion to laparotomy. In conclusion, there was no difference in OS between conventional laparoscopy and RAL in type II endometrial cancer in a large retrospective cohort of patients from the NCDB. RAL was associated with a decreased risk of conversion to laparotomy.
Immune-Related Adverse Events Induced by Immune Checkpoint Inhibitors and CAR-T Cell Therapy: A Comprehensive Imaging-Based Review
Authors: Pozzessere Chiara , Mazini Bianca , Omoumi Patrick , Jreige Mario , Noirez Leslie , Digklia Antonia , Fasquelle François , Sempoux Christine , Dromain Clarisse
Published: July 2024

Immunotherapy has revolutionized oncology care, improving patient outcomes in several cancers. However, these therapies are also associated with typical immune-related adverse events due to the enhanced inflammatory and immune response. These toxicities can arise at any time during treatment but are more frequent within the first few months. Any organ and tissue can be affected, ranging from mild to life-threatening. While some manifestations are common and more often mild, such as dermatitis and colitis, others are rarer and more severe, such as myocarditis. Management depends on the severity, with treatment being held for >grade 2 toxicities. Steroids are used in more severe cases, and immunosuppressive treatment may be considered for non-responsive toxicities, along with specific organ support. A multidisciplinary approach is mandatory for prompt identification and management. The diagnosis is primarily of exclusion. It often relies on imaging features, and, when possible, cytologic and/or pathological analyses are performed for confirmation. In case of clinical suspicion, imaging is required to assess the presence, extent, and features of abnormalities and to evoke and rule out differential diagnoses. This imaging-based review illustrates the diverse system-specific toxicities associated with immune checkpoint inhibitors and chimeric antigen receptor T-cells with a multidisciplinary perspective. Clinical characteristics, imaging features, cytological and histological patterns, as well as the management approach, are presented with insights into radiological tips to distinguish these toxicities from the most important differential diagnoses and mimickers—including tumor progression, pseudoprogression, inflammation, and infection—to guide imaging and clinical specialists in the pathway of diagnosing immune-related adverse events.
Post-Progression Analysis of EGFR-Mutant NSCLC Following Osimertinib Therapy in Real-World Settings
Authors: Attili Ilaria , Corvaja Carla , Spitaleri Gianluca , Trillo Aliaga Pamela , Del Signore Ester , Passaro Antonio , de Marinis Filippo
Published: July 2024

Background: Platinum-based chemotherapy is the current standard treatment option in patients with EGFR-mutant non-small-cell lung cancer (NSCLC) who progress on osimertinib. However, outcomes with chemotherapy are dismal, and the treatment of central nervous system (CNS) disease is an unmet need in this setting. Methods: Patients with EGFR-mutant NSCLC who were candidates to receive osimertinib in the metastatic setting at our Center from 2015 to 2022 were retrospectively evaluated to identify patients who received standard platinum-based chemotherapy post-osimertinib. Data were collected on treatment outcomes, with a focus on brain metastases and progression patterns. Results: A total of 220 patients received indication for osimertinib in the study period; n = 176 had adequate follow-up data. Overall, n = 117 patients experienced disease progression on osimertinib. The median time to osimertinib progressive disease (PD) was 15 months (95% confidence interval CI 13–18). Of them, 51 patients (45%) had no access to further treatments. Of the remaining patients, n = 8 received experimental treatments, and n = 55 received standard platinum-based chemotherapy and were considered for this study. Median duration of chemotherapy was 3 months (95% CI 2–5); the best responses among 53 evaluable patients were observed as follows: 15% partial response/complete response (PR/CR), 40% stable disease (SD), 45% PD. Median progression-free survival (PFS) and overall survival (OS) were 3 (95% CI 2–5) and 10 (95% CI 6–15) months, respectively. All patients had baseline and follow-up brain radiologic assessments, and n = 23 had brain metastases at the start of chemotherapy. With a median follow-up of 13 months, intracranial PD occurred in 47% patients, being the first site of PD in 59% of cases. The median time for intracranial (IC) PD was 2 months (95% CI 2–7). IC PD occurred as oligometastatic in 29%, whereas in 71% of cases, it was associated with systemic PD. Conclusions: Access to subsequent treatments and CNS progression are confirmed unmet needs in EGFR-mutant NSCLC patients. Clinical and CNS-specific outcomes in patients receiving standard chemotherapy after the failure of osimertinib are dismal. Novel upfront treatment options with demonstrated prolonged PFS and better CNS outcomes may help address this important issue.
Dissecting the Natural Patterns of Progression and Senescence in Pediatric Low-Grade Glioma: From Cellular Mechanisms to Clinical Implications
Authors: Gorodezki David , Schuhmann Martin U. , Ebinger Martin , Schittenhelm Jens
Published: July 2024

Pediatric low-grade gliomas (PLGGs) comprise a heterogeneous set of low-grade glial and glioneuronal tumors, collectively representing the most frequent CNS tumors of childhood and adolescence. Despite excellent overall survival rates, the chronic nature of the disease bears a high risk of long-term disease- and therapy-related morbidity in affected patients. Recent in-depth molecular profiling and studies of the genetic landscape of PLGGs led to the discovery of the paramount role of frequent upregulation of RAS/MAPK and mTOR signaling in tumorigenesis and progression of these tumors. Beyond, the subsequent unveiling of RAS/MAPK-driven oncogene-induced senescence in these tumors may shape the understanding of the molecular mechanisms determining the versatile progression patterns of PLGGs, potentially providing a promising target for novel therapies. Recent in vitro and in vivo studies moreover indicate a strong dependence of PLGG formation and growth on the tumor microenvironment. In this work, we provide an overview of the current understanding of the multilayered cellular mechanisms and clinical factors determining the natural progression patterns and the characteristic biological behavior of these tumors, aiming to provide a foundation for advanced stratification for the management of these tumors within a multimodal treatment approach.
Widespread Distribution of Luteinizing Hormone/Choriogonadotropin Receptor in Human Juvenile Angiofibroma: Implications for a Sex-Specific Nasal Tumor
Authors: Wemmert Silke , Pyrski Martina , Pillong Lukas , Linxweiler Maximilian , Zufall Frank , Leinders-Zufall Trese , Schick Bernhard
Published: July 2024

Juvenile angiofibroma (JA) is a rare, sex-specific, and highly vascularized nasal tumor that almost exclusively affects male adolescents, but its etiology has been controversial. The G protein-coupled hormone receptor LHCGR [luteinizing hormone (LH)/choriogonadotropin (hCG) receptor] represents a promising new candidate for elucidating the underlying mechanisms of sex specificity, pubertal manifestation, and JA progression. We used highly sensitive RNAscope technology, together with immunohistochemistry, to investigate the cellular expression, localization, and distribution of LHCGR in tissue samples from JA patients. Our results provide evidence for LHCGR expression in subsets of cells throughout JA tissue sections, with the majority of LHCGR+ cells located in close vicinity to blood vessels, rendering them susceptible to endocrine LH/hCG signaling, but LHCGR+ cells were also detected in fibrocollagenous stroma. A majority of LHCGR+ cells located near the vascular lumen co-expressed the neural crest stem cell marker CD271. These results are intriguing as both LH and hCG are produced in a time- and sex-dependent manner, and are known to be capable of inducing cell proliferation and angiogenesis. Our results give rise to a new model that suggests endocrine mechanisms involving LHCGR and its ligands, together with autocrine and paracrine signaling, in JA vascularization and cell proliferation.
Enhanced Migration of Fuchs Corneal Endothelial Cells by Rho Kinase Inhibition: A Novel Ex Vivo Descemet’s Stripping Only Model
Authors: Parekh Mohit , Miall Annie , Chou Ashley , Buhl Lara , Deshpande Neha , Price Marianne O. , Price Francis W. , Jurkunas Ula V.
Published: July 2024

Descemet’s Stripping Only (DSO) is a surgical technique that utilizes the peripheral corneal endothelial cell (CEnC) migration for wound closure. Ripasudil, a Rho-associated protein kinase (ROCK) inhibitor, has shown potential in DSO treatment; however, its mechanism in promoting CEnC migration remains unclear. We observed that ripasudil-treated immortalized normal and Fuchs endothelial corneal dystrophy (FECD) cells exhibited significantly enhanced migration and wound healing, particularly effective in FECD cells. Ripasudil upregulated mRNA expression of Snail Family Transcriptional Repressor (SNAI1/2) and Vimentin (VIM) while decreasing Cadherin (CDH1), indicating endothelial-to-mesenchymal transition (EMT) activation. Ripasudil activated Rac1, driving the actin-related protein complex (ARPC2) to the leading edge, facilitating enhanced migration. Ex vivo studies on cadaveric and FECD Descemet’s membrane (DM) showed increased migration and proliferation of CEnCs after ripasudil treatment. An ex vivo DSO model demonstrated enhanced migration from the DM to the stroma with ripasudil. Coating small incision lenticule extraction (SMILE) tissues with an FNC coating mix and treating the cells in conjunction with ripasudil further improved migration and resulted in a monolayer formation, as detected by the ZO-1 junctional marker, thereby leading to the reduction in EMT. In conclusion, ripasudil effectively enhanced cellular migration, particularly in a novel ex vivo DSO model, when the stromal microenvironment was modulated. This suggests ripasudil as a promising adjuvant for DSO treatment, highlighting its potential clinical significance.
A Transcriptomics Analysis of the Regulation of Lens Fiber Cell Differentiation in the Absence of FGFRs and PTEN
Authors: Upreti Anil , Padula Stephanie L. , Weaver Jacob M. , Wagner Brad D. , Kneller Allison M. , Petulla Anthony L. , Lachke Salil A. , Robinson Michael L.
Published: July 2024

Adding 50% vitreous humor to the media surrounding lens explants induces fiber cell differentiation and a significant immune/inflammatory response. While Fgfr loss blocks differentiation in lens epithelial explants, this blockage is partially reversed by deleting Pten. To investigate the functions of the Fgfrs and Pten during lens fiber cell differentiation, we utilized a lens epithelial explant system and conducted RNA sequencing on vitreous humor-exposed explants lacking Fgfrs, or Pten or both Fgfrs and Pten. We found that Fgfr loss impairs both vitreous-induced differentiation and inflammation while the additional loss of Pten restores these responses. Furthermore, transcriptomic analysis suggested that PDGFR-signaling in FGFR-deficient explants is required to mediate the rescue of vitreous-induced fiber differentiation in explants lacking both Fgfrs and Pten. The blockage of β-crystallin induction in explants lacking both Fgfrs and Pten in the presence of a PDGFR inhibitor supports this hypothesis. Our findings demonstrate that a wide array of genes associated with fiber cell differentiation are downstream of FGFR-signaling and that the vitreous-induced immune responses also depend on FGFR-signaling. Our data also demonstrate that many of the vitreous-induced gene-expression changes in Fgfr-deficient explants are rescued in explants lacking both Fgfrs and Pten.
Inflammatory Cytokines and Clinical Outcome Following Biological Therapy in Adult Bio-Naïve Psoriasis Patients
Authors: Florian Teodora-Larisa , Florian Ioan-Alexandru , Vesa Stefan Cristian , Beni Lehel , Orăsan Meda
Published: July 2024

Inflammatory cytokines may hold the key to the clinical evolution of psoriasis. The aims of this study are to find a correlation between levels of inflammatory cytokines such as TNF-α, IL-23, IL-17A, and IL-17F and disease duration and severity scores in psoriasis; to test if the decrease in any of the aforementioned cytokines is correlated with an amelioration in disease severity scores; and to analyze if any of the four biologic agents used are linked with a greater decrease in overall cytokine levels. We enrolled 23 adult patients under treatment with ixekizumab, secukinumab, guselkumab, or adalimumab and measured psoriasis disease severity scores PASI (Psoriasis Area Severity Index) and DLQI (Dermatology Life Quality Index), as well as the levels of the aforementioned cytokines at the start of therapy and after 3 months of continuous treatment. Inclusion criteria were the presence of psoriasis, age above 18 years and the need to initiate biological therapy (lack of response to standard treatment). Biological therapies resulted in an amelioration of PASI and DLQI scores, as well as levels of TNF-α, IL-23 and IL-17F. Disease duration and PASI and DLQI scores did not correlate with cytokine levels except DLQI and IL-23 score, in a paradoxically inversely proportional manner. IL-23, in particular, could be a useful biomarker for checking treatment response in psoriasis.
Downregulation of Splicing Factor PTBP1 Curtails FBXO5 Expression to Promote Cellular Senescence in Lung Adenocarcinoma
Authors: Li Haoyu , Sun Xiaoxiao , Lv Yuanyuan , Wei Gang , Ni Ting , Qin Wenxin , Jin Haojie , Jia Qi
Published: July 2024

Polypyrimidine tract-binding protein 1 (PTBP1) plays an essential role in splicing and post-transcriptional regulation. Moreover, PTBP1 has been implicated as a causal factor in tumorigenesis. However, the involvement of PTBP1 in cellular senescence, a key biological process in aging and cancer suppression, remains to be clarified. Here, it is shown that PTBP1 is associated with the facilitation of tumor growth and the prognosis in lung adenocarcinoma (LUAD). PTBP1 exhibited significantly increased expression in various cancer types including LUAD and showed consistently decreased expression in multiple cellular senescence models. Suppression of PTBP1 induced cellular senescence in LUAD cells. In terms of molecular mechanisms, the silencing of PTBP1 enhanced the skipping of exon 3 in F-box protein 5 (FBXO5), resulting in the generation of a less stable RNA splice variant, FBXO5-S, which subsequently reduces the overall FBXO5 expression. Additionally, downregulation of FBXO5 was found to induce senescence in LUAD. Collectively, these findings illustrate that PTBP1 possesses an oncogenic function in LUAD through inhibiting senescence, and that targeting aberrant splicing mediated by PTBP1 has therapeutic potential in cancer treatment.
Investigation of Social Constraints, Psychosocial Adjustment and Optimism among Dialysis Patients
Authors: Zorba Eirini , Fasoi Georgia , Grapsa Eirini , Zartaloudi Afroditi , Polikandrioti Maria , Alikari Victoria , Stavropoulou Areti , Dafogianni Chrysoula , Impis Orchan , Gerogianni Georgia
Published: July 2024

Background: Social constraints are perceived as unsupportive behaviors, leading to inadequate psychosocial adjustment, while optimism can help people recover from distress and reduce any negative effects of chronic disease. The aim of this study was to investigate social constraints, psychosocial adjustment and optimism among patients on dialysis. Methods: In this study, 402 patients undergoing dialysis in Greece completed the following questionnaires: (i) the Social Constraints Scale (SCS) for the assessment of social constrains, (ii) the Psychosocial adjustment to illness scale (PAIS-SR) for the assessment of psychosocial adjustment, and (iii) the LOT-R scale for the assessment of optimism. A Mann–Whitney test was used for the comparison of continuous variables between two groups. Spearman correlation coefficients (rho) were used to explore the association of two continuous variables. Multiple linear regression analysis was used with the SCS scale. Results: Greater difficulty in psychosocial adjustment in the domestic, vocational, extended family and social environments, sexual relationships, and health care as well as greater psychological distress were significantly associated with a greater occurrence of social constraints (p < 0.001). Additionally, greater optimism was significantly associated with fewer social constraints and lower difficulty in adjusting to their disease (p < 0.001). Conclusions: Greater difficulty in all dimensions of psychosocial adjustment is associated with more social constraints, while optimism is associated with fewer social constraints and better disease adjustment.
Preparation of CrCoFeNiMn High-Entropy Alloy Coatings Using Gas Atomization and Laser Cladding: An Investigation of Microstructure, Mechanical Properties, and Wear Resistance
Authors: Tian Haodong , Yu Yuzhen , Wang Xi , Chen Fan , Liu He
Published: July 2024

In this study, a spherical CrCoFeNiMn high-entropy alloy (HEA) powder with uniform size was prepared using gas atomization. High-quality CrCoFeNiMn HEA coatings were then applied to a 316L stainless steel substrate using prepowdered laser cladding. The main focus of the study is on the phase structure composition and stability, microstructure evolution mechanism, mechanical properties, and wear resistance of CrCoFeNiMn HEA coatings. The results show that the CrCoFeNiMn HEA coatings prepared using gas atomization and laser melting techniques have a single FCC phase structure with a stable phase composition. The coatings had significantly higher diffraction peak intensities than the prepared HEA powders. The coating showed an evolution of columnar and equiaxed crystals, as well as twinned dislocation structures. Simultaneously, the microstructure transitions from large-angle grain boundaries to small-angle grain boundaries, resulting in a significant refinement of the grain structure. The CrCoFeNiMn HEA coating exhibits excellent mechanical properties. The microhardness of the coating increased by 66.06% when compared to the substrate, the maximum wear depth was reduced by 65.59%, and the average coefficient of friction decreased by 9.71%. These improvements are mainly attributed to the synergistic effects of grain boundary strengthening, fine grain strengthening, and twinning and dislocation strengthening within the coating.
Flexural Eigenfrequency Analysis of Healthy and Pathological Tissues Using Machine Learning and Nonlocal Viscoelasticity
Authors: Farajpour Ali , Ingman Wendy V.
Published: July 2024

Biomechanical characteristics can be used to assist the early detection of many diseases, including breast cancer, thyroid nodules, prostate cancer, liver fibrosis, ovarian diseases, and tendon disorders. In this paper, a scale-dependent viscoelastic model is developed to assess the biomechanical behaviour of biological tissues subject to flexural waves. The nonlocal strain gradient theory, in conjunction with machine learning techniques such as extreme gradient boosting, k-nearest neighbours, support vector machines, and random forest, is utilised to develop a computational platform for biomechanical analysis. The coupled governing differential equations are derived using Hamilton’s law. Transverse wave analysis is conducted to investigate different normal and pathological human conditions including ovarian cancer, breast cancer, and ovarian fibrosis. Viscoelastic, strain gradient, and nonlocal effects are used to describe the impact of fluid content, stiffness hardening caused by the gradients of strain components, and stiffness softening associated with the nonlocality of stress components within the biological tissues and cells. The integration of the scale-dependent biomechanical continuum model with machine learning facilitates the adoption of the developed model in practical applications by allowing for learning from clinical data, alongside the intrinsic mechanical laws that govern biomechanical responses.
Effects of Lipid Phase Content on the Technological and Sensory Properties of O/W Emulsions Containing Bemotrizinol-Loaded Nanostructured Lipid Carriers
Authors: Santonocito Debora , Puglia Carmelo , Montenegro Lucia
Published: July 2024

Different lipid phase ratios (12, 14, and 16% w/w) were assessed for their ability to affect the technological and sensory properties of O/W emulsions in which bemotrizinol (BMTZ), a broad-spectrum sunscreen agent, was incorporated free or loaded into nanostructured lipid nanocarriers (NLC) to reduce its release from the vehicle and, hence, its skin permeation. The following technological properties were evaluated in vitro: spreadability, viscosity, pH, occlusion factor, BMTZ release, and sun protection factor (SPF). Sensory attributes were assessed by panelists in three different phases: before/during pick-up, rub-in, and after application. Raising the lipid phase ratio led to an increase in viscosity (from 8017 ± 143 cPs to 16,444 ± 770 cPs) and to a corresponding decrease in spreadability (from 9.35 ± 0.21 cm to 7.50 ± 0.10 cm), while the incorporation of BMTZ-loaded NLC determined a decrease in the occlusion factor (from 47.75 ± 1.16 to 25.91 ± 1.57) and an increase in SPF (from 6% for formulations containing 12% lipid phase to 15% for formulations containing 16% lipid phase). No BMTZ release was observed from all emulsions. Sensory attributes were mainly affected by the lipid phase ratio. These results suggest that the lipid phase ratio and BMTZ incorporation into NLC could contribute to determining the technological and sensory properties of O/W emulsions.
Two Modifications of Nitrilotris(methylenephenylphosphinic) Acid: A Polymeric Network with Intermolecular (O=P–O–H)3 vs. Monomeric Molecules with Intramolecular (O=P–O–H)3 Hydrogen Bond Cyclotrimers
Authors: Knerr Steven , Brendler Erica , Gericke Robert , Kroke Edwin , Wagler Jörg
Published: July 2024

Nitrilotris(methylenephenylphosphinic) acid (NTPAH3) was silylated using hexamethyldisilazane to produce the tris(trimethylsilyl) derivative NTPA(SiMe3)3. From the latter, upon alcoholysis in chloroform, NTPAH3 could be recovered. Thus, a new modification of that phosphinic acid formed. Meanwhile, NTPAH3 synthesized in aqueous hydrochloric acid crystallized in the space group P3c1 with the formation of O-H⋅⋅⋅O H-bonded networks (NTPAH3P), in chloroform crystals in the space group R3c formed (NTPAH3M), the constituents of which are individual molecules with exclusively intramolecular O-H⋅⋅⋅O hydrogen bonds. Both solids, NTPAH3P and NTPAH3M, were characterized by single-crystal X-ray diffraction, multi-nuclear (1H, 13C, 31P) solid-state NMR spectroscopy, and IR spectroscopy as well as quantum chemical calculations (both of their individual constituents as isolated molecules as well as in the periodic crystal environment). In spite of the different stabilities of their constituting molecular conformers, the different crystal packing interactions rendered the modifications of NTPAH3P and NTPAH3M similarly stable. In both solids, the protons of the acid are engaged in cyclic (O=P–O–H)3 H-bond trimers. Thus, the trialkylamine N atom of this compound is not protonated. IR and 1H NMR spectroscopy of these solids indicated stronger H-bonds in the (O=P–O–H)3 H-bond trimers of NTPAH3M over those in NTPAH3P.
Addressing the Rising Trend in Early-Age-Onset Cancers in Canada
Authors: Wildgoose Petra , Servidio-Italiano Filomena , Raphael Michael J. , Slovinec D’Angelo Monika , Macaulay Cassandra , Kassam Shaqil , Nixon Nancy , Perea José , Hamilton Sarah , Ramjeesingh Ravi , Gill Sharlene , Pollett Aaron , Ogino Shuji , Ugai Tomotaka , Gupta Abha
Published: July 2024

A multi-disciplinary symposium on early-age onset cancer (EAOC) was held in October 2023 to explore challenges experienced by this rapidly growing population. A major outcome of the symposium was recognition of the remarkable similarities of EAOC patients’ journeys across cancer sites. Prevention and early detection of cancer are hindered by a lack of awareness among patients and family doctors that cancer can and does occur in younger persons. Distinct characteristics of the disease—such as a later stage at diagnosis and more aggressive tumor biology—require more potent treatments, which result in profound physical and psychosocial consequences that are unique to this age group. EAOC patient empowerment emerged as another key theme of the symposium. The development of a greater number of specialized clinics was called for, and patient support groups were recognized for the vital role they play in empowering patients and their families. Leading-edge medical advancements hold tremendous hope across the spectrum of EAOC care. New technologies based on genomic profiling, immunotherapy and microbiome alteration contribute to the development of highly effective, personalized approaches to treatment. All symposium participants expressed their commitment to speak with one resounding voice to advocate for equitable access to leading care practices for EAOC patients; thus, a fourth symposium is planned for November 2024.
Morphological and Molecular Identification of Porpita porpita (Hydrozoa: Porpitidae) Larval and Colonial Phases
Authors: Santiago-Valentín Jeimy Denisse , Bautista-Guerrero Eric , Rodríguez-Troncoso Alma Paola , Franco-Gordo María del Carmen , Razo-López Mauricio Alejandro , Godínez-Domínguez Enrique
Published: July 2024

Porpita porpita is a colonial polymorphic hydrozoan distributed in temperate and tropical zones. This species, like most hydrozoans, possesses a metagenetic life cycle with alternating life forms: medusa stage, polypoid colony, and planula larva. However, a characterization of its early stages of development is still lacking. For this study, an integrative description of the larval stages and the hydroid colony was performed using molecular and histologic tools. The results show that P. porpita develops through three larval stages: preplanula, planula, and premetamorphic planula. The preplanula is distinguished by an absence of polarity, the planula by differentiation of the oral–aboral poles, and the premetamorphic stage by cellular differentiation. Furthermore, two morphologies of young hydroids with different developmental patterns of gonozooids and dactylozooids were observed; notably, it was not possible to observe the gastrozooid in either. Taxonomic identification was confirmed using mitochondrial (COI) and ribosomal (18S and 28S) markers. Our analysis indicates that the COI gene exhibits higher intraspecific variability compared to the 18s and 28s rDNA ribosomal genes. The presented results support the future identification of P. porpita based on morphological characteristics, regardless of the stage of development. Specifically, they shed light on the diversity of mesozooplankton in reef communities.
MV-MFF: Multi-View Multi-Feature Fusion Model for Pneumonia Classification
Authors: Alsulami Najla , Althobaiti Hassan , Alafif Tarik
Published: July 2024

Pneumonia ranks among the most prevalent lung diseases and poses a significant concern since it is one of the diseases that may lead to death around the world. Diagnosing pneumonia necessitates a chest X-ray and substantial expertise to ensure accurate assessments. Despite the critical role of lateral X-rays in providing additional diagnostic information alongside frontal X-rays, they have not been widely used. Obtaining X-rays from multiple perspectives is crucial, significantly improving the precision of disease diagnosis. In this paper, we propose a multi-view multi-feature fusion model (MV-MFF) that integrates latent representations from a variational autoencoder and a β-variational autoencoder. Our model aims to classify pneumonia presence using multi-view X-rays. Experimental results demonstrate that the MV-MFF model achieves an accuracy of 80.4% and an area under the curve of 0.775, outperforming current state-of-the-art methods. These findings underscore the efficacy of our approach in improving pneumonia diagnosis through multi-view X-ray analysis.
Real-World Research on Retinal Diseases Using Health Claims Database: A Narrative Review
Authors: Ahn Seong Joon
Published: July 2024

Real-world data (RWD) has emerged as a crucial component in understanding and improving patient outcomes across various medical conditions, including retinal diseases. Health claims databases, generated from healthcare reimbursement claims, offer a comprehensive source of RWD, providing insights into patient outcomes, healthcare utilization, and treatment effectiveness. However, the use of these databases for research also presents unique challenges. This narrative review explores the role of real-world research on retinal diseases using health claims databases, highlighting their advantages, limitations, and potential contributions to advancing our understanding and management of the diseases. The review examines the applications of health claims databases in retinal disease research, including epidemiological studies, comparative effectiveness and safety analyses, economic burden assessments, and evaluations of patient outcomes and quality of care. Previous findings demonstrate the value of these databases in generating prevalence and incidence estimates, identifying risk factors and predictors, evaluating treatment effectiveness and safety, and understanding healthcare utilization patterns and costs associated with retinal diseases. Despite their strengths, health claims databases face challenges related to data limitations, biases, privacy concerns, and methodological issues. Accordingly, the review also explores future directions and opportunities, including advancements in data collection and analysis, integration with electronic health records, collaborative research networks and consortia, and the evolving regulatory landscape. These developments are expected to enhance the utility of health claims databases for retinal disease research, resulting in more comprehensive and impactful findings across diverse retinal disorders and robust real-world insights from a large population.
Left Atrial Volume Index Predicts Atrial Fibrillation Recurrence after Catheter Ablation Only in Obese Patients—Brief Report
Authors: Naji Franjo Husam , Alatic Jan , Balevski Igor , Suran David
Published: July 2024

Background: It has been shown that obesity and a higher body mass index (BMI) are associated with a higher recurrence rate of atrial fibrillation (AF) after successful catheter ablation (CA). The same has been proven for the left atrial volume index (LAVI). It has also been shown that there is a correlation between LAVI and BMI. However, whether the LAVI’s prognostic impact on AF recurrence is BMI-independent remains unclear. Methods: We prospectively included 62 patients with paroxysmal AF who were referred to our institution for CA. All patients underwent radiofrequency CA with standard pulmonary veins isolation. Transthoracic 2-D echocardiography was performed one day after CA to obtain standard measures of cardiac function and morphology. Recurrence was defined as documented AF within 6 months of the follow-up period. Patients were also instructed to visit our outpatient clinic earlier in case of symptoms suggesting AF recurrence. Results: We observed AF recurrence in 27% of patients after 6 months. The mean BMI in our cohort was 29.65 ± 5.08 kg/cm2 and the mean LAVI was 38.04 ± 11.38 mL/m2. We further divided patients into two groups according to BMI. Even though the LAVI was similar in both groups, we found it to be a significant predictor of AF recurrence only in obese patients (BMI ≥ 30) and not in the non-obese group (BMI < 30). There was also no significant difference in AF recurrence between both cohorts. The significance of the LAVI as an AF recurrence predictor in the obesity group was also confirmed in a multivariate model. Conclusions: According to our results, the LAVI tends to be a significant predictor of AF recurrence after successful catheter ablation in obese patients, but not in normal-weight or overweight patients. This would suggest different mechanisms of AF in non-obese patients in comparison to obese patients. Further studies are needed in this regard.
Topotecan in a Real-World Small-Cell Lung Cancer Cohort: Prognostic Biomarkers Improve Selection of Patients for Second-Line Treatment
Authors: Lambrecht Laura , Arnold Paola , Behr Jürgen , Mertsch Pontus , Tufman Amanda , Kauffmann-Guerrero Diego
Published: July 2024

Background: Small-cell lung cancer (SCLC) is a highly aggressive tumor, and overall survival (OS) remains poor despite intensive efforts to develop new treatment strategies. In second line, topotecan is the only approved drug, with a median OS of 5.9 months. However, real-world SCLC patients are often in worse condition and harbor more comorbidities than study populations. Therefore, the real-world performance of topotecan may differ from that seen in studies. Here, we analyzed outcomes of SCLC patients receiving topotecan and identified predictive and prognostic markers. Patients and Methods: We retrospectively analyzed 44 consecutive SCLC patients receiving topotecan between 2015 and 2022. We analyzed baseline characteristics (age, ECOG-PS, topotecan cycles, and dosage) and pre-treatment blood values (LDH, CRP, sodium) as well as prognostic scores (neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio (TLR), Glasgow Prognostic Score, prognostic nutritional score, systemic inflammation index (SII), and the prognostic index) extracted from electronic patients’ charts to identify predictive and prognostic markers. Results: In our cohort, mPFS and mOS were only 1.9 and 5.6 months, respectively. Gender, ECOG-PS, active brain metastases, NLR, GPS, PNI, and SII significantly influenced PFS and OS in univariate analysis. ECOG-PS (p > 0.001), active brain metastases (p = 0.001), and SII (p = 0.008) were significant independent prognostic variables in a multivariate COX regression model. Selecting patients by these three markers achieved an mPFS of 5.7 months and thus increased the mPFS three-fold. Patients not meeting all criteria had an mPFS of 1.8 months (p = 0.006). Patients identified by prognostic markers had an mOS of 9.1 months (p = 0.002). Conclusions: The efficacy of topotecan in SCLC real-world patients is poor, indicating that many patients were treated without any benefit. Easy-to-obtain markers can predict response and treatment efficacy and should therefore be validated in larger cohorts to identify patients who are more likely to benefit from topotecan.
Dietary Habits and Caries Prevalence in Older Adults: A Scoping Review
Authors: Gkavela Grigoria , Pappa Eftychia , Rahiotis Christos , Mitrou Panagiota
Published: July 2024

Caries is very common in the elderly as there are several aggravating factors, such as a decrease of the ability to self-care and, by extension, insufficient oral hygiene, a carious diet, limited exposure to fluoride, xerostomia, gingival recession, and limited access to dental care. This study aimed to review the dietary risk factors for root caries prevalence in older adults, from socially active people to frail patients. A comprehensive search strategy was used to select studies from PubMed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. Root caries is prevalent in the elderly due to gingival recession and root exposure to the oral environment. Dietary risk factors significantly affect root caries prevalence in older adults, including a high intake of sugars and an alteration of their composition preference in this age group. Caries risk appears more significant in frail, institutionalized patients fed softer food or supplements.
The Incidence of Obstructive Sleep Apnea in Patients with Dento-Skeletal Malformation
Authors: D’Amato Giuseppe , Todaro Mattia , Saponaro Gianmarco , De Angelis Paolo , Moro Alessandro , Azzuni Francesca , Capasso Benedetta , Gasparini Giulio
Published: July 2024

Purpose: The aim of this article is to analyze the incidence of undiagnosed obstructive sleep apnea (OSA) in patients affected by dento-skeletal malformation. We also evaluated the patterns most affected by the condition and calculated the post surgical changes. Methods: We conducted a retrospective cohort study on 71 patients including 35 men and 36 women. The patients studied were affected by dento-skeletal class II and III malformations and underwent bimaxillary orthognathic surgery in all cases. Patients were evaluated with polysomnography before surgery and at least 6 months after surgery to assess any improvement or worsening of the apnea hypopnea index (AHI) index. Regarding AHI evaluation criteria, an AHI > 5 was considered indicative of OSA, 4 < AHI < 5 was considered borderline and AHI < 4 was considered indicative of non-OSA. We also considered demographic variables like age at the time of intervention and gender, and anatomical variables like the pattern of the dento-skeletal deformity and the presence or absence of maxillary hypoplasia. Qualitative variables were described as absolute and relative frequencies, while quantitative variables were summarized as mean and standard deviation. To quantitatively express the relationship between two variables, the correlation coefficient was calculated. The covariance array was used to evaluate multiple correlations. Results: Our study shows that there is a significant percentage (33%) of patients who undergo orthognathic surgery with an AHI > 5 and also a percentage of patients (11%) who can be considered to be “borderline.” It emerges that the pattern most at risk is the one characterized by retruded maxilla and patients with dento-skeletal class II. Considering the post surgical period, the statistical analysis shows that after surgery, only 8% of malformed patients present an AHI > 5, compared to the 20.5% described in the Italian population. Conclusions: In patients who receive orthognathic surgery, the presence of obstructive sleep apnea is significantly higher than in the general population. When planning the surgical correction of a dento-skeletal malformation, the surgeon must aim not only for the esthetics results, but also for proper stomatognathic and respiratory function; this cannot be achieved without taking polysomnography information into account.
Likelihood Inference for Factor Copula Models with Asymmetric Tail Dependence
Authors: Joe Harry , Li Xiaoting
Published: July 2024

For multivariate non-Gaussian involving copulas, likelihood inference is dominated by the data in the middle, and fitted models might not be very good for joint tail inference, such as assessing the strength of tail dependence. When preliminary data and likelihood analysis suggest asymmetric tail dependence, a method is proposed to improve extreme value inferences based on the joint lower and upper tails. A prior that uses previous information on tail dependence can be used in combination with the likelihood. With the combination of the prior and the likelihood (which in practice has some degree of misspecification) to obtain a tilted log-likelihood, inferences with suitably transformed parameters can be based on Bayesian computing methods or with numerical optimization of the tilted log-likelihood to obtain the posterior mode and Hessian at this mode.
Explainable Artificial Intelligence-Based Decision Support Systems: A Recent Review
Authors: Kostopoulos Georgios , Davrazos Gregory , Kotsiantis Sotiris
Published: July 2024

This survey article provides a comprehensive overview of the evolving landscape of Explainable Artificial Intelligence (XAI) in Decision Support Systems (DSSs). As Artificial Intelligence (AI) continues to play a crucial role in decision-making processes across various domains, the need for transparency, interpretability, and trust becomes paramount. This survey examines the methodologies, applications, challenges, and future research directions in the integration of explainability within AI-based Decision Support Systems. Through an in-depth analysis of current research and practical implementations, this article aims to guide researchers, practitioners, and decision-makers in navigating the intricate landscape of XAI-based DSSs. These systems assist end-users in their decision-making, providing a full picture of how a decision was made and boosting trust. Furthermore, a methodical taxonomy of the current methodologies is proposed and representative works are presented and discussed. The analysis of recent studies reveals that there is a growing interest in applying XDSSs in fields such as medical diagnosis, manufacturing, and education, to name a few, since they smooth down the trade-off between accuracy and explainability, boost confidence, and also validate decisions.
MSCFS-RP: A Colored-Petri-Net-Based Analysis Model for Master–Slave Cloud File Systems with Replication Pipelining
Authors: Zhou Wenbo
Published: July 2024

As a typical information system, a cloud file system enables the storage, retrieval, and management of data on remote servers or server clusters. The reliable design of such systems is critical to ensure the security of data and availability of services. However, designing correct-by-construction systems is challenging due to the complexity of and concurrency inherent in cloud file systems. Further, existing works on cloud file system analysis often focus on specific systems or lack formal modeling and verification, leading to potential design flaws and security vulnerabilities. To address these issues, we propose MSCFS-RP, which is a formal analysis model based on colored Petri nets. Leveraging the strengths of colored Petri nets in representing diverse information types with colored tokens and defining explicit rules for concurrent interactions, our model captures the writing and reading processes of clients, meta servers, and clusters. With strong formalism and support for verification using CPN Tools, we rigorously evaluate key properties such as replication consistency under various scenarios. The results demonstrate that MSCFS-RP satisfies these properties, validating its effectiveness and trustworthiness in managing information within cloud storage systems.
Correction: Grzegórska et al. Phytoremediation—From Environment Cleaning to Energy Generation—Current Status and Future Perspectives. Energies 2020, 13, 2905
Authors: Grzegórska Anna , Rybarczyk Piotr , Rogala Andrzej , Zabrocki Dawid
Published: July 2024

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Numerical and Experimental Analysis of Vortex Profiles in Gravitational Water Vortex Hydraulic Turbines
Authors: Velásquez Laura , Rubio-Clemente Ainhoa , Chica Edwin
Published: July 2024

This work compared the suitability of the k-ϵ standard, k-ϵ RNG, k-ω SST, and k-ω standard turbulence models for simulating a gravitational water vortex hydraulic turbine using ANSYS Fluent. This study revealed significant discrepancies between the models, particularly in predicting vortex circulation. While the k-ϵ RNG and standard k-ω models maintained relatively constant circulation values, the k-ϵ standard model exhibited higher values, and the k-ω SST model showed irregular fluctuations. The mass flow rate stabilization also varied, with the k-ϵ RNG, k-ω SST, and k-ω standard models being stabilized around 2.1 kg/s, whereas the k-ϵ standard model fluctuated between 1.9 and 2.1 kg/s. Statistical analyses, including ANOVA and multiple comparison methods, confirmed the significant impact of the turbulence model choice on both the circulation and mass flow rate. Experimental validation further supported the numerical findings by demonstrating that the k-ω shear stress transport (SST) model most closely matched the real vortex profile, followed by the k-ϵ RNG model. The primary contribution of this work is the comprehensive evaluation of these turbulence models, which provide clear guidance on their applicability to gravitational water vortex hydraulic turbine simulations.