bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative Beta-Blocker Supply and Survival in Women With Epithelial Ovarian Cancer and a History of Cardiovascular Conditions
Authors: Spilsbury Katrina , Tuesley Karen M. , Pearson Sallie-Anne , Coory Michael D. , Donovan Peter , Steer Christopher B. , Stewart Louise M. , Pandeya Nirmala , Jordan Susan J.
Published: August 2022

PURPOSE

Surgery for epithelial ovarian cancer (EOC) may activate stress-inflammatory responses that stimulate tumor growth and increase metastatic growth. Animal and in vitro studies have shown that inhibition of the catecholamine-induced inflammatory response via beta-adrenergic receptor blockade has antitumor potential in EOC. However, observational studies have reported mixed results. We assessed whether beta-blocker (BB) use at the time of primary ovarian cancer surgery was associated with improved survival in a large population-based study.

MATERIALS AND METHODS

Using linked administrative data, a population-based cohort of 3,844 Australian women age 50 years or older with a history of cardiovascular conditions who underwent surgery for EOC was followed for survival outcomes. The average treatment effect of selective BB (SBB) and nonselective BB (NSBB) supply at the time of surgery on survival was estimated from a causal inference perspective using covariate-balanced inverse probability of treatment weights with flexible parametric survival models that allowed for time-varying survival effects.

RESULTS

Around the time of surgery, 560 (14.5%) women were supplied a SBB and 67 (1.7%) were supplied a NSBB. At 2 years postsurgery, the survival proportion was 80% (95% CI, 68 to 88) for women dispensed NSBBs at surgery compared with 69% (95% CI, 67 to 70) for women not supplied NSBBs. The survival advantage appeared to extend to at least 8 years postsurgery. No association was observed for women dispensed a SBB around the time of surgery.

CONCLUSION

Perioperative supply of NSBBs appeared to confer a survival advantage for women age over 50 years with a history of cardiovascular conditions. Long-term clinical trials are required to confirm these findings.
A Simple Cervicovaginal Epigenetic Test for Screening and Rapid Triage of Women With Suspected Endometrial Cancer: Validation in Several Cohort and Case/Control Sets
Authors: Herzog Chiara , Marín Fátima , Jones Allison , Evans Iona , Reisel Daniel , Redl Elisa , Schreiberhuber Lena , Paytubi Sonia , Pelegrina Beatriz , Carmona Álvaro , Peremiquel-Trillas Paula , Frias-Gomez Jon , Pineda Marta , Brunet Joan , Ponce Jordi , Matias-Guiu Xavier , de Sanjosé Silvia , Alemany Laia , Olaitan Adeola , Wong Michael , Jurkovic Davor , Crosbie Emma J. , Rosenthal Adam N. , Bjørge Line , Zikan Michal , Dostalek Lukas , Cibula David , Sundström Karin , Dillner Joakim , Costas Laura , Widschwendter Martin
Published: August 2022

PURPOSE

Endometrial cancer (EC) incidence has been rising over the past 10 years. Delays in diagnosis reduce survival and necessitate more aggressive treatment. We aimed to develop and validate a simple, noninvasive, and reliable triage test for EC to reduce the number of invasive diagnostic procedures and improve patient survival.

METHODS

We developed a test to screen and triage women with suspected EC using 726 cervical smear samples from women with and without EC, and validated the test in 562 cervicovaginal samples using three different collection methods (cervical smear: n = 248; vaginal swab: n = 63; and self-collection: n = 251) and four different settings (case/control: n = 388; cohort of women presenting with postmenopausal bleeding: n = 63; a cohort of high-risk women with Lynch syndrome: n = 25; and a nested case/control setting from a screening cohort and samples taken up to 3 years before EC diagnosis: n = 86).

RESULTS

We describe the Women's cancer risk IDentification – quantitative polymerase chain reaction test for Endometrial Cancer (WID-qEC), a three-marker test that evaluates DNA methylation in gene regions of GYPC and ZSCAN12. In cervical, self-collected, and vaginal swab samples derived from symptomatic patients, it detected EC with sensitivities of 97.2% (95% CI, 90.2 to 99.7), 90.1% (83.6 to 94.6), and 100% (63.1 to 100), respectively, and specificities of 75.8% (63.6 to 85.5), 86.7% (79.3 to 92.2), and 89.1% (77.8 to 95.9), respectively. The WID-qEC identified 90.9% (95% CI, 70.8 to 98.9) of EC cases in samples predating diagnosis up to 1 year. Test performance was similar across menopausal status, age, stage, grade, ethnicity, and histology.

CONCLUSION

The WID-qEC is a noninvasive reliable test for triage of women with symptoms suggestive of ECs. Because of the potential for self-collection, it could improve early diagnosis and reduce the reliance for in-person visits.
Long-Term Outcomes and Genetic Predictors of Response to Metastasis-Directed Therapy Versus Observation in Oligometastatic Prostate Cancer: Analysis of STOMP and ORIOLE Trials
Authors: Deek Matthew P. , Van der Eecken Kim , Sutera Philip , Deek Rebecca A. , Fonteyne Valérie , Mendes Adrianna A. , Decaestecker Karel , Kiess Ana Ponce , Lumen Nicolaas , Phillips Ryan , De Bruycker Aurélie , Mishra Mark , Rana Zaker , Molitoris Jason , Lambert Bieke , Delrue Louke , Wang Hailun , Lowe Kathryn , Verbeke Sofie , Van Dorpe Jo , Bultijnck Renée , Villeirs Geert , De Man Kathia , Ameye Filip , Song Daniel Y. , DeWeese Theodore , Paller Channing J. , Feng Felix Y. , Wyatt Alexander , Pienta Kenneth J. , Diehn Maximillian , Bentzen Soren M. , Joniau Steven , Vanhaverbeke Friedl , De Meerleer Gert , Antonarakis Emmanuel S. , Lotan Tamara L. , Berlin Alejandro , Siva Shankar , Ost Piet , Tran Phuoc T.
Published: August 2022

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co‐primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

The initial STOMP and ORIOLE trial reports suggested that metastasis-directed therapy (MDT) in oligometastatic castration-sensitive prostate cancer (omCSPC) was associated with improved treatment outcomes. Here, we present long-term outcomes of MDT in omCSPC by pooling STOMP and ORIOLE and assess the ability of a high-risk mutational signature to risk stratify outcomes after MDT. The primary end point was progression-free survival (PFS) calculated using the Kaplan-Meier method. High-risk mutations were defined as pathogenic somatic mutations within ATM, BRCA1/ 2, Rb1, or TP53. The median follow-up for the whole group was 52.5 months. Median PFS was prolonged with MDT compared with observation (pooled hazard ratio [HR], 0.44; 95% CI, 0.29 to 0.66; P value < .001), with the largest benefit of MDT in patients with a high-risk mutation (HR high-risk, 0.05; HR no high-risk, 0.42; P value for interaction: .12). Within the MDT cohort, the PFS was 13.4 months in those without a high-risk mutation, compared with 7.5 months in those with a high-risk mutation (HR, 0.53; 95% CI, 0.25 to 1.11; P = .09). Long-term outcomes from the only two randomized trials in omCSPC suggest a sustained clinical benefit to MDT over observation. A high-risk mutational signature may help risk stratify treatment outcomes after MDT.
Matched Comparison of Hearing Outcomes in Patients With Vestibular Schwannoma Treated With Stereotactic Radiosurgery or Observation
Authors: Schnurman Zane , Gurewitz Jason , Smouha Eric , McMenomey Sean O. , Roland J. Thomas , Golfinos John G. , Kondziolka Douglas
Published: August 2022

BACKGROUND:

Previous studies comparing hearing outcomes in patients managed with stereotactic radiosurgery (SRS) and a watch-and-wait strategy were limited by small sample sizes that prevented controlling for potential confounders, including initial hearing status, tumor size, and age.

OBJECTIVE:

To compare hearing outcomes for patients with vestibular schwannomas (VS) managed with observation and SRS while controlling for confounders with propensity score matching.

METHODS:

Propensity score matching was used to compare 198 patients with unilateral VS with initial serviceable hearing (99 treated with SRS and 99 managed with observation alone) and 116 with initial class A hearing (58 managed with SRS and 58 with observation), matched by initial hearing status, tumor volume, age, and sex. Kaplan–Meier survival methods were used to compare risk of losing class A and serviceable hearing.

RESULTS:

Between patients with VS managed with SRS or observation alone, there was no significant difference in loss of class A hearing (median time 27.2 months, 95% CI 16.8-43.4, and 29.2 months, 95% CI 20.4-62.5,P= .88) or serviceable hearing (median time 37.7 months, 95% CI 25.7-58.4, and 48.8 months, 95% CI 38.4-86.3,P= .18). For SRS patients, increasing mean cochlear dose was not related to loss of class A hearing (hazard ratio 1.3,P= .17) but was associated with increasing risk of serviceable hearing loss (hazard ratio of 1.5 per increase in Gy,P= .017).

CONCLUSION:

When controlling for potential confounders, there was no significant difference in loss of class A or serviceable hearing between patients managed with SRS or with observation alone.
Molecular and cellular architecture of the larval sensory organ in the cnidarian Nematostella vectensis
Authors: Gilbert Eleanor , Teeling Callum , Lebedeva Tatiana , Pedersen Siffreya , Chrismas Nathan , Genikhovich Grigory , Modepalli Vengamanaidu
Published: August 2022

Cnidarians are the only non-bilaterian group to evolve ciliated larvae with an apical sensory organ, which is possibly homologous to the apical organs of bilaterian primary larvae. Here, we generated transcriptomes of the apical tissue in the sea anemone Nematostella vectensis and showed that it has a unique neuronal signature. By integrating previously published larval single-cell data with our apical transcriptomes, we discovered that the apical domain comprises a minimum of six distinct cell types. We show that the apical organ is compartmentalised into apical tuft cells (spot) and larval-specific neurons (ring). Finally, we identify ISX-like (NVE14554), a PRD class homeobox gene specifically expressed in apical tuft cells, as an FGF signalling-dependent transcription factor responsible for the formation of the apical tuft domain via repression of the neural ring fate in apical cells. With this study, we contribute a comparison of the molecular anatomy of apical organs, which must be carried out across phyla to determine whether this crucial larval structure evolved once or multiple times.
Fast-growing growth hormone transgenic coho salmon (Oncorhynchus kisutch) show a lower incidence of vaterite deposition and malformations in sagittal otoliths
Authors: Chalan Irvin , Solsona Laia , Coll-Lladó Clara , Webb Paul B. , Sakhrani Dionne , Devlin Robert H. , Garcia de la serrana Daniel
Published: August 2022

In fish otoliths, CaCO3 normally precipitates as aragonite, and more rarely as vaterite or calcite. A higher incidence of vaterite deposition in otoliths from aquaculture-reared fish has been reported and it is thought that high growth rates under farming conditions might promote its deposition. To test this hypothesis, otoliths from growth hormone (GH) transgenic coho salmon and non-transgenic fish of matching size were compared. Once morphometric parameters were normalized by animal length, we found that transgenic fish otoliths were smaller (−24%, −19%, −20% and −30% for length, width, perimeter and area, respectively; P<0.001) and rounder (−12%, +13.5%, +15% and −15.5% in circularity, form factor, roundness and ellipticity; P<0.001) than otoliths from non-transgenic fish of matching size. Interestingly, transgenic fish had smaller eyes (−30% eye diameter) and showed a strong correlation between eye and otolith size. We also found that the percentage of otoliths showing vaterite deposition was significantly smaller in transgenic fish (21–28%) than in non-transgenic fish (69%; P<0.001). Likewise, the area affected by vaterite deposition within individual otoliths was reduced in transgenic fish (21–26%) compared with non-transgenic fish (42.5%; P<0.001). Our results suggest that high growth rates per se are not sufficient to cause vaterite deposition in all cases, and that GH overexpression might have a protective role against vaterite deposition, a hypothesis that needs further investigation.
Shear wave elastography as a supplemental tool in the assessment of unsuspicious axillary lymph nodes in patients undergoing breast ultrasound examination
Authors: Togawa Riku , Binder Leah-Larissa , Feisst Manuel , Barr Richard G. , Fastner Sarah , Gomez Christina , Hennigs André , Nees Juliane , Pfob André , Schäfgen Benedikt , Stieber Anne , Riedel Fabian , Heil Jörg , Golatta Michael
Published: August 2022

Objectives:

To define reference values for shear wave elastography (SWE) in unsuspicious axillary lymph nodes in patients undergoing breast ultrasound examination.

Methods:

In total, 177 clinically and sonographically unsuspicious axillary lymph nodes were prospectively evaluated with SWE using Virtual Touch Tissue Imaging Quantification (VTIQ) in 175 women. Mean values of tissue stiffness for axillary fatty tissue, lymph node cortex, and lymph node hilus were measured. Additionally, test-retest reliability of SWE in the assessment of axillary lymph node stiffness was evaluated by repeating each measurement three times.

Results:

In 177 axillary lymph nodes, the mean stiffness of lymph node cortex, hilus, and surrounding fatty tissue as quantified by SWE was 1.90 m/s (SD: 0.34 m/s), 2.02 m/s (SD: 0.37 m/s), and 1.75 m/s (SD: 0.38 m/s), respectively. The mean stiffness of cortex and hilus was significantly higher compared to fatty tissue (p < 0.0001). SWE demonstrated good test–retest reliability in the assessment of stiffness of the lymph node hilus, cortex, and the surrounding fatty tissue with an intraclass correlation of 0.79 (95% CI: 0.75; 0.83), 0.75 (95% CI: 0.70; 0.79), and 0.78 (95% CI: 0.74; 0.82), respectively, (p < 0.0001).

Conclusions:

Reference values for SWE in unsuspicious axillary lymph nodes are determined. These results may help to better identify axillary lymph node metastasis for breast cancer patients when combined with other lymph node features. SWE is a reliable method for the objective quantification of tissue stiffness of axillary lymph nodes.

Advances in knowledge:

This study presents physiological reference values for tissue stiffness by examining the axillary lymph nodes with SWE in 175 women with sonomorphologically unsuspicious lymph nodes.
Ambulatory blood pressure monitoring using telemedicine: proof-of-concept cohort and failure modes and effects analyses
Authors: Armitage Laura C. , Lawson Beth K. , Roman Cristian , Thompson Beth , Biggs Christopher , Rutter Heather , Lewis-Jones Martin , Ede Jody , Tarassenko Lionel , Farmer Andrew , Watkinson Peter
Published: August 2022

Background: The COVID-19 pandemic has accelerated adoption of remote consulting in healthcare. Despite opportunities posed by telemedicine, most hypertension services in Europe have suspended ambulatory blood pressure monitoring (ABPM).

Methods: We examined the process and performance of remotely delivered ABPM using two methodologies: firstly, a Failure Modes and Effects Analysis (FMEA) and secondly, a quantitative analysis comparing ABPM data from a subgroup of 65 participants of the Screening for Hypertension in the INpatient Environment (SHINE) diagnostic accuracy study. The FMEA was performed over seven sessions from February to March 2021, with a multidisciplinary team comprising a patient representative, a research coordinator with technical expertise and four research clinicians.

Results: The FMEA identified a single high-risk step in the remote ABPM process. This was cleaning of monitoring equipment in the context of the COVID-19 pandemic, unrelated to the remote setting.

A total of 14 participants were scheduled for face-to-face ABPM appointments, before the UK March 2020 COVID-19 lockdown; 62 were scheduled for remote ABPM appointments since emergence of the COVID-19 pandemic between November 2020 and August 2021. A total of 65 (88%) participants completed ABPMs; all obtained sufficient successful measurements for interpretation. For the 10 participants who completed face-to-face ABPM, there were 402 attempted ABPM measurements and 361 (89%) were successful. For the 55 participants who completed remote ABPM, there were 2516 attempted measurements and 2214 (88%) were successful. There was no significant difference in the mean per-participant error rate between face-to-face (0.100, SD 0.009) and remote (0.143, SD 0.132) cohorts (95% CI for the difference -0.125 to 0.045 and two-tailed P-value 0.353).

Conclusions: We have demonstrated that ABPM can be safely and appropriately provided in the community remotely and without face-to-face contact, using video technology for remote fitting appointments, alongside courier services for delivery of equipment to participants.
A Bitter Pill to Swallow? The Consequences of Patient Evaluation in Online Health Question-and-Answer Platforms
Authors: Chen Chen , Walker Dylan
Published: August 2022

Online health question-and-answer platforms (OHQPs), where patients post health-related questions, evaluate advice from multiple doctors and select their most preferred answer, are a prominent channel for patients to receive medical advice in China. They are gaining traction globally and have the potential to circumvent resource-based, geographic, or circumstantial barriers that limit access to care. At the same time, they are underregulated in contrast to brick-and-mortar points of care. Ours is the first study to evaluate the quality of healthcare advice promoted by these platforms and to provide insight into how patients respond to advice. We found that, though advice is generally good, patients cannot discern good advice from bad, choose poor advice (when offered) as often as good advice, and do so to a greater extent in vulnerable categories such as pediatrics, cancers/tumors, and internal medicine. Moreover, we found that OHQPs exacerbate care avoidance. Our findings suggest that platform owners and policymakers should ensure that signals of expert consensus are provided to patients to better assist their choices on OHQPs. We also unveiled bad actors on OHQPs, including drug promoters and spammers, indicating that stronger oversight and accountability mechanisms are needed. Physician peer reviewing and auditing can address both problems.
Dynamic Interday and Intraday Scheduling
Authors: Zacharias Christos , Liu Nan , Begen Mehmet A.
Published: August 2022

Adaptive Patient Flow Management

Appointment scheduling has significant clinical, operational, and economical impact on healthcare systems. An informed scheduling strategy that can effectively match patient demand and service capacity dynamically is vital for the business of medical providers, quality of care, and patient satisfaction. By regulating patient flow via an appointment system, healthcare providers can mitigate arrival process variability and improve operational performance. The simultaneous consideration of appointment day (interday scheduling) and time of day (intraday scheduling) in dynamic scheduling decisions is an important theoretical and practical problem that has remained open because of its stochastic nature, complex structure, and large dimensionality. Zacharias et al. (2022) fill this critical gap in the literature. They introduce a novel dynamic programming framework, designed with the intention of bridging two independently established streams of literature, and to leverage their latest advances in tackling the joint problem. They advance the theory of the field to provide a rigorous and practically implantable solution.
Mechanism Design Under Approximate Incentive Compatibility
Authors: Balseiro Santiago R. , Besbes Omar , Castro Francisco
Published: August 2022

An assumption that is pervasive in revenue management and economics is that buyers are perfect optimizers. However, in practice, buyers may be limited by their computational capabilities or lack of information and may not be able to perfectly optimize their response to a selling mechanism. This has motivated the introduction of approximate incentive compatibility as a solution concept for practical mechanisms. In “Mechanism Design under Approximate Incentive Compatibility,” Balseiro, Besbes, and Castro study, for the first time, the problem of designing optimal selling mechanisms when buyers are imperfect optimizers. Their work characterizes structural properties of approximate incentive compatible mechanisms and establishes fundamental bounds on how much revenue can be garnered by moving from exact to approximate incentive constraints. Their work brings a new perspective to the theory of mechanism design by shedding light on a novel class of optimization problems, techniques, and challenges that emerge when relaxing incentive constraints.
Measuring subepidermal moisture to detect early pressure ulcer development: a systematic review
Authors: Moore Zena , McEvoy Natalie L , Avsar Pinar , Byrne Sorcha , Vitoriano Budri Aglecia Moda , Nugent Linda , O'Connor Tom , Curley Gerard , Patton Declan
Published: August 2022

Objective:

The aim was to assess evidence related to the measuring of subepidermal moisture (SEM) to detect early, nonvisible development of pressure ulcers (PUs).

Method:

Using systematic review methodology, all quantitative animal and human research studies written in English were considered. In January 2021, PubMed, CINAHL, SCOPUS, Cochrane and EMBASE databases were searched. The primary outcome of interest was the validity of SEM measurement to detect early PU development. The secondary outcome was time to PU detection, sensitivity and specificity of SEM measurement, and the impact of SEM measurements on PU prevention. Data analysis was undertaken using RevMan and narrative synthesis.

Results:

A total of 17 articles met the inclusion criteria. In all studies, a consistent abnormal deviation in SEM measurements corresponded with evidence of visual PU development. Time to PU development, explored in four studies, showed earlier detection of PU development using SEM measurement. RevMan analysis identified the mean difference in time to PU development (SEM measurement versus visual skin assessment, VSA) was 4.61 days (95% confidence interval: 3.94–5.28; p=0.0001) in favour of SEM measurements. The sensitivity of SEM measurements was reported in four studies, and scores varied from 48.3% to 100.0%. Specificity was also reported in four studies and scores ranged from 24.4% to 83.0%. The impact of the detection of abnormal SEM measurements on PU prevention was explored by one study. Results showed a 93% decrease in PU rates when staff acted on the results of the SEM readings.

Conclusion:

The findings of this review identified that SEM measurement detects PU development earlier than VSA. Furthermore, when staff responded to abnormal SEM measurements, prevention strategies were enhanced, with a subsequent reduction in visible PU development. SEM measurement may therefore be a useful addition to PU prevention strategies.

Declaration of interest:

The School of Nursing & Midwifery, RCSI has a research agreement with Bruin Biometrics. Funding for the study was through an Irish Research Council PhD Enterprise Partnership Scheme with Bruin Biometrics. The authors have no other conflicts of interest.
Use of low-frequency contact ultrasonic debridement with and without polyhexamethylene biguanide in hard-to-heal leg ulcers: an RCT
Authors: Vallejo Alison , Wallis Marianne , McMillan David
Published: August 2022

Objective:

The primary aim of this research was to investigate the combination effect of polyhexamethylene biguanide (PHMB) and low-frequency contact ultrasonic debridement (LFCUD) on the bacterial load in hard-to-heal wounds in adults, compared with ultrasonic debridement alone. Secondary outcomes included wound healing, quality of life (QoL) and pain scores.

Method:

In this single-blinded, randomised, controlled trial participants were randomised to two groups. All participants received LFCUD weekly for six weeks, plus six weeks of weekly follow-up. The intervention group received an additional 15-minute topical application of PHMB post-LFCUD, at each dressing change and in a sustained dressing product. The control group received non-antimicrobial products and the wounds were cleansed with clean water or saline. Wound swabs were taken from all wounds for microbiological analysis at weeks 1, 3, 6 and 12.

Results:

A total of 50 participants took part. The intervention group (n=25) had a lower bacterial load at week 12 compared with the control group (n=25) (p<0.001). There was no difference in complete wound healing between the groups (p=0.47) or wound-related QoL (p=0.15). However, more wounds deteriorated in the control group (44%) compared with the intervention group (8%, p=0.01). A higher proportion of wounds reduced in size in the intervention group (61% versus 12%, p=0.019). Pain was lower in the intervention group at week six, compared with controls (p=0.04).

Conclusion:

LFCUD without the addition of an antimicrobial agent such as PHMB, cannot be recommended. Further research requires longer follow-up time and would benefit from being powered sufficiently to test the effects of multiple covariates.
The role of mast cells in cellular modifications evoked by Exendin-4 in treated wounds: a preclinical study
Authors: Paroli Gaia , Murciano Nicoletta , Mancini Caterina , Soldaini Marta , Rijli Sarah , DeSiena Gaetano , Bacci Stefano
Published: August 2022

Objective:

To assess the response of cellular infiltration in wounds treated with Exendin-4.

Method:

In this study, 16 mice were used. On each mouse, two wounds were produced, one above the other, in order to study the effects of the various treatments carried out. The wounds then received an intradermal injection of either saline (20μl; Group 1) or Exendin-4 (Exe4, 62ng; Group 2) in the upper and lower wounds, respectively. The mice were euthanised in order to collect the wounds at time of abrasion (T0), at 48 hours (T1), 96 hours (T2) and 144 hours (T3). The expression of the glucagon-like peptide-1 receptor (GLP-1R) was evaluated by Western blot in wound lysates. Histological and histochemistry methods were applied in cryosections.

Results:

In T2 and T3 treated wounds, the mast cells degranulation index increased while GLP-1R expression, tumour necrosis factor (TNF)-α, or heat shock protein (HSP)47 antigens were detected in their cytoplasm. These cells interacted with dendritic cells, vessels or granulocytes. The density of dendritic cells increased progressively, and intercellular connections were found between these cells and vessels. Among the dendritic cells at T2, only M2 macrophages increased. However, M1 cells expressed transforming growth factor (TGF)-β and both interacted with either fibroblasts or with vessels. The number of plasmacytoid dendritic cells increased and established close contacts with regulatory T cells.

Conclusion:

We propose that after treatment with Exe4, early activation of mast cells is critical in wound healing acceleration. This is crucial in understanding the potential effect of this drug for viable clinical therapies.
Wound tissue segmentation by computerised image analysis of clinical pressure injury photographs: a pilot study
Authors: Li Dan , Mathews Carol , Zamarripa Cecilia , Zhang Fei , Xiao Qian
Published: August 2022

Objective:

Wound tissues can provide ample information about the wound development and healing process. However, the manual identification and measurement of wound tissue types is time-consuming and challenging due to the complexities of pressure injuries (PI). This study aims to develop an image analysis algorithm to automatically identify and differentiate wound tissue types from PI wound beds.

Method:

This was a cross-sectional algorithm development study. PI photographs were obtained from a western Pennsylvania hospital. We used our previously developed wound bed segmentation tool to identify PI wound beds. We then used the k-means clustering method to classify the subzones on the wound beds. Finally, the support vector machine classifier was used to identify the classified subzones to certain types of wound tissue.

Results:

An image analysis algorithm was developed, using 64 selected PI photographs, to automatically identify different wound tissues for PIs.

Conclusion:

Validation of the wound tissue identification of the PIs by image analysis algorithm demonstrated that our image analysis algorithm is a reliable and objective approach to monitoring wound healing progress through clinical PI photographs, and offers new insight into PI evaluation and documentation.
Now is the time to strengthen cyber defences
Authors: Madou Matias
Published: August 2022

Thanks in part to the Covid-19 pandemic, cybercrime is at an all-time high and many organisations are struggling to cope. A large number of companies have had to grapple with security strategies for the first time, and those that already had plans in place found them being tested to the full.
Container attacks: a blast radius analysis
Authors: Morag Assaf
Published: August 2022

Containers may seem to offer greater security through segregation. But they are increasingly becoming a focus for attackers looking to escape the confines of containers in order to move laterally across the system. This is typically achieved through maliciously crafted container images, as recent research using honeypots has shown.
Industry 4.0: The security implications of operational technology
Authors: Shah Sachin
Published: August 2022

Over the past several years, we have been experiencing the fourth industrial revolution, more commonly known as Industry 4.0. This evolution is being exacerbated by the influx of new technologies, advanced digitalisation, artificial intelligence, and the cloud, which is pushing the operational technology (OT) world into new realms with regards to security. Consequently, to achieve Industry 4.0, organisations must embrace the convergence between OT and information technology (IT), while understanding the vital role that cyber security plays throughout this process.
The biggest challenges of manually managing PKI certificates
Authors: Ricci Anthony
Published: August 2022

Business processes have always been built on trust, and as digital transformation moves more devices and people online, the need for digital trust is rapidly increasing. Today, being able to trust the identity of endpoints, the people using them, and their data and documents, is fundamental to society.
Azerbaycan'daki düğün törenlerinin çeşitliliği bağlamında Nahçıvan bölgesinin düğün gelenekleri
Authors: Mammadova Günay
Published: August 2022

Bu makalenin amacı Azerbaycan müzik folklorünün önemli öğelerinden biri olan düğün törenlerinin Nahçıvan yöresine ait özelliklerinin kültürel ve müzikal açıdan incelenmesini amaçlamaktadır. Araştırma modeli, nitel araştırma yöntemlerinden durum çalışması ve doküman analizi tekniklerine uygun olarak tasarlanmıştır. Düğün türkülerinin derlenmesi ve Sibelius Music Notation Software programı ile nota analizleri yapılmıştır. Araştırmada, Nahçıvan bölgesinin seçilmesinin nedeni bölgenin folklorik özellikleri açısından zengin içeriğe sahip olması ve folklorik doğasının korunmasıdır. Araştırmada veri toplama araçları olarak ilgili dokümanlar ve görüşme yöntemi kullanılmıştır. Araştırmada Nahçıvan düğün ritüelinin öğeleri ve müzikal özellikleri ilgili kaynaklar ve görüşmeler ışığında sunulmuştur. Düğün ritüelinin unsurlarından icra edilen eserler müzikal açıdan analiz edilmiştir. Nahçıvan yöresi düğünlerinde; kız beğenme, söz kesme, elçilik, nişan, bayramlık, kız düğünü, kına gecesi, erkek düğünü, duvak töreni, el öpme aşamaları bulunmaktadır. Yallı Dansı, yörenin önemli bir müzikal sembolüdür. Bu dans topluca yapılır, çeşitliliği ve dans ezgileri kendine özgüdür. Düğünlerde kültürel aktarımla günümüze kadar gelen oyunlar Köçeri, Tanzara, Tello, Galadan-galaya, Urfanı’dır. Araştırmada, Hakışta, Gülüm Hey, Kına Gecesi ve Gelin Uğurlama türkülerinin nota analizleri yapılarak sunulmuştur.
Phase noise measurements and diagnoses of a large array of fiber lasers by PISTIL
Authors: Rouzé Bastien , Fsaifes Ihsan , Bellanger Severine , Veinhard Matthieu , Rousseaux Thomas , Primot Jérome , Chanteloup Jean-Christophe , Bellanger Cindy
Published: August 2022

One of the most promising solutions to access high power laser chains is to achieve a coherent combination of a large number of elementary lasers. To interfere constructively, these laser sources should be identical and operate under the same conditions. However, despite these efforts, differential delays appear in the course of time, which must be compensated for. While designing the required correction system, knowing the behavior of a laser as a function of the environmental conditions is not crucial, whereas having access to the differences in the behaviors of identical lasers is, leading to difficulties in modeling. The purpose of this paper is to illustrate how a large set of lasers can be simultaneously analyzed to estimate their variations and optimize a correction system. The X-Coherent Amplified Network laser relies on 61 fiber amplifiers, which are as identical as possible. This state of the art femtosecond digital laser therefore appears as an ideal candidate to study a large number of fiber lasers working under controlled conditions.
Optical fractal resonances in Cantor-like photonic crystals
Authors: Chen Xiaoling , Ni Hao , Zhao Dong , Wang Yang
Published: August 2022

We theoretically investigate the optical fractal effect in
one-dimensional quasiperiodic photonic crystals (PCs). Dielectric
multilayers arrayed alternately submit to the Cantor-like sequence
rule. The optical fractal phenomenon is induced by modulating the
generation number of the dielectric sequence. The optical fractal
effect corresponds to a series of resonant modes, and the Cantor-like
PCs approve more resonance modes than those in the Cantor PCs with the
same order number. The transmission channels of resonances
exponentially increase with the increase in the sequence generation
number. Furthermore, the central waves of the transmission channels
can be regulated by the incident angle flexibly. We expect this paper
may pave a new way for the development of wavelength division
multiplexers.
Optical coherence tomography refraction and optical path length correction for image-guided corneal surgery
Authors: Tian Yuan , Draelos Mark , McNabb Ryan P. , Hauser Kris , Kuo Anthony N. , Izatt Joseph A.
Published: August 2022

Optical coherence tomography (OCT) may be useful for guidance of ocular microsurgeries such as deep anterior lamellar keratoplasty (DALK), a form of corneal transplantation that requires delicate insertion of a needle into the stroma to approximately 90% of the corneal thickness. However, visualization of the true shape of the cornea and the surgical tool during surgery is impaired in raw OCT volumes due to both light refraction at the corneal boundaries, as well as geometrical optical path length distortion due to the group velocity of broadband OCT light in tissue. Therefore, uncorrected B-scans or volumes may not provide an accurate visualization suitable for reliable surgical guidance. In this article, we introduce a method to correct for both refraction and optical path length distortion in 3D in order to reconstruct corrected OCT B-scans in both natural corneas and corneas deformed by needle insertion. We delineate the separate roles of phase and group index in OCT image distortion correction, and introduce a method to estimate the phase index from the group index which is readily measured in samples. Using the measured group index and estimated phase index of human corneas at 1060 nm, we demonstrate quantitatively accurate geometric reconstructions of the true cornea and inserted needle shape during simulated DALK surgeries.
Effectiveness of collagen cross-linking induced by two-photon absorption properties of a femtosecond laser in ex vivo human corneal stroma
Authors: Chang Le , Zhang Lin , Cheng Zhenzhou , Zhang Nan , Wang Congzheng , Wang Yan , Liu Weiwei
Published: August 2022

This study aimed to investigate the effectiveness of two-photon induced collagen cross-linking (CXL) using femtosecond lasers in human corneal stroma. An 800-nm femtosecond laser optical path for CXL was established. Corneal samples that received two-photon induced CXL and ultraviolet-A (UVA) CXL underwent uniaxial stretching experiments, proteolytic resistance assays and observation of collagen fiber structure changes. Two-photon induced CXL can achieve corneal stiffening effects comparable to UVA CXL and showed better advantages at low strains. The cornea after two-photon induced CXL exhibited high enzymatic resistance and tight collagen fiber arrangement. Two-photon induced CXL promises to be a new option for keratoconus.
Numerical method for designing ultrashort and efficient adiabatic mode converters
Authors: Liang Tulu , Cheng Xi , Yu Mei , Zhang Lingyan , Shi Jin , Shao Wei
Published: August 2022

This paper proposes a fully numerical method for designing adiabatic mode converters (NM-AMCs). The proposed method can help compute efficient adiabatic guided-wave shapes for mode converters using a nonuniform section division technique. Such a scheme reduces the memory requirement and computational time for the design of adiabatic devices. Furthermore, the adiabatic mode converter comprises a ridge waveguide, which is difficult to design using analytical methods. This complex case of an adiabatic mode converter is used to demonstrate how the proposed method can readily generate a guided-wave shape that gives the same mode-connection power transfer with a far shorter length compared with a linear-shape converter. The efficiency of the device designed using this NM-AMC is significantly better than that of linear-shape converters; this designed adiabatic mode converter can enable a broad operating bandwidth. Moreover, the efficiency of the adiabatic mode converter that was designed using the NM-AMC method considerably exceeds that obtained using an analytical method proposed for a strip waveguide.
Tolerance enhancement of inefficient detection and frequency detuning by non-perfect phase-sensitive amplification in broadband squeezing-based precision measurement
Authors: Zhang Changchang , Wang Zhaolu , Liu Hongjun , Huang Nan
Published: August 2022

Phase-sensitive amplification (PSA) can significantly improve the degradation caused by inefficient detectors in squeezing-based precision measurements. However, broadband incident light will lead to non-perfect PSA. The present work focused on the enhancement of non-perfect PSA for squeezed states with broad bandwidth for the measurement of weak absorption detection. Numerical calculations of the quantum advantage show that non-perfect PSA can effectively improve the inefficiency of detection in slight drift frequency detuning.
Threshold of transverse mode instability considering four-wave mixing
Authors: Li Haobo , Huang Liangjin , Wu Hanshuo , Chen Yisha , Pan Zhiyong , Zhou Pu
Published: August 2022

In this work, the influence of four-wave mixing (FWM) effects on the transverse mode instability (TMI) is incorporated into the TMI model based on stimulated thermal Rayleigh scattering. The model is capable of analyzing the gain characteristics of different high-power fiber amplifiers, based on which the physical mechanism and functioning boundary of FWM are theoretically investigated. Consequently, a new TMI threshold formula is defined to resolve the inconsistencies in the previous TMI models. It is revealed that it is extremely necessary to consider the influence of FWM on TMI in ultra-large mode field laser systems.
Multi-gigawatt peak power post-compression in a bulk multi-pass cell at a high repetition rate
Authors: Raab Ann-Kathrin , Seidel Marcus , Guo Chen , Sytcevich Ivan , Arisholm Gunnar , L’Huillier Anne , Arnold Cord L. , Viotti Anne-Lise
Published: August 2022

The output of a

200

kHz

,

34

W

,

300

fs

ytterbium amplifier is compressed to

31

fs

with

>

88

%

efficiency to reach a peak power of

2.5

GW

, which to date is a record for a single-stage bulk multi-pass cell. Despite operation 80 times above the critical power for self-focusing in bulk material, the setup demonstrates excellent preservation of the input beam quality. Extensive beam and pulse characterizations are performed to show that the compressed pulses are promising drivers for high harmonic generation and nonlinear optics in gases or solids.
Singular-value decomposition and electromagnetic coherence of optical beams
Authors: Luo Meilan , Laatikainen Jyrki , Friberg Ari T. , Korotkova Olga , Setälä Tero
Published: August 2022

We investigate the implications of the singular-value decomposition of the cross-spectral density (CSD) matrix to the description of electromagnetic spectral spatial coherence of stationary light beams. We show that in a transverse plane any CSD matrix can be expressed as a mixture of two CSD matrices corresponding to beams which are fully polarized but in general spatially partially coherent. The polarization and coherence structures of these constituent beams are specified, respectively, by the singular vectors and singular values of the full CSD matrix. It follows that vector-beam coherence, including the coherence Stokes parameters and the degree of coherence, can be formulated in terms of only two correlation functions. We further establish two-point analogs of the spectral and characteristic decompositions of the polarization matrix and show that in the case of a Hermitian CSD matrix their composition is specified by the so-called degree of cross-polarization.
All-optical, tunable, V- and W-band microwave generation using semiconductor lasers at period-one nonlinear dynamics with asymmetric mutual injection stabilization
Authors: Tseng Chin-Hao , Liao Bin-Kai , Hwang Sheng-Kwang
Published: August 2022

This study investigates an optically injected semiconductor laser operating at period-one nonlinear dynamics for all-optical microwave generation. A novel, to the best of our knowledge, all-optical stabilization scheme is proposed to greatly enhance the spectral purity of such generated microwaves, which sends a small fraction of the injected laser output back to the injecting laser, not the injected laser itself. Mutual injection with highly different injection power between the two lasers, i.e., highly asymmetric mutual injection, is thus formed. As a result, the microwave linewidth is reduced by up to at least 85 times, the phase noise variance is improved by up to at least 750 times, and a side-peak suppression ratio of more than 44 dB is achieved. Microwave generation that is tunable up to at least 110 GHz with a 3-dB linewidth down to below 2 kHz is realized.
Dynamic phase retrieval method for ultrafast and precise vibration sensing based on time stretching
Authors: Chang Zhenghu , Cao Yulong , Huang Jingsheng , Wu Qiang , Liu Ai , Gao Lei , Zhu Tao
Published: August 2022

We demonstrate a method for retrieving the phase information from single-shot interference spectra obtained by dispersive Fourier transform, through which the error accumulation during phase retrieval is restrained. A Mach–Zehnder interferometer is proposed for vibration sensing with high speed. We find that relative phase trends at different time delays can be precisely retrieved to improve the signal-to-noise ratio when the time interval jitter between pulses within two arms is less than four times the pulse width. The verification experiment achieves a phase resolution of 5.3 mrad and a high-speed refresh frame rate of 51.8 MHz. Numerical simulations and experiments show that the method is effective for phase demodulation of dynamic interference spectra, and provides a reliable strategy for high-speed, precision sensing.
Humidity-induced direct modification of the optical response of plasmonic nanorod metamaterials
Authors: Jiang Yunlu , Krasavin Alexey V. , Nasir Mazhar E. , Wang Pan , Zayats Anatoly V.
Published: August 2022

Plasmonic nanorod metamaterials are often used as a high-performance optical sensing platform for the detection of biochemical and gas species. Here, we investigate the effect of environmental humidity on their optical response. Due to the high refractive index sensitivity, a significant change in the transmission is observed with ΔT/T reaching values of more than 5% when the relative humidity is changed from 11% to 75%. This is the result of the condensation of water molecules on a rough surface of the gold nanorods. This finding reveals the importance of protecting plasmonic nanostructures from relative humidity variations in many practical applications. By coating the nanorods with a monolayer of poly-L-histidine, the fractional change of transmission is doubled due to the hydrophilic property of the monolayer, which can be used for the development of high-sensitivity relative humidity and dew condensation sensors.
Computer simulations of Template-Directed RNA Synthesis driven by temperature cycling in diverse sequence mixtures
Authors: Chamanian Pouyan , Higgs Paul G.
Published: August 2022

We present simulations of non-enzymatic template-directed RNA synthesis that incorporate primer extension, ligation, melting, and reannealing. Strand growth occurs over multiple heating/cooling cycles, producing strands of several hundred nucleotides in length, starting with random oligomers of 4 to 10 nucleotides. A strand typically grows by only 1 or 2 nucleotides in each cycle. Therefore, a strand is copied from many different templates, not from one specific complementary strand. A diverse sequence mixture is produced, and there is no exact copying of sequences, even if single base additions are fully accurate (no mutational errors). It has been proposed that RNA systems may contain a virtual circular genome, in which sequences partially overlap in a way that is mutually catalytic. We show that virtual circles do not emerge naturally in our simulations, and that a system initiated with a virtual circle can only maintain itself if there are no mutational errors and there is no input of new sequences formed by random polymerization. Furthermore, if a virtual sequence and its complement contain repeated short words, new sequences can be produced that were not on the original virtual circle. Therefore the virtual circle sequence cannot maintain itself. Functional sequences with secondary structures contain complementary words on opposite sides of stem regions. Both these words are repeated in the complementary sequence; hence, functional sequences cannot be encoded on a virtual circle. Additionally, we consider sequence replication in populations of protocells. We suppose that functional ribozymes benefit the cell which contains them. Nevertheless, scrambling of sequences occurs, and the functional sequence is not maintained, even when under positive selection.