bluuebunny/crossref_metadata_2025 huggingface dataset:
Weakly Supervised Semantic Segmentation of PolSAR Image Based on Improved SEAM
Authors: Shao Qiqi , Yu Lingjuan , Guo Yuting , Xie Xiaochun , Zou Jianping , Li Liang
Published: March 2023

Weakly supervised semantic segmentation (WSSS) has been widely studied in optical image field. Self-supervised equivariant attention mechanism (SEAM) effectively improves the WSSS results with the image-level labels. However, when it is directly used in the WSSS of polarimetric synthetic aperture radar (PolSAR) image, the performance is very poor. In this paper, an improved SEAM (ISEAM) is proposed for WSSS of PolSAR image, which uses the improved ResNet as the backbone network. The improvement mainly includes two aspects. First, the structure of ResNet is lightweight, which aims to match the characteristics of PolSAR dataset. Second, a squeeze-and-extraction (SE) attention mechanism is added into the backbone network, which aims to obtain channel-wise information. Experiments on Flevoland and San Francisco datasets show that the proposed ISEAM can achieve better performance than the original SEAM.
Review of Supernumerary Robotic Limbs
Authors: Zhang Kailing , Long Yi , Luo Xiaofeng
Published: March 2023

Supernumerary robotic limbs (SRLs) are the expansion of human body. It can provide extra limbs to enhance human ability. It is a novel way to assist the existing limbs using SRLs without prejudice to the normal activities of the user’s arm. It has great application prospects in the fields of military, industry, rehabilitation training and assistance in daily life. Based on the public research results of SRLs around the world, the development state of SRLs are summarized from the mechanical architecture, actuation mode, motion intention prediction and control strategy. The technical problems for SRLs are analyzed and their future technical development is given.
A stochastic convolution kernel transform-based model for evaluating bearing performance degradation
Authors: Zhu Qiuning , Liu Hongqi , Zhu Jiaming , Zhu Junhui
Published: March 2023

Bearing performance degradation assessment can effectively reduce the accuracy degradation and failure of robotic arms caused by bearing failures. Existing performance degradation models based on deep learning and machine learning models have not yet considered the enhancement of degradation assessment by fault-related decoupling in the signal. Therefore, this paper proposes a random convolution kernel transform-based bearing performance degradation assessment model, which enriches the characterization of bearing degradation trends by decomposing the VMD signal and extracting multi-dimensional sensitive features from the decomposed IMFs. The multi-scale characterization of bearing degradation is enriched by a large number of stochastic convolution kernel transforms. A ridge regression classifier is applied to balance accuracy and computational complexity to achieve an intelligent assessment of bearing degradation trends, and the effectiveness of the proposed method is verified on the XJTU-SY dataset, where the accuracy of the proposed method exceeds that of existing fault degradation trend assessment models.
Driving Style Recognition of Leading Vehicles based on Semi-supervised Gaussian Mixture Model
Authors: Song Qingjin , Li Wenyun , Pan Yirong , Leng Aocheng , Zhu Ren
Published: March 2023

Driving style recognition of leading vehicles is important to ensure driving safety and improve the efficiency of road traffic. Current supervised learning based methods achieve high recognition accuracy, but their annotations are labor-intensive and time-consuming in practical scenarios. Although unsupervised learning based methods do not require manual labeling, their recognition accuracy is still low. In order to reduce the labeling cost and improve the accuracy of driving style recognition simultaneously, we propose a driving style recognition method based on semi-supervised Gaussian mixture model. Firstly, the driving data is collected and pre-processed by OBD-II vehicle recorder, and 22-dimensional driving style feature parameters are selected and constructed. Secondly, the kernel principal component analysis method is used to reduce the dimensionality and obtain 6-dimensional discriminative principal components. Finally, the Gaussian mixture model is trained by utilizing both the labeled data and unlabeled data. Concretely, the model parameters are measured by the expectation maximization algorithm and the likelihood function. The simulation experimental results demonstrate that the proposed method can effectively improve the driving style recognition accuracy, as well as reduce the reliance on labeled data.
Component Detection of Overhead Transmission Line Based on CBAM-Efficient-YOLOv5
Authors: Wang Shukun , Gao Lin , Hu Tao , Fu Desu , Liu Wei
Published: March 2023

In view of the low efficiency of the staff who need to detect the insulator, grading ring, spacer and other components with their naked eyes when inspecting the transmission line manually, a CBAM Efficient YOLOv5 algorithm is proposed to realize the automatic detection of the above components. The algorithm improves the lightweight of YOLOv5, uses EfficientNet lightweight network to replace the original feature extraction network, and uses CBAM (Convolutional Block Attention Module) with both channel and spatial attention to replace SE (Sequence and Exception) attention module. Finally, a lightweight network model is obtained, in which the model size is reduced by 45.8%, the average precision is 95.2%, and the detection precision of all targets is improved to more than 90%. On the premise of meeting the precision requirements, it is easier to deploy in embedded equipment such as unmanned aerial vehicle, so as to improve the work efficiency of line patrol.
Exploring the Hysteresis Effect in SOC Estimation of Li-ion Batteries
Authors: Li Wenyun , Ruan Siqi , Bahitbek Ardah , Gao Zihuan , Turak Nuramina , Li Heng
Published: March 2023

The global energy crisis and serious environmental pollution make governments attach importance to the development of regenerating green energy. As the best battery system at present, lithium-ion battery has developed rapidly into a new generation of energy storage power. SOC estimation is an important indicator in the development of lithium-ion batteries. If SOC can be properly estimated, it will be pivotal to the investigation and exploitation of batteries, and a number of algorithms for SOC estimation have already emerged. This paper first introduces several current SOC estimation methods, and then explains the influencing factors and hysteresis effect of SOC. Then the SOC estimation value was obtained by open circuit voltage method, based on the mean value calculated by the random forest output OCV-SOC curve to reduce hysteresis effect. The effect of temperature on SOC was analysed by plotting the OCV-SOC profiles for charging and discharging at different temperatures. Finally, this paper is summarized and puts forward the improvement.
Line of Sight Tracking Method Based on Feedback Linearization and Command Planning
Authors: Guo Fengyu , Xie Cheng , Chen Songlin
Published: March 2023

When the target just enters the field of view of the optoelectronic tracking system, there is a big pointing deviation. If the closed-loop control is directly performed at this time, overshoot or even oscillation will occur, which will easily cause the target to leave the field of view again. At present, most control algorithms are concerned about enhancing the steady-state tracking precision of the system, but seldom consider the transient performance of the system. In this paper, a new definition of pointing deviation is given, in addition, the model of the line-of-sight (LOS) tracking system is realized. On this basis, a method based on feedback linearization is raised, which can compensate measurable disturbance. For both transient response and steady-state performance, a new LOS planning method is presented, which accomplishes the planning and design of the target motion trajectory on the imaging plane. It can be able to avoid the target departing from the field of view and speed up the system response based on fixed control parameters. Through the analysis of experimental results, it can be indicated that the LOS tracking method proposed in this paper can availably promote the transient performance of the system and is existent of real value.
Research on Hierarchical Clustering LEACH Protocol Optimization Algorithm Based on Chebyshev Distance
Authors: Zhu Yunyun , Zhu Li , Xiao Yu , Zha Minghu , Hu Tao , Xiang Mian
Published: March 2023

For the problems of premature death of cluster head nodes, short network life cycle and fast energy consumption in hierarchical clustering LEACH protocol in wireless sensor networks, an improved routing protocol K-means LEACH distance optimization algorithm based on LEACH is proposed in this paper. The improved routing algorithm takes into account the problems such as random selection of cluster heads and tedious calculation of distance formula in LEACH algorithm, so K-means clustering algorithm is introduced. The specific scheme is to first divide the data into K classes, then select the appropriate cluster heads, and introduce the Chebyshev distance formula on the basis of K-means clustering algorithm. From the comparative analysis of the simulation results, the K-means LEACH distance optimization algorithm compared to the original LEACH algorithm wireless network node life cycle by 64%, node energy consumption by 26%, which is conducive to improving the stability of WSN, reducing node energy consumption and extending the network survival time.
Human Motion Capture Based on MEMS Sensor
Authors: Dong Zhuangzhuang , Cheng Guangxin , Lou Qixin , Li Ding , Gao Na , Xu Yunong , Yu Xudong
Published: March 2023

In order to realize the monitoring of human joint rehabilitation, a human motion capture and recognition system is constructed by using micro electro mechanical system (MEMS) sensor nodes. A two-stage extended Kalman filter algorithm is proposed for multi-sensor data fusion. The error matrix between the coordinate system of sensor node and the coordinate system of body was calculated by using the stationary posture calibration. The root mean squared error (RMSE) of the computed joint angle time series is less than 0.5°. The feature of joint angle time series was extracted and the support vector machine (SVM) classification model based on particle swarm optimization (PSO) was established. The experimental results show that the SVM algorithm optimized by PSO has better recognition effect than BP neural network. The average recognition rate can reach more than 97%. The human motion capture system designed in this paper can effectively realize human motion capture, recognition and joint rehabilitation monitoring.
Estimation of the Charge State in Lithium-ion Batteries Based on an Adaptive Particle Filter
Authors: Zhao Qianyue , Yang Huihui , Pan Yirong
Published: March 2023

Lithium-ion batteries have the advantages of high energy density, long life, and environmental friendliness, and are widely used as sources of energy in new energy vehicles. The charge state (SOC) of lithium-ion battery greatly represents the remaining service time of the battery, and in electric vehicles, it greatly determines the range of the electric vehicle. Therefore, how to estimate SOC from physical quantities such as end voltage and end current is crucial. This paper introduces the common lithium-ion battery charge state estimation method and its state model, and estimates the charge state based on the adaptive particle filter algorithm.
Self-avoiding walks and polygons confined to a square
Authors: Whittington S G
Published: March 2023

We prove several rigorous results about the asymptotic behaviour of the numbers of polygons and self-avoiding walks confined to a square on the square lattice. Specifically we prove that the dominant asymptotic behaviour of polygons confined to an L × L square is identical to that of self-avoiding walks that cross an L × L square from one corner vertex to the opposite corner vertex. We prove results about the sub-dominant asymptotic behaviour of self-avoiding walks crossing a square and polygons confined to a square and extend some results to self-avoiding walks and polygons in a hypercube in

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Culturally and Linguistically Informed Neuropsychological Evaluation Protocol for Primarily Spanish-Speaking Adults
Authors: Strutt Adriana M , Armendariz Victoria , Arias Franchesca , Diaz Santos Ana L , Zink Davor , Vuong Kevin Dat , Rossetti Maria Agustina
Published: March 2023

Objective

The Latina(o)/Hispanic (L/H) population represents the largest and fastest-growing ethnic group in the United States. Migration patterns have evolved and greater diversity (i.e., country of origin) is evident, highlighting the ever-changing heterogeneity of this community and the need for the field of neuropsychology to ensure equitable care for linguistically and culturally diverse communities. This paper aims to provide a flexible protocol of neuropsychological instruments appropriate for primarily Spanish-speaking adults residing in the United States.

Method

Spanish measures were selected based on availability, translations/cultural modifications, accompanying normative data sets, and clinician experience/acumen. Bilingual/bicultural providers of neuropsychological services to Spanish speakers across the training spectrum working at U.S.-based medical centers implemented a multimodal approach (i.e., literature search, clinical practice parameters, and focus groups) in the development of a multi-domain primary protocol that includes core and supplemental measures that are appropriate for individuals with varying linguistic proficiency and sociocultural demographic characteristics.

Results

A multi-domain, evidence-based, flexible neuropsychological protocol is presented. Recommendations for test selection based on sociocultural demographic factors and examples of clinical assessment practices are provided via a case illustration. Most instruments included may be applied across cultural and regional backgrounds.

Conclusion

Provision of neuropsychological services to primarily Spanish-speaking adults presents unique challenges. Existing Spanish measures and accompanying data rarely capture the heterogeneity of L/H individuals. Although Spanish has the largest number of neurocognitive instruments, relative to other languages, robust and representative norms continue to be scarce. Future studies should prioritize collecting normative data from educationally and geographically diverse samples.
Age, but not an immune challenge, triggers terminal investment in the Pacific field cricket, Teleogryllus oceanicus
Authors: Rutkowski Nicola-Anne J , Foo Yong Zhi , Jones Therésa M , McNamara Kathryn B
Published: March 2023

The terminal investment hypothesis proposes that, when individuals are faced with a threat to survival, they will increase investment in current reproduction. The level of the threat necessary to elicit terminal investment (the dynamic terminal investment threshold) may vary based on other factors that also influence future reproduction. Here, we tested whether there is an interactive effect of age and an immune challenge on the dynamic terminal investment threshold in the Pacific field cricket, Teleogryllus oceanicus. We measured the courtship call, mating attractiveness, ejaculate size, and offspring production of T. oceanicus males. We found only limited support for the dynamic terminal investment threshold: there was no consistent evidence of a positive interaction between male age and immune challenge intensity. However, we found evidence for age-related terminal investment: older males produced a larger spermatophore than younger males. Older males also had a slower calling rate compared to younger males, suggesting a potential trade-off between these two pre- and post-copulatory traits. As some, but not all, reproductive traits responded plastically to cues for terminal investment, our research highlights the importance of considering a broad range of pre-and post-copulatory traits when exploring the potential for terminal investment to occur.
Changes in superoxide dismutase 3 (SOD3) expression in periodontal tissue during orthodontic tooth movement of rat molars and the effect of SOD3 onin vitrohypoxia-exposed rat periodontal ligament cells
Authors: Jindarojanakul Phanchanit , Kobayashi Yukiho , Kamimoto Hiroyuki , Niki Yuki , Chan Myo Aye , Satrawaha Sirichom , Moriyama Keiji
Published: March 2023

Background/Objectives

Hypoxia during orthodontic tooth movement (OTM) induces reactive oxygen species (ROS) production in periodontal tissues. Superoxide dismutase 3 (SOD3) is an anti-inflammatory enzyme that protects cells from ROS. This study investigated the expression and function of SOD3 during rat OTM and in hypoxia-exposed rat periodontal ligament (PDL) cells.

Materials/Methods

OTM of right maxillary first molars were performed in 8-week-old male Sprague–Dawley rats using closed-coil spring for 1 and 14 days (n = 6 per group). SOD3 and hypoxia-inducible factor 1-alpha (HIF-1α) protein expression was evaluated by immunohistochemistry. The effects of SOD3 on cell viability and proliferation, ROS production, and mRNA expression of Hif1-α, receptor activator of nuclear factor kappa-Β ligand (Rankl), and osteoprotegerin (Opg) in PDL cells and osteoclast differentiation were investigated under normal and hypoxic conditions.

Results

SOD3 expression in PDL tissues significantly decreased on the compression side on day 1 and on both sides on day 14 of OTM. HIF-1α levels significantly increased on the compression side on day 14. Cell viability, cell proliferation, and Opg mRNA expression decreased, whereas ROS production and Hif1-α and Rankl mRNA expression increased in the PDL cells upon SOD3 silencing. Hypoxia reduced Sod3 and Opg mRNA expression and increased ROS, Rankl mRNA expression, and osteoclast formation; SOD3 treatment attenuated these effects.

Conclusion/Implications

SOD3 plays a role in periodontal tissue remodelling during OTM and in hypoxia-exposed PDL cells through ROS, HIF-1α, and RANKL/OPG pathways. Moreover, SOD3 treatment could attenuate the negative effects of hypoxia on the PDL cells.
Ending Economic Sanctions in the Shadow of Bargaining Problems
Authors: Cilizoglu Menevis
Published: March 2023

Can imposers of sanctions end economic coercion without the fear of strengthening their targets’ capabilities? Senders may prefer to end sanctions given its ex post inefficiency, yet doing so might provide the target greater access to resources and contribute to its offensive behavior. Targets’ inability to credibly commit to reversing their policies while enjoying the gains from sanctions relief, coupled with the difficulty of perfectly observing their compliance behavior, creates an obstacle for ending sanctions and resuming profitable economic transactions. Using a game-theoretic model of sanctions removal under uncertainty about targets’ intentions and compliance behavior, I formally demonstrate and empirically find that sanctions are more likely to end if senders can successfully detect targets’ compliance, but only if the target considers the promised sanctions relief attractive. Targets that offset the costs of sanctions will not value the promised sanctions relief and choose not to negotiate over sanctions removal.
The Use of Laser Doppler Imaging in Nitric Acid Burns: A Case Report and Literature Review
Authors: Owoso Toluwaniyin , Kankam Hadyn K N , Abdulsalam Abdulrazak , Lewis Darren
Published: March 2023

Laser Doppler imaging (LDI) technology has been validated to assess thermal burn depth by predicting wound healing potential. However, there is no clear evidence for its use in chemical burns. We present a case of an 8% total burn surface area (TBSA) nitric acid burn following an industrial accident, in an otherwise healthy 36-year-old man. LDI assessment was suggestive of poor healing potential of >21 days, warranting surgical management. However, conservative management was opted for based on clinical assessment as the wound eschar appeared thin and more consistent with epithelial staining. Patient follow-up confirmed a total burn healing time of two months, suggesting that the LDI assessment was accurate. A comprehensive literature review was performed using the MEDLINE (PubMed) database to identify animal or clinical studies evaluating the efficacy of LDI in chemical burns. A qualitative synthesis of our findings is presented. We identified two experimental studies in porcine models with sulfur mustard burns, each confirming the accuracy of LDI assessment when compared to the histopathology findings. Limited experimental animal studies on the use of LDI suggest similar validity in chemical burns, and this correlates with the clinical outcome in this case. However, this alone is insufficient to prove its validity and define its role in the assessment of chemical burns. Clinical trials are required to further assess and define the parameters of LDI use and efficacy in this context.
Extracellular vesicles fromMycobacterium tuberculosis–infected neutrophils induce maturation of monocyte-derived dendritic cells and activation of antigen-specific Th1 cells
Authors: Vázquez-Flores Luis , Castañeda-Casimiro Jessica , Vallejo-Castillo Luis , Álvarez-Jiménez Violeta D , Peregrino Eliud S , García-Martínez Mariano , Barreda Dante , Rosales-García Víctor Hugo , Segovia-García C David , Santos-Mendoza Teresa , Wong-Baeza Carlos , Serafín-López Jeanet , Chacón-Salinas Rommel , Estrada-Parra Sergio , Estrada-García Iris , Wong-Baeza Isabel
Published: March 2023

Tuberculosis remains one of the leading public health problems in the world. The mechanisms that lead to the activation of the immune response against Mycobacterium tuberculosis have been extensively studied, with a focus on the role of cytokines as the main signals for immune cell communication. However, less is known about the role of other signals, such as extracellular vesicles, in the communication between immune cells, particularly during the activation of the adaptive immune response. In this study, we determined that extracellular vesicles released by human neutrophils infected with M. tuberculosis contained several host proteins that are ectosome markers. In addition, we demonstrated that extracellular vesicles released by human neutrophils infected with M. tuberculosis released after only 30 min of infection carried mycobacterial antigens and pathogen-associated molecular patterns, and we identified 15 mycobacterial proteins that were consistently found in high concentrations in extracellular vesicles released by human neutrophils infected with M. tuberculosis; these proteins contain epitopes for CD4 T-cell activation. We found that extracellular vesicles released by human neutrophils infected with M. tuberculosis increased the expression of the costimulatory molecule CD80 and of the coinhibitory molecule PD-L1 on immature monocyte-derived dendritic cells. We also found that immature and mature dendritic cells treated with extracellular vesicles released by human neutrophils infected with M. tuberculosis were able to induce IFN-γ production by autologous M. tuberculosis antigen-specific CD4 T cells, indicating that these extracellular vesicles acted as antigen carriers and transferred mycobacterial proteins to the antigen-presenting cells. Our results provide evidence that extracellular vesicles released by human neutrophils infected with M. tuberculosis participate in the activation of the adaptive immune response against M. tuberculosis.
Retrospective review of changes in testosterone dosing and physiologic parameters in transgender and gender-diverse individuals following hysterectomy with and without oophorectomy
Authors: Grimstad Frances W , Fraiman Elad , Garborcauskas Garrett , Ferrando Cecile A
Published: March 2023

Background

As more transgender and gender-diverse patients undergo hysterectomy, gaps in knowledge remain about how testosterone dosing or other physiologic parameters change following surgery and how these are influenced by concomitant oophorectomy.

Aim

The aims of this study were to determine the incidence of testosterone dosing change after gender-affirming hysterectomy and to compare this incidence between patients who underwent oophorectomy and ovarian preservation.

Methods

This multicenter retrospective cohort study consisted of transmasculine patients who underwent hysterectomy for gender affirmation.

Outcomes

Outcome measures included testosterone dosing changes at least 3 months following hysterectomy, as identified by clinical documentation, as well as clinical and laboratory parameters assessed for a change after hysterectomy: free and total testosterone, estradiol, hemoglobin, hematocrit, total cholesterol, weight, and blood pressure.

Results

Of the 50 patients, 32 (64%) underwent bilateral oophorectomy, 10 (20%) unilateral oophorectomy, and 8 (16%) maintained both ovaries. Eight percent (n = 4) changed testosterone dosing following hysterectomy. Those who underwent bilateral oophorectomy were no more likely to change their testosterone dose than those who did not (P = .09). Those who also used menstrual suppression were 1.31 times more likely to change doses of testosterone after hysterectomy (95% CI, 1.09-1.82; P = .003). For those who had pre- and posthysterectomy laboratory and clinical values, the majority saw no clinically significant change. However, among patients who underwent bilateral oophorectomy, the calculated free testosterone increased by 90.1 ± 288.4 ng/dL (mean ± SD), and estradiol dropped by 20.2 ± 29.0 pg/mL.

Clinical Implications

In a field where access to care can be a significant barrier, there is unlikely to be a need for routine reassessment of testosterone dose or laboratory parameters following hysterectomy, whether or not a bilateral oophorectomy occurs.

Strengths and Limitations

Limitations of the study include its retrospective nature and the lack of consistent clinical laboratory testing, which resulted in limited data about any given hormonal change. The heterogeneity of our population limited the number of patients undergoing or not undergoing oophorectomy; however, it allowed our study to more truly reflect a clinical environment.

Conclusion

In a multisite cohort of individuals who underwent hysterectomy for gender affirmation, few patients changed testosterone dosing after surgery. In addition, dosing change was not associated with the presence or absence of bilateral oophorectomy, and most measured laboratory values remained consistent following hysterectomy.
Rice microRNA156/529-SQUAMOSA PROMOTER BINDING PROTEIN-LIKE7/14/17 modules regulate defenses against bacteria
Authors: Hui Shugang , Ke Yinggen , Chen Dan , Wang Lei , Li Qingqing , Yuan Meng
Published: March 2023

Rice (Oryza sativa L.) microRNA156/529-SQUAMOSA PROMOTER BINDING PROTEIN-LIKE7/14/17 (miR156/529-SPL7/14/17) modules have pleiotropic effects on many biological pathways. OsSPL7/14 can interact with DELLA protein SLENDER RICE1 (SLR1) to modulate gibberellin acid (GA) signal transduction against the bacterial pathogen Xanthomonas oryzae pv. oryzae. However, whether the miR156/529-OsSPL7/14/17 modules also regulate resistance against other pathogens is unclear. Notably, OsSPL7/14/17 functioning as transcriptional activators, their target genes, and the corresponding downstream signaling pathways remain largely unexplored. Here, we demonstrate that miR156/529 play negative roles in plant immunity and that miR156/529-regulated OsSPL7/14/17 confer broad-spectrum resistance against 2 devastating bacterial pathogens. Three OsSPL7/14/17 proteins directly bind to the promoters of rice Allene Oxide Synthase 2 (OsAOS2) and NONEXPRESSOR OF PATHOGENESIS-RELATED GENES1 (OsNPR1) and activate their transcription, regulating jasmonic acid (JA) accumulation and the salicylic acid (SA) signaling pathway, respectively. Overexpression of OsAOS2 or OsNPR1 impairs the susceptibility of the osspl7/14/17 triple mutant. Exogenous application of JA enhances resistance of the osspl7/14/17 triple mutant and the miR156 overexpressing plants. In addition, genetic evidence confirms that bacterial pathogen-activated miR156/529 negatively regulate pathogen-associated molecular pattern (PAMP)-triggered immunity (PTI) responses, such as pattern recognition receptor Xa3/Xa26-initiated PTI. Our findings demonstrate that bacterial pathogens modulate miR156/529-OsSPL7/14/17 modules to suppress OsAOS2-catalyzed JA accumulation and the OsNPR1-promoted SA signaling pathway, facilitating pathogen infection. The uncovered miR156/529-OsSPL7/14/17-OsAOS2/OsNPR1 regulatory network provides a potential strategy to genetically improve rice disease resistance.
Comparing the Accuracy of Seven Scoring Systems in Predicting Survival of Lung Cancer Patients With Spinal Metastases
Authors: Yan Yuan , Zhong Guoqing , Lai Huahao , Huang Chongquan , Yao Mengyu , Zhou Maolin , Zhou Chengzhi , Wang Jing , Cheng Shi , Zhang Yu
Published: March 2023

Study Design.

Retrospective case series.

Objective.

To investigate the accuracy of seven scoring systems for the prediction of survival in lung cancer patients with spinal metastases (SPM).

Summary of Background Data.

Although survival scoring systems have been developed for surgical decision-making, the reliability and validity of these models are unclear for specific cancer types. As the prevalence of patients with lung cancer increases, it is imperative to determine the accuracy of these models for lung cancer patients with SPM.

Materials and Methods.

This is a retrospective study of a cohort of lung cancer patients with SPM who underwent spine surgery between 2019 and 2021 at two centers. The optimal area under the curve (AUC) was calculated to evaluate the accuracy of seven candidate scoring systems at 3, 6, and 12 months. Calibration and decision curve analysis was used for further validation.

Results.

A total of 166 patients (mean age: 58.98±10.94; 105 males and 61 females) with SPM were included. The median postoperative survival was 12.87±0.93 months. The modified Bauer score, revised Tokuhashi score, Linden score, Tomita score, the Skeletal Oncology Research Group nomogram, and the New England Spinal Metastasis Score in prediction survival at 3, 6, and 12 months showed a slightly weaker AUC (range 0.464–0.659). The AUC of the Katagiri-New score in predicting 1-year survival for lung cancer patients was the highest (0.708; range 0.619–0.798). The decision curve analysis showed that the Katagiri-New score led to a greater net benefit than the strategies of changing management for all patients or none of the patients.

Conclusions.

This study suggests that the most commonly used models have limitations in predicting survival in patients undergoing spinal surgery for metastatic lung cancer and underestimate survival. In this sample of lung cancer patients, the Katagiri-New Scoring system score had the best performance in predicting 1-year survival.

Level of Evidence.

4.
A Concept Analysis of Family Presence During COVID-19
Authors: Dudeck Sarah , Hibler Erika , Gill Karamvir , Shantz Tara , Kovick Laura , Cypress Brigitte , Caboral-Stevens Meriam
Published: March 2023

Background

In 2020, the COVID-19 pandemic required health care organizations throughout the United States to implement strict visitor restriction policies to mitigate the spread of the virus. These policy changes had a direct impact on family presence (FP) in hospital settings.

Purpose

The aim of this study was to conduct a concept analysis of FP during the COVID-19 pandemic.

Methods

Walker and Avant's 8-step method was used.

Results

Four defining attributes of FP during COVID-19 were derived based on a review of the literature: being there or with, seeing is believing, during challenging times, and subjective advocates. The COVID-19 pandemic was the main antecedent of the concept. The consequences and empirical referents were discussed. Model, borderline, and contrary cases were developed.

Conclusion

This concept analysis provided an understanding of the concept of FP during COVID-19, which is imperative to optimizing patient care outcomes, as literature identified a support person or system as an extension of the care team that facilitates successful care management. Whether by advocating for their patients to have a support person present during team rounds, or by stepping in as the patient's main support system in the absence of family, nurses must find a way to do what is best for their patients even during the unprecedented times of a global pandemic.
A novel point-of-care test for cirrhosis based on dimeric to monomeric IgA ratio in blood: a pilot cohort study
Authors: Howell Jessica , Van Huy , Pham Minh D. , Sawhney Rohit , Li Fan , Bhat Purnima , Lubel John , Kemp William , Bloom Steven , Majumdar Avik , McCaughan Geoff , Spelman Timothy , Doyle Joseph S. , Hellard Margaret , Visvanathan Kumar , Thompson Alexander , Anderson David
Published: March 2023

Background and Aims:

Dimeric IgA to monomeric IgA ratio (dIgA ratio) is a biomarker of gut mucosal leakage in liver cirrhosis. We evaluated the diagnostic performance of a novel point-of-care (POC) dIgA ratio test for cirrhosis.

Methods:

Plasma samples from people with chronic liver disease were analyzed using the BioPoint POC dIgA ratio antigen immunoassay lateral flow test. Cirrhosis was defined by Fibroscan>12.5 kPa, clinical evidence of cirrhosis or liver histopathology. POC dIgA test diagnostic accuracy was determined in a test cohort using receiver operating characteristic curve analysis; optimal cutoffs for sensitivity and specificity were then applied to a validation cohort.

Results:

A total of 1478 plasma samples from 866 patients with chronic liver disease were included (test cohort n = 260, validation cohort n = 606). In all, 32% had cirrhosis; 44% Child-Pugh A, 26% Child-Pugh B, and 29% Child-Pugh C. Median POC dIgA ratio was higher in cirrhosis (0.9) compared with no cirrhosis (0.4, p < 0.001), and in Child-Pugh class B/C compared with A cirrhosis (1.4 Child-Pugh B/C vs. 0.6 Child-Pugh A, p < 0.001). POC dIgA ratio test had good diagnostic accuracy for liver cirrhosis in the test cohort (area under the receiver operating characteristic curve=0.80); a dIgA ratio cutoff of 0.6 had a sensitivity of 74% and specificity of 86%. POC dIgA test accuracy was moderate in the validation cohort (area under the receiver operating characteristic curve=0.75; positive predictive value 64%, negative predictive value 83%). Using a dual cutoff approach, 79% of cirrhosis cases were correctly diagnosed and further testing was avoided in 57%.

Conclusions:

POC dIgA ratio test had moderate accuracy for cirrhosis. Further studies evaluating the accuracy of POC dIgA ratio testing for cirrhosis screening are warranted.
MANAGEMENT OF A UNIQUE CASE OF COATS'-LIKE X-LINKED RETINITIS PIGMENTOSA ASSOCIATED WITH AN RPGR VARIANT IN THE ERA OF ANTI-VASCULAR ENDOTHELIUM GROWTH FACTOR
Authors: Pederzolli Matteo , Sacconi Riccardo , Bandello Francesco , Querques Giuseppe
Published: March 2023

Purpose:

To describe a unique case of X-linked Coats'-like retinitis pigmentosa, a form of exudative retinitis pigmentosa, in association with an RPGR variant, and its management with intravitreal anti–vascular endothelium growth factor drugs, along with a peculiar optical coherence tomography finding observed in a late stage of disease.

Methods:

Case report.

Results:

A 33-year-old man previously treated with anti–vascular endothelium growth factors for macular edema came to our clinic for bilateral visual loss. A hemizygous RPGR variant (c.2442_2445del) was found and a diagnosis of Coats'-like Retinitis Pigmentosa was made. He was initially treated with carbonic anhydrase inhibitors; when efficacy wore off, he was switched to anti–vascular endothelium growth factor injections in both eyes with improvement. After a year without treatment, VA drastically worsened in both eyes; optical coherence tomography displayed disruption and increased hyper-reflectivity of the inner retinal layers in the right eye.

Conclusion:

The c.2442_2445del variant is added to a number of known ORF 15 RPGR mutations associated with Coats'like Retinitis Pigmentosa. Anti–vascular endothelium growth factor treatment was successful in blocking visual loss in our patient and withholding treatment had a negative impact on his visual outcome.
“The Effects of Tranexamic Acid in Breast Surgery: A Systematic Review and Meta-Analysis”
Authors: Huynh Minh NQ , Wong Chloe R. , McRae Matthew C , Voineskos Sophocles , McRae Mark H
Published: March 2023

Background:

Tranexamic acid (TXA) is used in trauma and surgical settings. Its role in reducing postoperative blood loss in breast surgery remains unclear. The primary objective of this study is to determine the effect of TXA on post-operative blood loss in breast surgery.

Methods:

Searches of PubMed, Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials was performed from inception to April 3, 2020. Inclusion criteria were any retrospective reviews, prospective cohort studies, and randomized control trials that administered TXA (topical or IV) in the context of breast surgery. Quality of studies were evaluated using the RoB 2.0 and ROBINS-I tools, respectively. Data was pooled and a meta-analysis was performed.

Results:

In total, seven studies were included, representing 1226 patients (TXA = 632, control = 622 patients). TXA was administered: topically (20 mL of 25 mg/mL TXA intraoperatively; n=258 patients), intravenously (1-3 g perioperatively; n=743 patients), or both (1-3 g daily up to 5 days post-operatively; n=253 patients). TXA administration reduced hematoma formation in breast surgery (risk ratio, 0.48; 95% CI 0.32 to 0.73), with no effect on drain output (mean difference, -84.12 mL; 95% CI -206.53 to 38.29), seroma formation (risk ratio, 0.92; 95% CI 0.60 to 1.40) or infection rates (risk ratio, 1.01; 95% CI 0.46 to 2.21). No adverse effects were reported.

Conclusions:

The use of TXA in breast surgery is a safe and effective modality with low level evidence that it reduces hematoma rates without affecting seroma rates, postoperative drain output, or infection rates.
Free Tissue Transfer to the Knee for a Complex Wound Coverage When Good Recipient Vessels Are Not Available
Authors: Pyon Rachel E. , Pu Dustin F. , Zeiderman Matthew R. , Pu Lee L.Q.
Published: March 2023

Free tissue transfer to the knee can be difficult due to limited options for reliable recipient vessels and vein grafts or arteriovenous loops may also be associated with an increased risk of flap failure. In this study, the authors describe our experience with creating proper recipient vessels for free flap reconstructions around the knee using the descending branch (DB) of the lateral circumflex femoral vessels (LCFV) or anterior tibial vessels (ATV). Three patients underwent free flap reconstruction of knee wounds secondary to trauma, prosthesis infection, and radiation therapy. The anterolateral thigh, rectus abdominis, and latissimus dorsi flaps were used to close the wounds, respectively. Dissection of the DB of LCFV was carried between the rectus femoris and vastus lateralis, and between the peroneus longus and brevis for the ATV. These recipient's vessels were created and placed in a more desirable location adjacent to the defect for microvascular anastomoses. The DB of LCFV and ATV were dissected successfully and both arterial and venous micro-anastomose were performed in an end-to-end manner with the recipient's vessels. All patients had successful free tissue reconstructions with uneventful postoperative courses. The flaps remained viable and reliable soft tissue coverage with acceptable contour had been accomplished during follow-up. Either DB of LCFV or ATV can serve as adequate recipient vessels after being placed adjacently to soft tissue defects for a straightforward free tissue transfer to the knee. The creation of such recipient vessels avoids vein grafts or arteriovenous loops and allows for a reliable free flap reconstruction of the knee.
The Efficacy of 3D Virtual Surgery, CAD/CAM, and 3D Printing Technology for Maxillomandibular Advancement in Obstructive Sleep Apnea Patients
Authors: Ha Sung-Ho , Oh Ji-Seok , Jeong Chun-Gi , Baek Seung-Hak , Choi Jin-Young
Published: March 2023

Objective:

Maxillomandibular advancement (MMA) is the most effective surgical method for treating obstructive sleep apnea, and it moves the maxillomandibular complex forward to increase the entire upper airway volume. By using 3-dimensional (D) virtual surgery, computer-aided design/computer-aided manufacturing, and 3D printing technologies, it is possible to overcome all the limitations of conventional methods.

Materials and Methods:

In this study, (modified) MMA was performed by applying 3D technologies to obstructive sleep apnea patients. Virtual surgery was done as surgical plan, cutting guides, and customized plates were made by computer-aided design/computer-aided manufacturing and 3D printing technologies for surgical procedures.

Results:

After surgery, all patients improved their appearance, quality of sleep, and sleep apnea level were dramatically improved. Through these results, it was found that there are many advantages in using 3D technologies for preparing and implementing MMA.

Conclusions:

It was confirmed that the accuracy and efficiency of surgery were increased by applying 3D technologies. This suggests that 3D technologies are very useful tools in surgical area.
Risk Factors for Acute Postoperative Complications Following Operative Management of Le Fort Fractures—A NSQIP Study
Authors: Wood Matabele Kasey Leigh , Seitz Allison J. , Doan Ton C. , Poore Samuel O.
Published: March 2023

Introduction:

Le Fort fractures comprise a pattern of complex midfacial fractures that arise secondarily to craniofacial trauma. Although management of these fractures has been detailed within the literature, there is a paucity of research examining postoperative outcomes after surgical repair. The primary aim of this study is to assess patient outcomes after operative management of Le Fort fractures, and examine factors influencing the risk for developing postoperative complications, through utilization of the ACS-NSQIP database.

Methods:

The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases recorded between 2012 and 2019 with International Classification of Disease (ICD)-9 and ICD-10 codes corresponding to Le Fort fractures. Patient demographics, clinical variables, and postoperative variables were recorded. Logistic regression analysis was conducted to identify independent risk factors for postoperative complications.

Results:

Identification of cases with appropriate ICD codes, and exclusion of those with missing data, yielded 562 patients for analysis. There were no cases of minor complications and 14 cases of severe complications (3 cases of wound dehiscence, 3 cases of transfusion requirement, 1 case of failure to wean from the ventilator for more than 48 h, 1 pulmonary embolism, and 8 cases of reoperation), corresponding to an overall complication rate of 2.49%. Logistic regression analysis revealed steroid use as an independent predictor of severe postoperative complications (OR =13.73, 95% CI: 1.08–128.02, P=0.02).

Conclusion:

The present study is the first to conduct a risk factor analysis of patients with Le Fort fractures using the ACS-NSQIP national database. The overall postoperative complication rate was 2.49%, with 14 cases of complications recorded in 8 years. Although this may suggest that surgical management of Le Fort fractures is generally well-tolerated, it should be noted that this problem is frequently associated with other severe injuries of the head and neck that may influence patient prognosis. Given this, further analysis would benefit from a larger patient cohort and longer postoperative data as the ACS-NSQIP database only records outcomes within 30 days.
A single-nucleus transcriptome-wide association study implicates novel genes in depression pathogenesis
Authors: Zeng Lu , Fujita Masashi , Gao Zongmei , White Charles C. , Green Gilad S. , Habib Naomi , Menon Vilas , Bennett David A. , Boyle Patricia A. , Klein Hans-Ulrich , De Jager Philip L.
Published: March 2023

Background

Depression is a common psychiatric illness and global public health problem. However, our limited understanding of the biological basis of depression has hindered the development of novel treatments and interventions.

Methods

To identify new candidate genes for therapeutic development, we examined single-nucleus RNA sequencing (snucRNAseq) data from the dorsolateral prefrontal cortex (N=424) in relation to ante-mortem depressive symptoms. To complement these direct analyses, we also used genome- wide association study (GWAS) results for depression (N=500,199) along with genetic tools for inferring the expression of 22,159 genes in 7 cell types and 55 cell subtypes to perform transcriptome-wide association studies (TWAS) of depression followed by Mendelian randomization (MR).

Results

Our single-nucleus TWAS analysis identified 71 causal genes in depression that have a role in specific neocortical cell subtypes; 59 of 71 genes were novel compared to previous studies. Depression TWAS genes showed a cell type specific pattern, with the greatest enrichment being in both excitatory and inhibitory neurons as well as astrocytes. Gene expression in different neuron subtypes have different directions of effect on depression risk. Compared to lower genetically correlated traits (e.g. body mass index) with depression, higher correlated traits (e.g., neuroticism) have more common TWAS genes with depression. In parallel, we performed differential gene expression analysis in relation to depression in 55 cortical cell subtypes, and we found that genes such asANKRD36,MADD,TAOK3,SCAIandCHUKare associated with depression in specific cell subtypes.

Conclusions

These two sets of analyses illustrate the utility of large snucRNAseq data to uncover both genes whose expression is altered in specific cell subtypes in the context of depression and to enhance the interpretation of well-powered GWAS so that we can prioritize specific susceptibility genes for further analysis and therapeutic development.
FERROKINETIC EVALUATION OF PATIENTS WITH ACUTE CORONARY SYNDROME AT A SOUTH AMERICAN HOSPITAL, PILOT STUDY
Authors: Dulcey Sarmiento Luis Andres , Theran Leon Juan Sebastián , Peña Valentina Cabrera , Parales Strauch Rafael Guillermo , Caltagirone Raimondo , Blanco Pimiento Edgar Camilo , Ciliberti Artavia María Paula , Martinez Juan Camilo
Published: March 2023

Introduction

Alterations in the ferrokinetic profile are associated with cardiovascular disease, and the short- and long-term prognosis of these alterations is currently unknown.

Design

Prospective cohort analytical observational study

Methods

To determine the prognostic value of the alterations of the ferrokinetic profile in patients with myocardial infarction with and without ST-segment elevation, in a Health institution from July 2017 to May 2018. Results : From72patients, the main affected gender was male, in ages over 56 years old, the infarction with ST elevation being the most frequent. Among the associated comorbidities, the main one was hypertension with (n: 22; 53.7%) for infarction with elevation and (n: 23; 74.2%) for infarction without ST elevation. The most frequent alteration of the parameters of the ferrokinetic profile studied, was the iron deficit, found in (n:15; 36.6%) of the patients with ST elevation and (n:13; 41.9%) without ST elevation. Low levels of hemoglobin were present at admission (n:10; 24.4%) of the subgroup with ST elevation and (n:10; 32.3%) for no ST elevation, increasing the percentage to (n:13; 31.7%) (RR: 2) (95% CI -0.131-30.63), associated with low hemoglobin values at day 7 of hospitalization. There were 2 deaths (2.77%), which presented low levels of iron without anemia and infarction with ST elevation complicated by cardiogenic shock.

Conclusions

iron deficiency is a common comorbidity with a high mortality rate, and the decrease in hemoglobin after hospital admission was related to mortality, so both parameters should be taken into account in Infarction and cardiovascular disease.