bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring beamline momentum acceptance for tracking respiratory variability in lung cancer proton therapy: a simulation study
Authors: Giovannelli Anna Chiara , Köthe Andreas , Safai Sairos , Meer David , Zhang Ye , Weber Damien Charles , Lomax Antony John , Fattori Giovanni
Published: August 2023

Objective. Investigating the aspects of proton beam delivery to track organ motion with pencil beam scanning therapy. Considering current systems as a reference, specify requirements for next-generation units aiming at real-time image-guided treatments. Approach. Proton treatments for six non-small cell lung cancer (NSCLC) patients were simulated using repeated 4DCTs to model respiratory motion variability. Energy corrections required for this treatment site were evaluated for different approaches to tumour tracking, focusing on the potential for energy adjustment within beamline momentum acceptance (dp/p). A respiration-synchronised tracking, taking into account realistic machine delivery limits, was compared to ideal tracking scenarios, in which unconstrained energy corrections are possible. Rescanning and the use of multiple fields to mitigate residual interplay effects and dose degradation have also been investigated. Main results. Energy correction requirements increased with motion amplitudes, for all patients and tracking scenarios. Higher dose degradation was found for larger motion amplitudes, rescanning has beneficial effects and helped to improve dosimetry metrics for the investigated limited dp/p of 1.2% (realistic) and 2.4%. The median differences between ideal and respiratory-synchronised tracking show minimal discrepancies, 1% and 5% respectively for dose coverage (CTV V95) and homogeneity (D5-D95). Multiple-field planning improves D5-D95 up to 50% in the most extreme cases while it does not show a significant effect on V95. Significance. This work shows the potential of implementing tumour tracking in current proton therapy units and outlines design requirements for future developments. Energy regulation within momentum acceptance was investigated to tracking tumour motion with respiratory-synchronisation, achieving results in line with the performance of ideal tracking scenarios. ±5% Δp/p would allow to compensate for all range offsets in our NSCLC patient cohort, including breathing variability. However, the realistic momentum of 1.2% dp/p representative of existing medical units limitations, has been shown to preserve plan quality.
Determination of nonradiative carrier lifetimes in quantum well laser diodes from subthreshold characteristics
Authors: McVay E , Deri R J , Fenwick W E , Baxamusa S H , Li J , Allen N P , Mittelberger D , Swertfeger R B , Telford S J , Boisselle M C , Pope D L , Dutra D M , Martin L , Gilmore L , Thaler G , Crowley M , Song J , Thiagarajan P
Published: August 2023

A method for determination of non-radiative carrier lifetimes in the waveguide and active regions of quantum well laser diodes is presented. This method is suitable for characterization of fully packaged devices and requires no special measurement equipment if the device structure is known. The proposed approach is experimentally demonstrated for several 800 nm laser diodes.
Compression strategies for large-scale electrophysiology data
Authors: Buccino Alessio P , Winter Olivier , Bryant David , Feng David , Svoboda Karel , Siegle Joshua H
Published: August 2023

Objective. With the rapid adoption of high-density electrode arrays for recording neural activity, electrophysiology data volumes within labs and across the field are growing at unprecedented rates. For example, a one-hour recording with a 384-channel Neuropixels probe generates over 80 GB of raw data. These large data volumes carry a high cost, especially if researchers plan to store and analyze their data in the cloud. Thus, there is a pressing need for strategies that can reduce the data footprint of each experiment. Approach. Here, we establish a set of benchmarks for comparing the performance of various compression algorithms on experimental and simulated recordings from Neuropixels 1.0 (NP1) and 2.0 (NP2) probes. Main results. For lossless compression, audio codecs (FLAC and WavPack) achieve compression ratios (CRs) 6% higher for NP1 and 10% higher for NP2 than the best general-purpose codecs, at the expense of decompression speed. For lossy compression, the WavPack algorithm in ‘hybrid mode’ increases the CR from 3.59 to 7.08 for NP1 and from 2.27 to 7.04 for NP2 (compressed file size of ∼14% for both types of probes), without adverse effects on spike sorting accuracy or spike waveforms. Significance. Along with the tools we have developed to make compression easier to deploy, these results should encourage all electrophysiologists to apply compression as part of their standard analysis workflows.
Analysis of interleaved fuzzy Logic MPPT approach for PV system
Authors: Arulmurugan R , Sivakumar N , Baraneetharan E
Published: August 2023

In this article, a detailed novel interleaved fuzzy logic control based Maximum Power Point Algorithm was designed. It was derived from the conventional hill climbing method, which is used to track solar Photo Voltaic (PV) systems over changing temperature and irradiance. The proposed system composed of the PV panel source, Maximum Power Point Tracking (MPPT) with designed interleaved Fuzzy Logic controller, DC to DC charge controller, and load. The designed fuzzy logic controller contains the two fuzzy subsets, one fuzzy concentrate the change in power with respect to change in voltage and another fuzzy concentrate the change in power with respect to change in current, compare with two fuzzy model uses to track the path more perfect compare to existing method as a novelty of the article. The proposed interleaved fuzzy MPPT optimally tune the parameters of the controller. The proposed system analyzed the few sub criteria, such as time response, stability and power efficiency. The performance of the presented controller has been validated with conventional controllers such as fractional open circuit approach, fractional short circuit approach and hill climbing approach. The proposed leads the highest tracking performance compared to existing. In addition, the proposed performed effectively in different environmental conditions.
Development and Performance Comparison of AC and DC Data Logger for Solar PV Application in Agriculture
Authors: Bansal Shweta , Patel R N , Nigam Manoj Kumar , Ruchira
Published: August 2023

Energy demand has outpaced energy supply. The use of renewable energy is one solution to this energy demand - supply imbalance. For better utilization of energy at the rural areas, a study was conducted to compare the performance of solar systems with and without inverter. The design and development for a low-cost ac and dc data recorder for PV systems is presented in this study. The data logger prototype consists of a micro converter, SD card, and current and voltage sensors. It measures the daily power usage of both ac and dc appliances. The data logger is interfaced with a personal computer, a mobile device, and an LED display, and it provides the daily energy consumption, the average energy consumption, the charging and discharging conditions, and system failure information. The designed hardware was tested under variety of load and no-load conditions, and the graph for various parameters both ac and dc appliances were then analyzed. This technology captures data in milliseconds with human-impossible precision. Microsoft Excel can aggregate all data and generate a graph for each microsecond, which enhances accuracy, eliminates human error, and saves time. This will improve the economy and make them more energy independent.
PI Controlled Bridged Grid-Connected Solar PV Network for Electric Vehicle Battery Charging
Authors: Sharma Desh Deepak , Kumar Ravindra
Published: August 2023

The Z-source inverter (ZSI) topology replaces multiple stages into a single stage in power conversion so it is going to be an appropriate topology for 1-phase grid-connected PV system. In this paper, the various z-source topologies are discussed as available in different literature. This paper has proposed a proportional and integral (PI) Controlled bridged grid-connected solar photovoltaic (PV) network for electrical vehicle charging. The different modulation techniques applied in these topologies have been described. The bridged grid-connected network equipped with solar modules can prove effective in developing charging infrastructures for electric vehicles (EVs) at residential or commercial complexes. The different parameters of this suggested topology may vary during different time instants of a whole day at different modes of procedure i.e solar PV generation to the grid, EV to grid, and both PV and EV to grid. The simulation work has been done with the PWM technique to obtain battery voltage and grid voltage, Fast Fourier Transform, and total harmonic distortion.
Seasonal Variations of pH and Dissolved Oxygen Concentrations in Major Rivers of Uttar Pradesh
Authors: Ghildyal Divya , Chaudhary Manisha
Published: August 2023

The variations in pH and Dissolve Oxygen (DO) concentrations were analysed in surface river water samples for three seasons Pre-Monsoon, Monsoon and Autumn (January to December 2022) for four major rivers Ganga, Yamuna, Gomti and Hindon flowing through Uttar Pradesh, India. For river Ganga pH range varied from 7.65 to 8.47 and DO varied from 6.4mg/l to 9.26mg/l. For river Yamuna pH range varied from 7.31 to 10.5 and DO varied from 0 to 8.1mg/l. Gomti river showed, pH range between 7.2 to 8.48, while DO varied from 0.63mg/l to 8.4mg/l. For, river Hindon, pH varied from 6.8 to 7.66 and DO observed was between 0 to 1.8mg/l. Correlation Matrix showed a significant weak positive correlation between pH and DO for all three seasons for rivers Ganga and Yamuna, while river Gomti showed a significant weak positive correlation in Pre-Monsoon and Monsoon season, and a weak negative correlation in Autumn lastly river Hindon showed weak negative correlation between pH and DO for Pre-Monsoon, and Monsoon and a weak positive significant correlation for Autumn season. Dissolved Oxygen was found in good concentration in river Ganga, and almost nilfor river Hindon. An increasing trend line for DO was observed for rivers Ganga and Yamuna while river Gomti showed a constant trend line lastly river Hindon showed almost nil DO. This study helped to identify the variations of pH and DO, and also to find the correlation between them for Pre-Monsoon, Monsoon and Autumn seasons for the river water samples. The study will prove helpful for designing of water treatment plants accompanying seasonal variations.
Wire-Free Vehicle Charging Using Solar System
Authors: Saini Manoj , Khan Shagufta , Sharma Amit Kumar , Srivastava Yatharth , Chandrasen Shukla Om , Tripathi Sahaj , Dubey Shivam
Published: August 2023

These days everything runs on electricity, without electricity it becomes hard to spend time. Our daily use items like phones, laptops, and other items work on electricity. So electricity is our basic requirement and its connection is establishing rapidly. This is a great opportunity for us to shift to an electric vehicle as nature warns us of pollution. Also, there are different sources available for generating electricity and this electricity can be easily used to move the car. To move the car through electricity, an electricity bank i.e., batteries are installed inside the car which needs to be recharged after a fixed mile run. This recharging can be done in different manners but the need of better fast and efficient charging system has been increases. People don’t want to carry different chargers for different devices or wait for long hours at changing stations so to make charging in an easy way this paper purposed a charging system based on wire-free technology. This paper elaborates on the concept of wireless charging and improves the concept of stationary wireless electric car charging.
A Comprehensive Analysis of Power Converter Topologies and Control Methods for Extremely Fast Charging of Electric Vehicles
Authors: Manoj Vasupalli , Pilla Ramana , Sura Srinivasa Rao
Published: August 2023

Power electronic converters must be researched and developed to offer high-power, low-cost, and reliable contributions to solving the electric vehicle battery problem in light of the widespread usage and expected rise of EVs. An adequate charging infrastructure is required to accommodate the growing number of electric cars (EVs). Off-board chargers for electric vehicles (EVs) are talked about here, along with their alternating current (AC) and direct current (DC) power stages. Concerns that may arise during the design process of an XFC station are addressed, as are the common topologies for power electronics converters that are efficient for XFC. Electric cars can be charged inside or outside the car, but for fast charging, the shorter, lighter outlets outside the car are the best choice. Focusing on technical specifics, ongoing research, and difficulties, we analyze the most up-to-date topologies and control strategies for AC-DC and dc-DC power stages in off-board chargers. And most of the newest multi-port charging stations that combine photovoltaics (PV), energy storage, electric vehicles (EVs), and the power grid are shown as well. By contrasting the AC-DC rectifier, dc-dc converter, and multiport converter in respect of their architecture, voltage and power ranges, efficiency, and the ways in which they impact workability, future research on EV charging solutions may be guided.
Fault Prediction in Electrical Assets Using Infrared Thermography
Authors: parashar S , kumar A , sharma P , rana S , kumar D
Published: August 2023

An infrared thermography technique is discussed in this paper to locate and diagnose the electrical equipment issue. Overheating is among major problems for an electrical device and entire power system. These overheated hotspots must be detected so that the fault can be predicted before it occurs. We used a thermal image of an electrical device taken from a infrared camera to apply our method to detect the hot region and find the maximum temperature and minimum temperature in the image. Image de-noising is done with the help of morphological reconstruction followed by Watershed transformation for image segmentation to identify and separate the region having high pixel intensity as we know that area with high pixel intensity will also have high temperature. Our method achieved near to exact maximum and minimum temperature of electrical device.
Multi-coil wireless power transfer (WPT) technique for boosting efficiency in large air gap systems
Authors: Ghosh Prabhat Chandra
Published: August 2023

An energy-efficient high-powermulti-coil wireless power transfer system (WPT) has been studied in this paper. The proposed system was first analyzed and examined using theoretical modeling; this was followed by finite element analysis and circuit simulation to confirm the goal. As the air gap between the transmitter and receiver coils widens, the coupling coefficient of a WPT system will drop. A large-air-gap WPT system’s coupling coefficient can be raised by adding relay coils between the transmitting and receiving coils. On the other hand, an increased coupling coefficient improves the system’s overall power transfer efficiency. The suggested multi-coil system, which has an air gap of 15 cm and a lateral misalignment of 3 cm between the transmitting and receiving coils, has been simulated and verified using the Maxwell 3-D finite element tool and Ansys Simplorer circuit simulation software.
Optimal Positioning of Distributed Energy using Intelligent Hybrid Optimization
Authors: Paul Ward Ul Hijaz , Siddiqui Anwar Shahzad , Kirmani Sheeraz
Published: August 2023

The renewable based energy source integration into the smart grid has seen a rapid surge lately and so has the role of distributed energy. By reducing the power losses within distribution network, the appropriate location and size of the distributed energy or distributed generation sources could be found. In this paper, it has been proposed that where the distribution generating units should be placed. An intelligent optimization technique has been utilized to position different distribution generators in the best possible way. These advancements have both the advantages and disadvantages of their own. The research employs a novel optimization technique based on a hybrid of genetic algorithm and particle swarm optimization techniques. Placing the distribution generations properly lowers the power losses and improves the profile of the voltage in the distribution system.
CNN –based Spiral drawing classifier to detect Early-Stage Parkinson’s Disease
Authors: Khare Yash , Singh Pratima
Published: August 2023

Parkinson’s disease is a neurological condition wherein one experiences a loss in control of motor movements. The disease usually infects gradually but worsens over time. Parkinson’s often starts with a tremor in one hand. Slow movements, stiffness in the body, and loss of balance are some of the major symptoms of the disease. Damaged nerve cells present in the brain cause drops in the levels of dopamine in the body. It is very difficult to detect Early-Stage Parkinson’s Disease.

Researchers have now been able to detect Parkinson’s disease at an early stage (Perhaps at Stage 2 or Stage 3), but there have been no significant advancements in the detection of Parkinson’s at the initial stage. Analyzing the handwriting styles can be one of the initial symptoms of the disease. The dataset given by NIATS of the Federal University of Uberlandia was used in our research. In this study, we present a CNN model that can distinguish between spiral drawings made by patients with Parkinson’s disease and those made by people not suffering from Parkinson’s disease with high accuracy.
Functional Network of Neurocognitive Development in Correlations of BOLD Signals
Authors: Saurabh Sudhanshu , Gupta P. K.
Published: August 2023

Blood Oxygen Level Dependent (BOLD) fMRI is widely used for non-invasive brain mapping and neuroimaging. Despite the challenges, significant advancements have been made in empirically explaining several (BOLD) signal features. Before applying functional connectivity measures to assess the (BOLD) signal, preprocessing is required. Different stimuli produced by a regular periodic oscillation pulse and propagation loops were applied to generate the (BOLD) signal. The fundamentals of the brain and cognitive development are being highlighted through functional connectivity in a unique approach. In this work, we present an approach that analyzes variations in (BOLD) connectivity over time. Our approach emphasizes the temporal or spatial aspects however, simultaneous co-activation events may trigger (BOLD). Our findings show the measures to assess Functional Connectivity (FC) through Pearson’s correlation to describe FC. (BOLD) responses are used in a voxel-wise linear model with an estimation of the maximum likelihood to get the regressors’ correlated components.
Novel Particle Bee Optimisation based Framework for Fault Tolerance in Fog Environment
Authors: Sharma Pankaj , Gupta P K
Published: August 2023

Fog Computing characteristics have fascinated its services in many applicability areas such as Industrial IoT, health monitoring systems and high performance computing, weather forecasting, agronomy, etc. Here, data is captured using the various sensor nodes installed at different locations and further processed by a cloud-based server to obtain the desired results. Heterogeneity of fog nodes and end devices in fog computing architecture is a major feature that helps to utilize already existing computing resources, yet it complicates the managing process. Such a diversified environment must be considered when designing fog environments in terms of computing capabilities, power consumption, and connectivity. In this work An efficient Novel Particle Bee Optimization based Fault Tolerance framework has been projected that ensures the implementation of Fog computing in real time. The proposed framework handling live server faults and also diminishes latency and bandwidth usage of the network and improves Quality of Service (QoS). The achieved results for the projected technique represent the reduction of network bandwidth and reduction in overall cost.
Educational Software System For Teaching STEM To Visually Impaired People
Authors: Singh Pratima , Kapoor Ishita , Goyal Adarsh
Published: August 2023

‘Education for All’ is a farfetched dream for all Developing Countries. ‘Inclusive Education’ is still farther. Visually challenged individuals are still far from main steam Education. Their overall education is limited to humanity subjects only. They are not able to take up Science and Mathematics as a subject beyond middle school because of the lack of concepts, study material & sufficient teaching aid. The existing solution in Braille is a partial solution to this problem. Our research and resulting solutions enable them to develop the concepts & understanding of science & mathematics which help them study STEM subjects(Science, Technology, Engineering, Mathematics) beyond Middle School too. In the proposed solution, we have developed a Machine Learning-based Software –Hardware Integrated system that helps them understand middle level & higher concepts of Mathematics & Science. It is an integrated system that has a software application connected with hardware comprising features like ‘Concepts and Explanation’, ‘Study Material’, ‘and Practice and Test Yourself’. The whole application can be accessed using the TalkBack accessibility feature of the application. If a blind individual has to trace a Mathematical shape such as say ‘sinusoidal graph’, then the person will draw a graph in real-time on the digital screen attached to the hardware (along with real-time voice assistance for tracing the shape/graph). When the sketching of the shape is completed, the coordinates of the figure traced on the digital screen are mapped and those particular pins/buttons are raised on the hardware device. Thus, the blind individual can touch and understand the shape of the hardware board. Moreover, the figure sketched is further checked for its accuracy and the result is read aloud by the voice assistant embedded in the application which is based on Machine Learning Algorithms.
Novel low noise amplifier approach for deep brain stimulation
Authors: Sampath Kumar V , Upreti Kartik
Published: August 2023

This paper presents an analysis for a multi-stage Low Noise Amplifier (LNA) for application on deep brain stimulation. A low noise amplifier (LNA) with high gain, moderate bandwidth and reduced noise is designed and simulated using LT Spice and PTM BSIM4 CMOS models. The novel LNA circuit topology is proposed which uses a cascaded style to improve mid-band gain of an LNA. The proposed LNA achieves a gain margin which ranges between 60-67 (dB), 2X times; Phase Margin which ranges between 145 to 154 (deg), 3X times; Gain which ranges between 66 to 75 (dB), 2X times and bandwidth from kHz to MHz range. The current biasing circuit is used for enhancing stability and gain range. Also, optimal noise figure is achieved with the help of cascading input matching along with source degeneration technique.
The role of leading-edge serrations in controlling the flow over owls’ wing
Authors: Saussaman Tanner , Nafi Asif , Charland David , Ben-Gida Hadar , Gurka Roi
Published: August 2023

We studied the effects of leading-edge serrations on the flow dynamics developed over an owl wing model. Owls are predatory birds. Most owl species are nocturnal, with some active during the day. The nocturnal ones feature stealth capabilities that are partially attributed to their wing microfeatures. One of these microfeatures is small rigid combs (i.e. serrations) aligned at an angle with respect to the incoming flow located at the wings’ leading-edge region of the primaries. These serrations are essentially passive flow control devices that enhance some of the owls’ flight characteristics, such as aeroacoustics and, potentially, aerodynamics. We performed a comparative study between serrated and non-serrated owl wing models and investigated how the boundary layer over these wings changes in the presence of serrations over a range of angles of attack. Using particle image velocimetry, we measured the mean and turbulent flow characteristics and analyzed the flow patterns within the boundary layer region. Our experimental study suggests that leading-edge serrations modify the boundary layer over the wing at all angles of attack, but not in a similar manner. At low angles of attack (<20°), the serrations amplified the turbulence activity over the wing planform without causing any significant change in the mean flow. At 20° angle of attack, the serrations act to suppress existing turbulence conditions, presumably by causing an earlier separation closer to the leading-edge region, thus enabling the flow to reattach prior to shedding downstream into the wake. Following the pressure Hessian equation, turbulence suppression reduces the pressure fluctuations gradients. This reduction over the wing would weaken, to some extent, the scattering of aerodynamic noise in the near wake region.
An advanced review of climate change mitigation policies in Germany, France, and the Netherlands
Authors: Wang Di , Dong Liang , Mei Jianhao
Published: August 2023

Mitigation of climate change requires comprehensive policy arrangements. This article applies a systematic analysis framework comprising ‘vertical policy hierarchy—horizontal policy path—policy instruments’ with Germany, France, and the Netherlands as study cases, and first-hand policy and data from government websites collected, clustered, and matched. The study conducts a comparative analysis of the three countries’ systems, pathways, instruments, and their effectiveness in climate change mitigation. The findings indicate that, firstly, all three countries have relatively well-developed policy systems (laws, regulations, strategies, plans, and policy instruments) based on the six vertical policy hierarchy defined by government governance structure. Secondly, the three countries exhibit commonalities and disparities in seven sectors: energy, transport, buildings, industry, agriculture, forest, and waste. The commonalities stem from EU laws and directives, while disparities arise from resource endowments and emission structures. Thirdly, regarding policy instruments, the commonalities among the three countries are reflected in the dominance of Financial/Fiscal Mechanisms as the primary approach, the leadership position of Governance Mechanisms, the comprehensive coverage of Regulatory Reform, and the massive expenditure in the Direct investment. Individually, (1) the German Regulatory Reform primarily addresses energy resource transformation; France focuses on controlling the transport sector emissions; while the Netherlands commits to renewable energy generation. (2) Germany leads in terms of Commercialization Mechanisms. (3) Financial/Fiscal Mechanisms encompass all sectors, while Germany examplifies the transportation sector digitization, France’s provision of ecological housing loans, and the Netherlands’ support for sustainable agriculture. (4) France distinguishes itself with a forward-thinking approach towards Governance Mechanism including climate financial risks, ESG (Environmental, Social, and Governance) standards. Fourthly, the significant policy instruments analysis demonstrates that the climate governance of three countries incorporates not only direct or indirect efforts in emission reduction, but also considerations of institutional requirements, fairness, economic effectiveness, synergies, and transformative potential in policy considerations.
Comparing visitor motivation and demographics between an insect festival and science festivals
Authors: Pearson Gwen , Justus Emily
Published: August 2023

Both science festivals and insect festivals have increased in frequency in the last few decades. In order to compare insect festivals with science festivals, we modified a validated science festival visitor survey (EvalFest) for Purdue’s Bug Bowl, a long-running insect festival. Benchmarking against EvalFest and Collaboration for Ongoing Visitor Experience Studies (COVES) results, we found that Bug Bowl audiences were similar in having high levels of education, a high interest in science, and frequently visiting science venues. In fact, 23% of Bug Bowl survey takers indicated that they were actual scientists themselves. In contrast to EvalFest results, Bug Bowl had a higher rate of returning visitors than new visitors. Bug Bowl visitor motivations were primarily to have fun and bring their children for a learning experience, and they rated their experiences very positively. Ninety-one percent of Bug Bowl attendees surveyed lived in the state of Indiana. We discuss gaps in expected visitor demographics and possible applications for a shared common evaluation within a working group of insect festivals.
Individual and contextual risk factors for mortality in nursing home residents during the first wave of COVID-19 in France: a multilevel analysis of a nationwide cohort study
Authors: Rachas Antoine , Fontaine Roméo , Thomas Martine , Robine Jean-Marie , Gavazzi Gaëtan , Laurent Marie , Carcaillon-Bentata Laure , Canouï-Poitrine Florence
Published: August 2023

Background

Mortality amongst nursing home (NH) residents increased by 43% during the first wave of coronavirus disease 2019 (COVID-19). We estimated the ‘contextual effect’ on mortality, tried to explain it by NH characteristics and identified resident- and NH-level risk factors for mortality.

Methods

The contextual effect was measured for two cohorts of NH residents managed by the general scheme in metropolitan France (RESIDESMS data from 03/01/2020 to 05/31/2020 and 03/01/2019 to 05/31/2019) by the intraclass correlation coefficient (ICC) estimated from mixed-effects logistic regression.

Results

Amongst 385,300 residents (5,339 NHs) included in 2020 (median age 89 years, 25% men), 9.1% died, versus 6.7% of 379,926 residents (5,270 NHs) in 2019. In the empty model, the ICC was 9.3% in 2020 and 1.5% in 2019. Only the geographic location partially explained the heterogeneity observed in 2020 (ICC: 6.5% after adjustment). Associations with mortality were stronger in 2020 than in 2019 for male sex and diabetes and weaker for heart disease, chronic respiratory disease and residence <6 months. Mortality was higher in 2020 (15.1%) than 2019 (6.3%) in NHs with at least one death with a mention of COVID-19 and more heterogeneous (ICC: 8.0%) than in the others (mortality: 6.7% in both years; ICC: 1.1%).

Conclusion

Our results suggest that the COVID-19 crisis had a heterogeneous impact on mortality in NH residents and that geographic location explain a part of the contextual effect, which appears to have had little influence on mortality in NHs not being affected by the virus.
Multimodal deep learning approaches for single-cell multi-omics data integration
Authors: Athaya Tasbiraha , Ripan Rony Chowdhury , Li Xiaoman , Hu Haiyan
Published: August 2023

Integrating single-cell multi-omics data is a challenging task that has led to new insights into complex cellular systems. Various computational methods have been proposed to effectively integrate these rapidly accumulating datasets, including deep learning. However, despite the proven success of deep learning in integrating multi-omics data and its better performance over classical computational methods, there has been no systematic study of its application to single-cell multi-omics data integration. To fill this gap, we conducted a literature review to explore the use of multimodal deep learning techniques in single-cell multi-omics data integration, taking into account recent studies from multiple perspectives. Specifically, we first summarized different modalities found in single-cell multi-omics data. We then reviewed current deep learning techniques for processing multimodal data and categorized deep learning-based integration methods for single-cell multi-omics data according to data modality, deep learning architecture, fusion strategy, key tasks and downstream analysis. Finally, we provided insights into using these deep learning models to integrate multi-omics data and better understand single-cell biological mechanisms.
Metformin has anti-inflammatory effects and induces immunometabolic reprogramming via multiple mechanisms in hidradenitis suppurativa
Authors: Petrasca Andreea , Hambly Roisin , Kearney Niamh , Smith Conor M , Pender Emily K , Mac Mahon Julie , O’Rourke Aoife M , Ismaiel Mohamed , Boland Patrick A , Almeida Jose P , Kennedy Czara , Zaborowski Alexandra , Murphy Siun , Winter Desmond , Kirby Brian , Fletcher Jean M
Published: August 2023

Background

Targeting immunometabolism has shown promise in treating autoimmune and inflammatory conditions. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving painful lesions in apocrine gland-bearing skin. Therapeutic options for HS are limited and often ineffective; thus, there is a pressing need for improved treatments. To date, metabolic dysregulation has not been investigated in HS. As HS is highly inflammatory, we hypothesized that energy metabolism is dysregulated in these patients. Metformin, an antidiabetic drug, which is known to impact on cellular metabolic and signalling pathways, has been shown to have anti-inflammatory effects in cancer and arthritis. While metformin is not licensed for use in HS, patients with HS taking metformin show improved clinical symptoms.

Objective

To assess the effect and mechanism of action of metformin in HS.

Methods

To assess the effect of metformin in vivo, we compared the immune and metabolic profiles of peripheral blood mononuclear cells (PBMCs) of patients with HS taking metformin vs. those not taking metformin. To examine the effect of metformin treatment ex vivo, we employed a skin explant model on skin biopsies from patients with HS not taking metformin, which we cultured with metformin overnight. We used enzyme-linked immunosorbent assays, multiplex cytokine assays and quantitative real-time polymerase chain reaction (RT-PCR) to measure inflammatory markers, and Seahorse flux technology and quantitative RT-PCR to assess glucose metabolism.

Results

We showed that metabolic pathways are dysregulated in the PBMCs of patients with HS vs. healthy individuals. In metformin-treated patients, these metabolic pathways were restored and their PBMCs had reduced inflammatory markers following long-term metformin treatment. In the skin explant model, we found that overnight culture with metformin reduced inflammatory cytokines and chemokines and glycolytic genes in lesions and tracts of patients with HS. Using in vitro assays, we found that metformin may induce these changes via the NLR family pyrin domain containing 3 (NLRP3) inflammasome and the AMP-activated protein kinase (AMPK)–mammalian target of rapamycin (mTOR) pathway, which is linked to glycolysis and protein synthesis.

Conclusions

Our study provides insight into the mechanisms of action of metformin in HS. The anti-inflammatory effects of metformin support its use as a therapeutic agent in HS, while its effects on immunometabolism suggest that targeting metabolism is a promising therapeutic option in inflammatory diseases, including HS.
A single-centre retrospective review of treatment responses and adverse events of thalidomide in patients with inflammatory skin disease
Authors: McSweeney Sheila M , Mounsey Stephen , Arujuna Nisha , Garibaldinos Trish , Sarkany Robert , Fassihi Hiva
Published: August 2023

This retrospective review summarizes the effectiveness and safety concerns around using thalidomide in the treatment of inflammatory dermatoses.
Enumeration Of Subtrees Of Two Families Of Self-Similar Networks Based On Novel Two-Forest Dual Transformations
Authors: Sun Daoqiang , Liu Hongbo , Yang Yu , Li Long , Zhang Heng , Fahad Asfand
Published: August 2023

As a structural topological index, the number of subtrees has great significance for the analysis and design of hybrid locally reliable networks. In this paper, with generating function and introducing a novel two-forest dual transformation technique, we solve the subtree enumerating problems of two representatives of the self-similar networks, such as the hierarchical lattice and $(u,v)$-flower networks. Moreover, by means of the circle weight transfer technique, two linear time algorithms of computing the subtree generation functions of these two families of networks are also proposed. The subtree density of two special cases for these self-similar networks is briefly discussed as an application.
Single-nuclear transcriptome profiling identifies persistent fibroblast activation in hypertrophic and failing human hearts of patients with longstanding disease
Authors: Kattih Badder , Boeckling Felicitas , Shumliakivska Mariana , Tombor Lukas , Rasper Tina , Schmitz Katja , Hoffmann Jedrzej , Nicin Luka , Abplanalp Wesley T , Carstens Daniel C , Arsalan Mani , Emrich Fabian , Holubec Tomas , Walther Thomas , Puntmann Valentina O , Nagel Eike , John David , Zeiher Andreas M , Dimmeler Stefanie
Published: August 2023

Aims

Cardiac fibrosis drives the progression of heart failure in ischaemic and hypertrophic cardiomyopathy. Therefore, the development of specific anti-fibrotic treatment regimens to counteract cardiac fibrosis is of high clinical relevance. Hence, this study examined the presence of persistent fibroblast activation during longstanding human heart disease at a single-cell resolution to identify putative therapeutic targets to counteract pathological cardiac fibrosis in patients.

Methods and results

We used single-nuclei RNA sequencing with human tissues from two samples of one healthy donor, and five hypertrophic and two failing hearts. Unsupervised sub-clustering of 7110 nuclei led to the identification of 7 distinct fibroblast clusters. De-convolution of cardiac fibroblast heterogeneity revealed a distinct population of human cardiac fibroblasts with a molecular signature of persistent fibroblast activation and a transcriptional switch towards a pro-fibrotic extra-cellular matrix composition in patients with established cardiac hypertrophy and heart failure. This sub-cluster was characterized by high expression of POSTN, RUNX1, CILP, and a target gene adipocyte enhancer-binding protein 1 (AEBP1) (all P < 0.001). Strikingly, elevated circulating AEBP1 blood level were also detected in a validation cohort of patients with confirmed cardiac fibrosis and hypertrophic cardiomyopathy by cardiac magnetic resonance imaging (P < 0.01). Since endogenous AEBP1 expression was increased in patients with established cardiac hypertrophy and heart failure, we assessed the functional consequence of siRNA-mediated AEBP1 silencing in human cardiac fibroblasts. Indeed, AEBP1 silencing reduced proliferation, migration, and fibroblast contractile capacity and α-SMA gene expression, which is a hallmark of fibroblast activation (all P < 0.05). Mechanistically, the anti-fibrotic effects of AEBP1 silencing were linked to transforming growth factor-beta pathway modulation.

Conclusion

Together, this study identifies persistent fibroblast activation in patients with longstanding heart disease, which might be detected by circulating AEBP1 and therapeutically modulated by its targeted silencing in human cardiac fibroblasts.
33. QUALITY PERFORMANCE INDICATORS FOR THE SURGICAL TREATMENT OF OESOPHAGEAL CANCER- A SYSTEMATIC REVIEW
Authors: Kulasegaran Suheelan , (Joanna) Wang Yijiao , Woodhouse Braden , Maccormick Andrew , Srinivasa Sanket , Koea Jonathan
Published: August 2023

Background

A systematic review was undertaken to identify existing quality performance indicators (QPI) for the surgical treatment of oesophageal cancer (OC) with the aim of defining a set of QPIs that can be used in accreditation and allowing comparison of treatment and outcomes across jurisdictions, and provide a basis to develop quality improvement programs. These QPIs capture key components of patient care that are fundamental to the overall outcomes.

Methods

A systematic literature review was conducted by searching MEDLINE, PubMed, EMBASE, and SCOPUS with all literature available until the date of 1st March 2022 included. Search terms utilised were Quality of health care OR Quality improvement OR Quality control OR Quality indicators OR Benchmark, AND Oesophagectomy OR Esophagectomy OR Oesophageal neoplasm OR Esophageal Neoplasm OR Adenocarcinoma OR Squamous Cell Cancer OR Oesophageal resection OR Esophageal Resection OR Oesophageal cancer OR Esophageal Cancer OR Ivor Lewis OR Oesophageal Surgery OR Esophageal Surgery.

Results

Twenty-five articles were included in the final analysis. The selected studies included editorials, retrospective review, prospective review, expert guidelines and consensus. For OC QPIs, process measures included multi-disciplinary meetings, access to perioperative multimodal diagnostic pathways, and surgical metrics (margin negative resections and adequate lymphadenectomy). Outcome measures included the RO resection rate, reoperation, readmission rate, and length of hospital stay.

Conclusions

This systematic review summarises QPIs for the surgical management of OC. The data from this review will form the basis of a project to develop internationally agreed QPIs for OC resections.
39. HIGH PREOPERATIVE PLATELET TO LYMPHOCYTE RATIO IS ASSOCIATED WITH A GREATER RISK OF POSTOPERATIVE COMPLICATIONS AND RECURRENCES IN ESOPHAGEAL CANCER
Authors: Sasahara Masahiro , Kanda Mitsuro , Shimizu Dai , Takami Hideki , Inokawa Yoshikuni , Hattori Norifumi , Hayashi Masamichi , Tanaka Chie , Fujiwara Michitaka , Nakayama Goro , Kodera Yasuhiro
Published: August 2023

Background

Neoadjuvant treatment is currently the gold standard for advanced esophageal squamous cell carcinoma (ESCC). Several studies have examined the value of blood count-based indexes for predicting short- and long-term outcomes after esophagectomy for ESCC, but the relative predictive value of pretreatment, preoperative, and postoperative indexes has not yet been examined.

Methods

This study included 320 patients with thoracic ESCC who underwent subtotal esophagectomy after neoadjuvant chemotherapy or chemoradiotherapy at our institution. A total of 19 candidate blood parameters were measured before neoadjuvant treatment as well as preoperatively and postoperatively. The ability of the parameters to predict postoperative complications, overall survival (OS), and relapse-free survival (RFS) were assessed using receiver operating characteristic (ROC) curve analysis and Cox regression analysis.

Results

ROC curve analysis indicated that preoperative platelet to lymphocyte ratio (PLR) had the best predictive value with an optimal cutoff value of 166. Patients with high preoperative PLR (≥166) had significantly shorter OS and RFS and significantly higher incidences of hematogenous recurrence and postoperative pneumonia compared with patients with low preoperative PLR (<166). In multivariate analysis, high preoperative PLR and high preoperative serum carcinoembryonic antigen level were independent predictors of poor prognosis.

Conclusion

Preoperative PLR is a good predictor of short- and long-term prognosis in patients with advanced ESCC who receive neoadjuvant treatment followed by radical resection.
144. OPTIMIZING MEDIASTINAL ACCESS FOR RADICAL ESOPHAGECTOMY: A BILATERAL CERVICAL AND TRANSHIATAL APPROACH TO RESECT ESOPHAGEAL CANCER
Authors: Xu Wei , Jiang Yuequan
Published: August 2023

Background

Major medical centers have gradually attempted and promoted esophagectomy via mediastinal approach. However, this operation is challenging and requires a high level of technical proficiency from surgeons because of the limited space and restricted visibility of the mediastinum. The current surgical method limits its application in patients with locally advanced esophageal cancer, which underscores an urgent need for optimization to facilitate its refinement and dissemination.

Methods

We have implemented the following enhancements to the surgical procedure: 1. The cervical level was chosen for transecting the esophagus, and then the proximal esophageal stump was pulled down and invaginated. 2. Bilateral cervical incisions were made, with a small 0.5 cm incision at the anterior edge of the right sternocleidomastoid muscle. 3. The position of abdominal surgical incisions was adjusted so that all incisions were located on the left side of the abdominal midline. 4. A portion of the left diaphragm was dissected. 5. During the superior mediastinum procedure, gauze was positioned within the expanded superior mediastinum.

Results

1. The surgical field was fully exposed, expanding the operative space for upper mediastinal surgery. 2. The difficulty of this surgery was reduced, and it was easier to expose both RLNs and completely remove the mediastinal lymph nodes. 3. The 106recR could be completely removed under endoscopy. 4. The thoracic duct could be fully exposed and freed. 5. During surgery, gauze is placed in the upper mediastinum to aid in hemostasis and improve visibility. 6. Even if the tumor was slightly larger or locally invaded surrounding tissues, it could be completely resected. 7.Complete resection of the esophageal mesorectum was successfully achieved.

Conclusion

Esophagectomy for esophageal cancer via bilateral cervical and transhiatal approach can achieve radical resection and can be applied to patients with locally advanced esophageal cancer. This surgical method expands the surgical indications, reduces the surgical difficulty for surgeons, and facilitates the promotion and popularization of the mediastinal approach surgery.
149. LAPAROSCOPIC HELLER CARDIO-MYOTOMY IS NOT ALWAYS A SAFE OPERATION
Authors: Ezz Reda
Published: August 2023

Background

Laparoscopic Heller cardio-myotomy is the standard surgical treatment of achalasia. Although POEM (Per-oral endoscopic myotomy) has gained wide acceptance among gastroenterologists, yet many surgeons are still loyal to this operation. One of the complications of the operation which could happen is esophageal or gastric perforation during the myotomy. Intra-operative detection of the perforation and meticulous repair is very important to prevent serious sequelae.

Methods

Between may 2021 and Jan 2023, 46 cases of achalasia (Type I and II) were treated by laparoscopic Heller cardio-myotomy and anti-reflux procedure (Dor or Toupet). Myotomy was performed using muscles splitting combined with either harmonic or hook diathermy. Intra-operative perforations were reported and were repaired in all cases and tested for absence of leakage. Post-operative follow up of cases having intraoperative perforations and its management were documented. For those having perforations postoperative gastrographin swallow and meal was done and oral fluids intake started second postoperative day.

Results

Perforations occurred in 11 cases (24%) and were repaired using 3 l0 suture: monofilament non-absorbable suture: prolene (polypropyelene, J&J MedTech) in 4 cases, monofilament absorbable suture monocryl (poliglecaprone 25, J&J MedTech) in 3 cases and vicryl (polyglactin 910, J&J MedTech) in 4 cases.

Smooth post-operative recovery was noted in 7 cases having perforations (64%). Four patients (36%) developed Leakage second postoperative day confirmed by investigations. All these cases were repaired with Vicryl. Endoscopic stent was inserted with improvement of the condition in 3 cases (75%). One patient required reoperations twice and expired in the 29th day postoperative from ARDS.

Conclusion

Although perforations could happen during laparoscopic Heller cardio-myotomy, it has a benign postoperative course in most cases. This doesn’t mean that it is a simple operation. Laparoscopic Heller cardio-myotomy should be done in highly specialized esophageal center because its complications could lead to death if badly managed.