bluuebunny/crossref_metadata_2025 huggingface dataset:
Vein of Galen Aneurysmal Malformation: A Case Report
Authors: Clarke Naomi E. , Shekhawat Jatinder , Popat Himanshu , Lord David J. E. , Abdel-Latif Mohamed E.
Published: March 2024

Vein of Galen aneurysmal malformation is a relatively rare disease in which failure of the median prosencephalic vein of Markowski to involute early in gestation leads to a grossly dilated deep cerebral vein with multiple arterial feeders, causing a large arteriovenous shunt which leads to high-output cardiac failure. We describe a case of a term neonate who presented to a tertiary neonatal centre on day one of life with history, symptoms, and signs consistent with perinatal asphyxia; however, in the context of worsening multi-organ dysfunction and cardiomegaly, the infant was found to have a severe vein of Galen aneurysmal dilatation leading to high-output cardiac failure. The patient was transferred to a tertiary paediatric hospital and underwent a total of four coiling procedures to embolise the multiple feeder arteries supplying the aneurysmal malformation. This case highlights the difficulties in diagnosing this relatively uncommon condition, particularly in the context of a possible perinatal insult.
Ergonomic Assessment of Robotic versus Thoracoscopic Thymectomy
Authors: Taje Riccardo , Peer Michael , Gallina Filippo Tommaso , Ambrogi Vincenzo , Sharbel Azzam , Melis Enrico , Elia Stefano , Idit Matot , Facciolo Francesco , Patirelis Alexandro , Sorge Roberto , Pompeo Eugenio
Published: March 2024

Introduction: Robotic and thoracoscopic surgery are being increasingly adopted as minimally invasive alternatives to open sternotomy for complete thymectomy. The superior maneuverability range and three-dimensional magnified vision are potential ergonomical advantages of robotic surgery. To compare the ergonomic characteristics of robotic versus thoracoscopic thymectomy, a previously developed scoring system based on impartial findings was employed. The relationship between ergonomic scores and perioperative endpoints was also analyzed. Methods: Perioperative data of patients undergoing robotic or thoracoscopic complete thymectomy between January 2014 and December 2022 at three institutions were retrospectively retrieved. Surgical procedures were divided into four standardized surgical steps: lower-horns, upper-horns, thymic veins and peri-thymic fat dissection. Three ergonomic domains including maneuverability, exposure and instrumentation were scored as excellent(score-3), satisfactory(score-2) and unsatisfactory(score-1) by three independent reviewers. Propensity score matching (2:1) was performed, including anterior mediastinal tumors only. The primary endpoint was the total maneuverability score. Secondary endpoints included the other ergonomic domain scores, intraoperative adverse events, conversion to sternotomy, operative time, post-operative complications and residual disease. Results: A total of 68 robotic and 34 thoracoscopic thymectomies were included after propensity score matching. The robotic group had a higher total maneuverability score (p = 0.039), particularly in the peri-thymic fat dissection (p = 0.003) and peri-thymic fat exposure score (p = 0.027). Moreover, the robotic group had lower intraoperative adverse events (p = 0.02). No differences were found in residual disease. Conclusions: Robotic thymectomy has shown better ergonomic maneuverability compared to thoracoscopy, leading to fewer intraoperative adverse events and comparable early oncological results.
The Modified Neo-Bioscore System for Staging Breast Cancer Treated with Neoadjuvant Therapy Based on Prognostic Significance of HER2-Low Expression
Authors: Zhao Yingying , Chen Xinru , Wang Yaohui , Zhang Xueqing , Lu Jingsong , Yin Wenjin
Published: March 2024

Background: Recently, the classification of HER2 status evolves from binary to ternary, and HER2-low expression may exhibit prognostic significance. We aimed to investigate whether HER2-low tumor is distinct from HER2-zero or HER2-positive tumors, and then to develop a modified staging system (mNeo-Bioscore) that incorporates HER2-low status into Neo-Bioscore. Patients and Methods: This cohort study was conducted using data from the prospective database on breast cancer patients between January 2014 and February 2019. Results: Among 259 patients enrolled in the study, the HER2-low tumor exhibited significantly lower histological grade, pathological staging and Ki-67 level than the other two groups. HER2-low patients and HER2-positive patients receiving concurrent HER2-directed therapy may have similar LRFS (p = 0.531) and OS (p = 0.853), while HER2-zero peers may have significantly worse LRFS (p = 0.006) and OS (p = 0.017). In particular, a similar trend was also found in the patients without pathological complete response after surgery. Incorporation of HER2-low status made improvement in fit: 5-year OS rate estimates ranged from 33.33% to 100% for mNeo-Bioscore vs 61.36% to 100% for Neo-Bioscore. Conclusions: This study demonstrated that HER2-low tumor may exhibit prognostic significance. The innovative mNeo-Bioscore, based on a new classification of HER2 status, may serve as a prognostic staging system superior to Neo-Bioscore.
Accuracy and Efficacy of Artificial Intelligence-Derived Automatic Measurements of Transthoracic Echocardiography in Routine Clinical Practice
Authors: Shiokawa Noriko , Izumo Masaki , Shimamura Toshio , Kurosaka Yui , Sato Yukio , Okamura Takanori , Akashi Yoshihiro Johnny
Published: March 2024

Background: Transthoracic echocardiography (TTE) is the gold standard modality for evaluating cardiac morphology, function, and hemodynamics in clinical practice. While artificial intelligence (AI) is expected to contribute to improved accuracy and is being applied clinically, its impact on daily clinical practice has not been fully evaluated. Methods: We retrospectively examined 30 consecutive patients who underwent AI-equipped TTE at a single institution. All patients underwent manual and automatic measurements of TTE parameters using the AI-equipped TTE. Measurements were performed by three sonographers with varying experience levels: beginner, intermediate, and expert. Results: A comparison between the manual and automatic measurements assessed by the experts showed extremely high agreement in the left ventricular (LV) filling velocities (E wave: r = 0.998, A wave: r = 0.996; both p < 0.001). The automated measurements of LV end-diastolic and end-systolic diameters were slightly smaller (−2.41 mm and −1.19 mm) than the manual measurements, although without significant differences, and both methods showing high agreement (r = 0.942 and 0.977, both p < 0.001). However, LV wall thickness showed low agreement between the automated and manual measurements (septum: r = 0.670, posterior: r = 0.561; both p < 0.01), with automated measurements tending to be larger. Regarding interobserver variabilities, statistically significant agreement was observed among the measurements of expert, intermediate, and beginner sonographers for all the measurements. In terms of measurement time, automatic measurement significantly reduced measurement time compared to manual measurement (p < 0.001). Conclusions: This preliminary study confirms the accuracy and efficacy of AI-equipped TTE in routine clinical practice. A multicenter study with a larger sample size is warranted.
Risk Factors Associated with Adverse Events Leading to Methotrexate Withdrawal in Elderly Rheumatoid Arthritis Patients: A Retrospective Cohort Study
Authors: Avalos-Salgado Felipe Alexis , Gonzalez-Lopez Laura , Gonzalez-Vazquez Sergio , Ponce-Guarneros Juan Manuel , Santiago-Garcia Aline Priscilla , Amaya-Cabrera Edna Lizeth , Arellano-Cervantes Reynaldo , Gutiérrez-Aceves J. Ahuixotl , Alcaraz-Lopez Miriam Fabiola , Nava-Valdivia Cesar Arturo , Gonzalez-Ponce Fabiola , Rodriguez-Jimenez Norma Alejandra , Macias-Islas Miguel Angel , Valdivia-Tangarife Edgar Ricardo , Saldaña-Cruz Ana Miriam , Cardona-Muñoz Ernesto German , Gamez-Nava Jorge Ivan
Published: March 2024

Background: Rheumatoid arthritis (RA) in elderly population represents a challenge for physicians in terms of therapeutic management. Methotrexate (MTX) is the first-line treatment among conventional synthetic-disease-modifying anti-rheumatic drugs (cs-DMARDs); however, it is often associated with adverse events (AEs). Therefore, the objective of this study was to identify the incidence and risk factors of MTX discontinuation due to AEs in elderly patients with RA in a long-term retrospective cohort study. Methods: Clinical sheets from elderly RA patients taking MTX from an outpatient rheumatology consult in a university centre were reviewed. To assess MTX persistence, we used Kaplan–Meir curves and Cox regression models to identify the risk of withdrawing MTX due to adverse events. Results: In total, 198 elderly RA patients who reported using MTX were included. Of them, the rates of definitive suspension of MTX due to AEs were 23.0% at 5 years, 35.6% at 10 years and 51.7% at 15 years. The main organs and system involved were gastrointestinal (15.7%) and mucocutaneous (3.0%). Factors associated with withdrawing MTX due to AEs were MTX dose ≥ 15 mg/wk (adjusted HR: 2.46, 95% CI: 1.22–4.96, p = 0.012); instead, the folic acid supplementation was protective for withdrawal (adjusted HR: 0.28, 95% CI: 0.16–0.49, p < 0.001). Conclusions: Higher doses of MTX increase the risk of withdrawals in elderly RA, while folic acid supplementation reduces the risk. Therefore, physicians working in therapeutic management for elderly patients using MTX must focus on using lower MTX doses together with the concomitant prescription of folic acid.
Low ALT Is Associated with IBD and Disease Activity: Results from a Nationwide Study
Authors: Shafrir Asher , Katz Lior H. , Shauly-Aharonov Michal , Zinger Adar , Safadi Rifaat , Stokar Joshua , Kalisky Itay
Published: March 2024

Background: Sarcopenia is underdiagnosed in patients with inflammatory bowel disease (IBD). Low alanine transaminase (ALT) is associated with sarcopenia. We evaluated the association between low ALT and the presence of IBD and disease activity. Methods: Data were collected from a national Israeli health insurer cohort comprising 976,615 patients. Patients with a diagnosis of IBD were compared to healthy controls. After exclusion of patients with liver disease, ALT > 40 IU/L and age < 18, a total of 233,451 patients were included in the analysis. Low ALT was defined as <10 IU/L. Results: Low ALT was more common amongst patients with IBD than in healthy controls (7.76% vs. 5.7% p < 0.001). Low ALT was found in 148 (7.9%) of the patients with CD and 69 (6.9%) of the patients with UC. For CD, low ALT was associated with increased fecal calprotectin (FC) and CRP (223.00 μg/mg [63.45–631.50] vs. 98.50 [31.98–324.00], p < 0.001, 9.10 mg/L [3.22–19.32] vs. 3.20 [1.30–8.30], p < 0.001) and decreased albumin and hemoglobin (3.90 g/dL [3.60–4.20] vs. 4.30 [4.00–4.50], p < 0.001,12.20 g/dL [11.47–13.00] vs. 13.60 [12.60–14.70], p < 0.001). For UC, low ALT was associated with higher FC and CRP (226.50 μg/mg [143.00–537.00] vs. 107.00 [40.85–499.50], p = 0.057, 4.50 mg/L [1.90–11.62] vs. 2.30 [1.00–6.20], p < 0.001) and with lower albumin and hemoglobin (4.00 g/dL [3.62–4.18] vs. 4.30 [4.10–4.40], p < 0.001, 12.40 g/dL [11.60–13.20] vs. 13.60 [12.60–14.60], p < 0.001). These findings remained consistent following multivariate regression and in a propensity score-matched cohort. Conclusions: Low ALT is more common in patients with IBD and is associated with biochemical disease activity indices.
Incidence, Risk Factors, and Outcomes of De Novo Malignancy following Kidney Transplantation
Authors: Chukwu Chukwuma A. , Wu Henry H.L. , Pullerits Kairi , Garland Shona , Middleton Rachel , Chinnadurai Rajkumar , Kalra Philip A.
Published: March 2024

Introduction: Post-transplant malignancy is a significant cause of morbidity and mortality following kidney transplantation often emerging after medium- to long-term follow-up. To understand the risk factors for the development of de novo post-transplant malignancy (DPTM), this study aimed to assess the incidence, risk factors, and outcomes of DPTM at a single nephrology centre over two decades. Methods: This retrospective cohort study included 963 kidney transplant recipients who underwent kidney transplantation between January 2000 and December 2020 and followed up over a median follow-up of 7.1 years (IQR 3.9–11.4). Cox regression models were used to identify the significant risk factors of DPTM development, the association of DPTM with graft survival, and mortality with a functioning graft. Results: In total, 8.1% of transplant recipients developed DPTM, and the DPTM incidence rate was 14.7 per 100 patient-years. There was a higher mean age observed in the DPTM group (53 vs. 47 years, p < 0.001). The most affected organ systems were genitourinary (32.1%), gastrointestinal (24.4%), and lymphoproliferative (20.5%). Multivariate Cox analysis identified older age at transplant (aHR 9.51, 95%CI: 2.60–34.87, p < 0.001) and pre-existing glomerulonephritis (aHR 3.27, 95%CI: 1.10–9.77, p = 0.03) as significant risk factors for DPTM. Older age was significantly associated with poorer graft survival (aHR 8.71, 95%CI: 3.77–20.20, p < 0.001). When age was excluded from the multivariate Cox model, DPTM emerged as a significant risk factor for poor survival (aHR 1.76, 95%CI: 1.17–2.63, p = 0.006). Conclusion: These findings underscore the need for tailored screening, prevention, and management strategies to address DPTM in an aging and immunosuppressed kidney transplant population.
Recurrent Middle Eastern Differentiated Thyroid Carcinoma Has Worse Outcomes Than Persistent Disease
Authors: Parvathareddy Sandeep Kumar , Siraj Abdul K. , Annaiyappanaidu Padmanaban , Ahmed Saeeda O. , Al-Sobhi Saif S. , Al-Dayel Fouad , Al-Kuraya Khawla S.
Published: March 2024

Background: Despite the excellent prognosis of differentiated thyroid carcinoma (DTC), recurrent and persistent disease remain major challenges. Emerging studies to differentiate between recurrent and persistent disease are controversial, with studies from the Middle East lacking. Methods: We retrospectively analyzed 1691 patients who underwent surgery ± I131 treatment for DTC, with a median age of 38.7 years and median follow-up of 95.3 months. Results: We found a similar prevalence rate for persistent and recurrent disease (17.7% vs. 17.9%) in Middle Eastern DTC patients. Relative to patients with persistent disease, patients with recurrent disease were significantly older (median age: 36.1 vs. 45.8 years; p < 0.0001) and were more likely to have ATA high-risk tumors (61.5% vs. 75.2%; p = 0.0003). On multivariate logistic regression analysis, both T and N status were independent predictors for recurrent as well as structural persistent disease. However, older age, bilaterality and extrathyroidal extension were independent predictors of recurrent disease alone. In addition, patients with recurrent disease had significantly worse cancer-specific survival (p < 0.0001), which remained significant in multivariate analysis. Conclusions: Although persistent and recurrent disease in Middle Eastern DTC have similar frequencies, recurrent disease has worse outcomes compared to persistent disease. Hence, differentiating recurrence from persistence has great potential clinical relevance for therapeutic and follow-up approaches, contributing to improving the outcomes of DTC patients of Middle Eastern ethnicity.
The Trajectory of Revisional Bariatric Surgery: Open to Laparoscopic to Robotic
Authors: Jawhar Noura , Sample Jack W. , Salame Marita , Marrero Katie , Tomey Daniel , Puvvadi Suraj , Ghanem Omar M.
Published: March 2024

Metabolic and bariatric surgery (MBS) is the most effective therapeutic intervention for patients with obesity, with sleeve gastrectomy (SG) being the most commonly performed primary MBS procedure. Long-term studies have demonstrated that 15–20% of patients require revisional bariatric surgery (RBS) due to weight-related issues or surgical complications. Despite the gold standard being laparoscopic revision, there are other available approaches such as open or robotic-assisted. An extensive literature review was performed for articles from their inception to February 2024. A descriptive review of MBS procedures (SG, Roux-en-Y gastric bypass (RYGB), single anastomosis duodeno-ileostomy (SADI) and biliopancreatic diversion-duodenal switch (BPD-DS)) was carried out to report and compare outcomes between primary and revisional bariatric surgery. A similar review was conducted to compare outcomes of revisional approaches (open, laparoscopic, robotic). RYGB remains the dominant RBS with a similar safety profile compared to revisional SADI and BPD-DS. In terms of the RBS surgical approach, all three options showed comparable short and long-term outcomes, with robotic RBS being associated with longer operative time and variable length of stay. Additional long-term studies are required to further validate our conclusions.
Fibrosis in Chronic Kidney Disease: Pathophysiology and Therapeutic Targets
Authors: Reiss Allison B. , Jacob Berlin , Zubair Aarij , Srivastava Ankita , Johnson Maryann , De Leon Joshua
Published: March 2024

Chronic kidney disease (CKD) is a slowly progressive condition characterized by decreased kidney function, tubular injury, oxidative stress, and inflammation. CKD is a leading global health burden that is asymptomatic in early stages but can ultimately cause kidney failure. Its etiology is complex and involves dysregulated signaling pathways that lead to fibrosis. Transforming growth factor (TGF)-β is a central mediator in promoting transdifferentiation of polarized renal tubular epithelial cells into mesenchymal cells, resulting in irreversible kidney injury. While current therapies are limited, the search for more effective diagnostic and treatment modalities is intensive. Although biopsy with histology is the most accurate method of diagnosis and staging, imaging techniques such as diffusion-weighted magnetic resonance imaging and shear wave elastography ultrasound are less invasive ways to stage fibrosis. Current therapies such as renin-angiotensin blockers, mineralocorticoid receptor antagonists, and sodium/glucose cotransporter 2 inhibitors aim to delay progression. Newer antifibrotic agents that suppress the downstream inflammatory mediators involved in the fibrotic process are in clinical trials, and potential therapeutic targets that interfere with TGF-β signaling are being explored. Small interfering RNAs and stem cell-based therapeutics are also being evaluated. Further research and clinical studies are necessary in order to avoid dialysis and kidney transplantation.
Esophagus Dilation and Quality of Life in Adults with Scleroderma and Concomitant Obstructive Sleep Apnea
Authors: Yakut Tugce , Cinar Caner , Karakurt Sait , Direskeneli Haner , Yalcinkaya Yasemin , Peker Yüksel
Published: March 2024

(1) Background: Systemic sclerosis (SSc) is a rare systemic disease, which often affects the esophagus, leading to dilation and complications such as dysphagia and reflux. Obstructive sleep apnea (OSA) is a chronic condition with recurrent episodes of upper airway collapsibility and is known to impair quality of life (QoL). The primary aim of this study was to investigate the occurrence of esophagus dilation in patients with SSc and concomitant OSA and, further, to address the impact of these conditions on QoL. (2) Methods: In this cross-sectional cohort study, 62 consecutive patients with SSc underwent chest computer tomography (CT) and home sleep apnea testing. The OSA diagnosis was based on AHI ≥ 15 events/h. The QoL was quantified using the short-form (SF)-36 questionnaire. The patients were dichotomized as high- vs. low-esophageal-diameter groups, based on the median cut-off values. (3) Results: The mean age was 48 ± 11 years; 58 (93.5%) were female; the mean BMI was 26.7 ± 5.0 kg/m2. The median esophageal diameter was 17.47 mm. A larger esophageal diameter was more frequently associated with the diffuse cutaneous subtype of SSc (p = 0.002) and significantly higher Warrick scores (p < 0.001), indicating more severe pulmonary fibrosis. There was a significant linear correlation between the Warrick score and the esophageal diameter (standardized β coefficient 0.544 [%95 confidence interval 0.250–0.609]; p < 0.001). In the subgroup analysis, the patients with both OSA and enlarged esophageal diameter experienced a significant decline in QoL, particularly in the domains of physical functioning, role physical, general health, role emotional, and vitality. (4) Conclusions: While OSA was not directly associated with enlarged esophageal diameter in patients with SSc, those with both OSA and enlarged esophageal diameter exhibited a significant decline in QoL. These findings suggest that the presence of OSA may exacerbate the adverse effects of esophageal dilation on QoL in SSc patients. Our results underline the importance of considering both gastrointestinal and sleep-related aspects in SSc management to enhance patient QoL.
Mechanisms Leading to Increased Insulin-Stimulated Cerebral Glucose Uptake in Obesity and Insulin Resistance: A High-Fat Diet and Exercise Training Intervention PET Study with Rats (CROSRAT)
Authors: Jalo Anna , Helin Jatta S. , Hentilä Jaakko , Nissinen Tuuli A. , Honkala Sanna M. , Heiskanen Marja A. , Löyttyniemi Eliisa , Malm Tarja , Hannukainen Jarna C.
Published: March 2024

Recent studies have shown that obesity and insulin resistance are associated with increased insulin-stimulated glucose uptake (GU) in the brain. Thus, insulin sensitivity seems to work differently in the brain compared to the peripheral tissues like skeletal muscles, but the underlying mechanisms remain unknown. Regular exercise training improves skeletal muscle and whole-body insulin sensitivity. However, the effect of exercise on glucose metabolism in the brain and internal organs is less well understood. The CROSRAT study aims to investigate the effects of exercise training on brain glucose metabolism and inflammation in a high-fat diet-induced rat model of obesity and insulin resistance. Male Sprague Dawley rats (n = 144) are divided into nine study groups that undergo different dietary and/or exercise training interventions lasting 12 to 24 weeks. Insulin-stimulated GU from various tissues and brain inflammation are investigated using [18F]FDG-PET/CT and [11C]PK11195-PET/CT, respectively. In addition, peripheral tissue, brain, and fecal samples are collected to study the underlying mechanisms. The strength of this study design is that it allows examining the effects of both diet and exercise training on obesity-induced insulin resistance and inflammation. As the pathophysiological changes are studied simultaneously in many tissues and organs at several time points, the study provides insight into when and where these pathophysiological changes occur.
Improving the Mechanical Properties of GlassFibre-Reinforced Laser-Sintered Parts Based on Degree of Crystallinity and Porosity Content Using a Warm Isostatic Pressing (WIP) Process
Authors: De Coninck Hellen , Choi Jae Won , Soete Jeroen , Meyers Sebastian , Van Hooreweder Brecht
Published: March 2024

Additively manufactured fibre-reinforced polymers are gaining traction. After the development and optimisation of a novel fibre-deposition system in a laser sintering (LS) setup, polyamide 12 specimens were produced with and without glass fibres. In this study, the relation between the crystallinity, porosity, and mechanical properties of LS specimens with and without fibres is investigated. After testing as-built LS specimens, a detrimental effect of the fibres on the specimens’ performance was observed with a decrease in UTS of 6%. The degree of crystallinity remained the same; however, a porosity content of 2.6% was observed in specimens with fibres. These pores can have a negative influence on the bonding between the fibres and the matrix. To investigate the influence of the pores, warm isostatic pressing (WIP) was performed on LS specimens with and without fibres. The WIP process shows a positive influence on the specimens without fibres, resulting in an increase in UTS of 8.5%. The influence of the WIP process on specimens with fibres, however, is much less pronounced, with an increase in UTS of only 2%. Neither the crystallinity nor the porosity are the cause of the less-than-expected increase in UTS in LS specimens with fibres. A number of hypotheses and mitigation strategies are provided.
Analyses of the Suction Anchor–Sandy Soil Interactions under Slidable Pulling Action Using DEM-FEM Coupling Method: The Interface Friction Effect
Authors: Peng Yu , Liu Bolong , Wang Gang , Wang Quan
Published: March 2024

The microscale mechanisms underlying the suction anchor–sandy soil interaction under slidable pulling actions of mooring lines remain poorly understood. This technical note addresses this knowledge gap by investigating the suction anchor–sandy soil interaction from micro to macro, with a particular emphasis on the effect of interface friction. The discrete element method (DEM) was utilized to simulate the sandy soil, while the finite element method (FEM) was employed to model the suction anchors. The peak pulling forces in numerical simulations were verified by centrifuge test results. The research findings highlight the significant influence of interface friction on the pulling force–displacement curves, as it affects the patterns of suction anchor–sandy soil interactions. Furthermore, clear relationships were established between the magnitude of interface friction, rotation angle, and pullout displacement of suction anchors. By examining the macro-to-micro behaviors of suction anchor–sandy soil interactions, this study concludes with a comprehensive understanding of failure patterns and their key characteristics under different interface friction conditions. The findings proved that the interface friction not only influences the anti-pullout capacity but also changes the failure patterns of suction anchor–soil interactions in marine engineering.
Research on the Effect of Natural Seawater in Domesticating Bacillus pasteurii and Reinforcing Calcareous Sand
Authors: Wang Ziyu , Chen Wenjing , Tong Zhiyao , Wu Wenjuan , Chen Xin , Deng Xiuqiong , Xie Yu
Published: March 2024

Microbial-Induced Calcium Carbonate Precipitation (MICP) is an environmentally friendly, efficient, and sustainable new soil reinforcement technology. For this study, Bacillus pasteurii were domesticated and cultured in a natural seawater environment with multiple gradients and used for coral reef calcareous sand reinforcement, comparing the mineral composition of the generated precipitates and the reinforcement strength under different domestication gradient conditions. The results revealed that, while the natural seawater environment inhibits the growth of Bacillus pasteurii, the gradient domestication method allows the bacteria to gradually adapt to the natural seawater environment. Notably, their shape becomes thin and long under the seawater environment. Furthermore, the MICP mineralisation reaction rate is faster in the natural seawater environment and, with an increase in the domestication gradient, the mineralisation reaction precipitates increased. At the same time, in the seawater environment, a small amount of mineral components were generated in addition to CaCO3, such as MgxCay(CO3)z, and the Mg2+ mineral content increased with an increase in the domestication gradient. When comparing the curing effect under different gradients in the natural seawater environment, it was found that the Bacillus pasteurii can effectively enhance the curing effect of the calcareous sand after multi-gradient domestication in the seawater environment, with the curing effect increasing with an increase in the domestication gradient. The results of this study provide new ideas for the application of MICP technology in seawater environments for the reinforcement of calcareous sand in the construction of South China Sea islands and reefs.
Ship Shaft-Rate Electric Field Signal Denoising Method Based on VMD-MSS
Authors: Wang Ye , Wang Dan , Chi Cheng , Yu Zhentao , Li Jianwei , Yu Lu
Published: March 2024

The presence of complex electromagnetic noise in the ocean significantly impacts the accuracy of ship shaft-rate electric field signal detection, necessitating the development of an effective denoising method to enhance detection precision. Nevertheless, traditional denoising methods encounter issues like low frequency resolution, challenging threshold configuration, and mode mixing. This study introduces a method that integrates variational mode decomposition (VMD) with multi-window spectral subtraction (MSS). The intrinsic mode functions (IMFs) of noisy signals are extracted using VMD, and the noise components within different IMFs are identified. The spectral features of both signal and noise within different IMFs are leveraged to eliminate noise signals via MSS. Subsequently, the denoised components of IMFs are rearranged to derive the denoised ship shaft-rate electric field signals, achieving noise reduction across various frequency bands. Following validation using simulation signals and empirical data, the noise reduction efficacy of VMD-MSS surpasses that of alternative methods, demonstrating robust performance even at low signal-to-noise ratios. The marine electromagnetic noise is effectively suppressed in the empirical data, while preserving the characteristics of ship’s shaft-rate signals, thereby validating the method’s efficacy and demonstrating its practical engineering value.
Surface Water (SW) and Shallow Groundwater (SGW) Nutrient Concentrations in Riparian Wetlands of a Mixed Land-Use Catchment
Authors: Abesh Bidisha Faruque , Anderson James T. , Hubbart Jason A.
Published: March 2024

Precipitation patterns, water flow direction, and local land-use practices affect surface water (SW) and shallow groundwater (SGW) nutrient concentrations in riparian wetlands. Given physical process complexities, spatiotemporal quantification of nutrients and physical factors influencing nutrient concentrations are needed to advance wetland water resource management. To address these needs, a study was conducted in riparian wetlands of a mixed land-use catchment in West Virginia (WV), USA. Observed data included SW–SGW levels and nutrient concentrations, including nitrate (NO3-N), nitrite (NO2-N), ammonium (NH4-N), orthophosphate (PO43-P), total nitrogen (total_N), and total phosphorus (total_P) from January 2020 to December 2021. Water samples were collected monthly from stream gauge sites (n = 4) and co-located piezometers (n = 13). Results showed that, on average, gaining stream conditions were observed in upstream sites, and losing stream conditions were observed in downstream sites. Observed nutrient profiles between SW and SGW included SW exhibiting a higher average NO3-N concentration (0.42 mg/L), while SGW displayed an elevated NH4-N concentration (1.55 mg/L) relative to other nitrogen species. Significantly high (p < 0.05) SW NO3- concentrations in summer and fall were attributed to increased precipitation and corresponding water level and, therefore, pressure head and transport fluctuations. Principal Component Analysis (PCA) showed differences in nutrient concentrations based on the water source type and catchment land use, explaining 65% of data variability. Spearman correlation analysis illustrated the correlation among nutrient concentrations, land use, and water level changes in SW and SGW environments. This study provides needed baseline data on nutrient dynamics for a riparian wetland in a mixed land-use catchment, supplying science-based information to advance land and water management practices in the study watershed and similar physiographic watersheds globally.
Land Tenure, Loans, and Farmers’ Cropland Conservation Behavior: Evidence from Rural Northwest China
Authors: Long Guoren , Zhou Xiaoyan , Li Jun
Published: March 2024

The pivotal role of farmers’ cropland conservation behavior (CCB) in advancing green agricultural practices is well-recognized. This paper underscores the critical role of stable land tenure in enhancing farmers’ CCB, exemplified by the practice of mulch recycling. Drawing on a survey of 349 cotton farmers in Xinjiang, Northwest China, it offers a systematic examination of how land tenure stability influences CCB and its underlying mechanisms. The findings reveal a significant positive correlation between land tenure stability and CCB. Notably, this relationship is mediated by the facilitation of land mortgages, wherein written contracts and extended land tenure durations enhance farmers’ participation in land mortgages, thereby bolstering CCB. Furthermore, the stabilizing effect of land tenure on CCB also mitigates the negative impacts of risk aversion and time preference. The study additionally highlights the differential effects of land tenure stability based on farm size and technical training; its facilitative role in CCB is more pronounced among larger-scale farmers and those engaged in technical training.
Paths and Mechanisms of Rural Transformation Promoted by Rural Collectively Owned Commercial Construction Land Marketization in China
Authors: Shen Duanshuai , Zhou Xiaoping , Xie Shuai , Lv Xiao , Peng Wenlong , Wang Yanan , Wang Baiyuan
Published: March 2024

Rural collectively owned commercial construction land marketization (RCCCLM), a land policy that is still being piloted despite being allowed by law, has been regarded as an indispensable policy tool that can meet the land demand for rural development. This study aims to analyze the typical modes and key paths of RCCCLM for rural transformation theoretically and practically. We developed an innovative theoretical framework of “Situation-Structure-Implementation-Outcome” to illustrate the relationship between RCCCLM and rural transformation. By tracing the process of the impact of RCCCLM on rural transformation in typical areas, this study fills the gap in existing research that has not yet explored the theoretical mechanisms between RCCCLM and rural transformation. The results show that a combination of such factors as geographical location and rural land use status brings about three major ways of RCCCLM, namely, local marketization, adjustive marketization and consolidation-based marketization, to promote rural transformation. The influencing mechanism of RCCCLM on rural transformation mainly concerns rights granting, rural land use structure reshaping, the transformation of farmers’ livelihood and improvement in rural governance capacity. Rural transformation follows a basic rule and phased characteristics of evolving from single function to multiple functions, and RCCCLM displays a differentiated driving effect on the evolution of rural functions in different stages of rural development. These findings will provide new insights into rural land use and rural transformation in China and other developing countries and help solve the bottlenecks in rural transformation.
Implications of Law’s Response to Mitochondrial Donation
Authors: Ludlow Karinne
Published: March 2024

Changes to Australian law in 2022 made Australia the second country to expressly permit the clinical use of mitochondrial donation (MD), a technology that makes heritable changes to the human genome. This paper considers these changes in the context of Australia’s broader controls on human embryo use to provide insights into future regulatory responses to other emerging genetic technologies, which could be used in reproduction.
Systematic Distribution of Bioluminescence in Marine Animals: A Species-Level Inventory
Authors: Claes Julien M. , Haddock Steven H. D. , Coubris Constance , Mallefet Jérôme
Published: March 2024

Bioluminescence is the production of visible light by an organism. This phenomenon is particularly widespread in marine animals, especially in the deep sea. While the luminescent status of numerous marine animals has been recently clarified thanks to advancements in deep-sea exploration technologies and phylogenetics, that of others has become more obscure due to dramatic changes in systematics (themselves triggered by molecular phylogenies). Here, we combined a comprehensive literature review with unpublished data to establish a catalogue of marine luminescent animals. Inventoried animals were identified to species level in over 97% of the cases and were associated with a score reflecting the robustness of their luminescence record. While luminescence capability has been established in 695 genera of marine animals, luminescence reports from 99 additional genera need further confirmation. Altogether, these luminescent and potentially luminescent genera encompass 9405 species, of which 2781 are luminescent, 136 are potentially luminescent (e.g., suggested luminescence in those species needs further confirmation), 99 are non-luminescent, and 6389 have an unknown luminescent status. Comparative analyses reveal new insights into the occurrence of luminescence among marine animal groups and highlight promising research areas. This work will provide a solid foundation for future studies related to the field of marine bioluminescence.
Fetal Alcohol Spectrum Disorder: The Honey Bee as a Social Animal Model
Authors: Camilli Marcelo P. , Simko Olena M. , Bevelander Breanne , Thebeau Jenna M. , Masood Fatima , da Silva Marina C. Bezerra , Raza Muhammad Fahim , Markova Sofiia , Obshta Oleksii , Jose Midhun S. , Biganski Sarah , Kozii Ivanna V. , Zabrodski Michael W. , Moshynskyy Igor , Simko Elemir , Wood Sarah C.
Published: March 2024

Animal models have been essential for advancing research of fetal alcohol spectrum disorder (FASD) in humans, but few animal species effectively replicate the behavioural and clinical signs of FASD. The honey bee (Apis mellifera) is a previously unexplored research model for FASD that offers the distinct benefit of highly social behaviour. In this study, we chronically exposed honey bee larvae to incremental concentrations of 0, 3, 6, and 10% ethanol in the larval diet using an in vitro rearing protocol and measured developmental time and survival to adult eclosion, as well as body weight and motor activity of newly emerged adult bees. Larvae reared on 6 and 10% dietary ethanol demonstrated significant, dose-responsive delays to pupation and decreased survival and adult body weight. All ethanol-reared adults showed significantly decreased motor activity. These results suggest that honey bees may be a suitable social animal model for future FASD research.
The Inverse and General Inverse of Trapezoidal Fuzzy Numbers with Modified Elementary Row Operations
Authors: Mashadi  , Safitri Yuliana , Sukono  , Prihanto Igif Gimin , Johansyah Muhamad Deni , Saputra Moch Panji Agung
Published: March 2024

Trapezoidal positive/negative fuzzy numbers have no single definition; instead, various authors define them in relation to different concepts. This means that arithmetic operations for trapezoidal fuzzy numbers also differ. For the operations of addition, subtraction, and scalar multiplication, there are not many differences; for multiplication, however, there are many differences. In general, multiplication is divided into various cases. For the inverse operation, there is not much to define; in general, for any trapezoidal fuzzy number u~, u~⊗1u~=i~=(1,1,0,0) does not necessarily apply. As a result of the different arithmetic operations for multiplication and division employed by various authors, several researchers have tackled the same problem and reached different solutions, meaning that the application will also produce different results. To date, many authors have proposed various alternatives for the algebra of the trapezoidal fuzzy number. In this paper, using the parametric form approach to trapezoidal fuzzy numbers, an alternative to multiplication with only one formula is constructed for various cases. Furthermore, based on the definition of multiplication for any trapezoidal fuzzy number, u~ is constructed 1u~ so that u~⊗1u~=i~=(1,1,0,0). Based on these conditions, we show that various properties that apply to real numbers also apply to any trapezoidal fuzzy number. Furthermore, we modify the elementary row operational steps for the trapezoidal fuzzy number matrix, which can be used to determine the inverse of a trapezoidal fuzzy number matrix with the order m×m. We also give the steps and examples necessary to determine the general inverse for a trapezoidal fuzzy number matrix of the order m×n with m ≠n. This ability to easily determine the inverse and general inverse of a trapezoidal fuzzy number matrix has a number of applications, such as solving fully trapezoidal fuzzy number linear systems and fuzzy transportation problems, especially in applications in fields outside of mathematics; for example, the application of triangular fuzzy numbers in medical problems is a topic currently receiving a significant amount of attention.
Synchronization Analysis for Quaternion-Valued Delayed Neural Networks with Impulse and Inertia via a Direct Technique
Authors: Yu Juan , Xiong Kailong , Hu Cheng
Published: March 2024

The asymptotic synchronization of quaternion-valued delayed neural networks with impulses and inertia is studied in this article. Firstly, a convergence result on piecewise differentiable functions is developed, which is a generalization of the Barbalat lemma and provides a powerful tool for the convergence analysis of discontinuous systems. To achieve synchronization, a constant gain-based control scheme and an adaptive gain-based control strategy are directly proposed for response quaternion-valued models. In the convergence analysis, a direct analysis method is developed to discuss the synchronization without using the separation technique or reduced-order transformation. In particular, some Lyapunov functionals, composed of the state variables and their derivatives, are directly constructed and some synchronization criteria represented by matrix inequalities are obtained based on quaternion theory. Some numerical results are shown to further confirm the theoretical analysis.
Distributed Fault Diagnosis via Iterative Learning for Partial Differential Multi-Agent Systems with Actuators
Authors: Wang Cun , Zhou Zupeng , Wang Jingjing
Published: March 2024

Component failures can lead to performance degradation or even failure in multi-agent systems, thus necessitating the development of fault diagnosis methods. Addressing the distributed fault diagnosis problem in a class of partial differential multi-agent systems with actuators, a fault estimator is designed under the introduction of virtual faults to the agents. A P-type iterative learning control protocol is formulated based on the residual signals, aiming to adjust the introduced virtual faults. Through rigorous mathematical analysis utilizing contraction mapping and the Bellman–Gronwall lemma, sufficient conditions for the convergence of this protocol are derived. The results indicate that the learning protocol ensures the tracking of virtual faults to actual faults, thereby facilitating fault diagnosis for the systems. Finally, the effectiveness of the learning protocol is validated through numerical simulation.
FMA-Net: Fusion of Multi-Scale Attention for Grading Cervical Precancerous Lesions
Authors: Duan Zhuoran , Xu Chao , Li Zhengping , Feng Bo , Nie Chao
Published: March 2024

Cervical cancer, as the fourth most common cancer in women, poses a significant threat to women’s health. Vaginal colposcopy examination, as the most cost-effective step in cervical cancer screening, can effectively detect precancerous lesions and prevent their progression into cancer. The size of the lesion areas in the colposcopic images varies, and the characteristics of the lesions are complex and difficult to discern, thus heavily relying on the expertise of the medical professionals. To address these issues, this paper constructs a vaginal colposcopy image dataset, ACIN-3, and proposes a Fusion Multi-scale Attention Network for the detection of cervical precancerous lesions. First, we propose a heterogeneous receptive field convolution module to construct the backbone network, which utilizes combinations of convolutions with different structures to extract multi-scale features from multiple receptive fields and capture features from different-sized regions of the cervix at different levels. Second, we propose an attention fusion module to construct a branch network, which integrates multi-scale features and establishes connections in both the spatial and channel dimensions. Finally, we design a dual-threshold loss function and introduce positive and negative thresholds to improve sample weights and address the issue of data imbalance in the dataset. Multiple experiments are conducted on the ACIN-3 dataset to demonstrate the superior performance of our approach compared to some classical and recent advanced methods. Our method achieves an accuracy of 92.2% in grading and 94.7% in detection, with average AUCs of 0.9862 and 0.9878. Our heatmap illustrates the accuracy of our approach in focusing on the locations of lesions.
Exploring Brain and Heart Interactions during Electroconvulsive Therapy with Point-of-Care Ultrasound
Authors: Chang Marvin G. , Barbour Tracy A. , Bittner Edward A.
Published: March 2024

Background: Electroconvulsive therapy (ECT) is a procedure commonly used to treat a number of severe psychiatric disorders, including pharmacologic refractory depression, mania, and catatonia by purposefully inducing a generalized seizure that results in significant hemodynamic changes as a result of an initial transient parasympathetic response that is followed by a marked sympathetic response from a surge in catecholamine release. While the physiologic response of ECT on classic hemodynamic parameters such as heart rate and blood pressure has been described in the literature, real-time visualization of cardiac function using point-of-care ultrasound (POCUS) during ECT has never been reported. This study utilizes POCUS to examine cardiac function in two patients with different ages and cardiovascular risk profiles undergoing ECT. Methods: Two patients, a 74-year-old male with significant cardiovascular risks and a 23-year-old female with no significant cardiovascular risks presenting for ECT treatment, were included in this study. A portable ultrasound device was used to obtain apical four-chamber images of the heart before ECT stimulation, after seizure induction, and 2 min after seizure resolution to assess qualitative cardiac function. Two physicians with expertise in echocardiography reviewed the studies. Hemodynamic parameters, ECT settings, and seizure duration were recorded. Results: Cardiac standstill was observed in both patients during ECT stimulation. The 74-year-old patient with a significant cardiovascular risk profile exhibited a transient decline in cardiac function during ECT, while the 23-year-old patient showed no substantial worsening of cardiac function. These findings suggest that age and pre-existing cardiovascular conditions may influence the cardiac response to ECT. Other potential contributing factors to the cardiac effects of ECT include the parasympathetic and sympathetic responses, medication regimen, and seizure duration with ECT. This study also demonstrates the feasibility of using portable POCUS for real-time cardiac monitoring during ECT. Conclusion: This study reports for the first time cardiac standstill during ECT stimulation visualized using POCUS imaging. In addition, it reports on the potential differential impact of ECT on cardiac function based on patient-specific factors such as age and cardiovascular risks that may have implications for ECT and perioperative anesthetic management and optimization.