bluuebunny/crossref_metadata_2025 huggingface dataset:
Bedside implications of the use of surrogate endpoints in solid and haematological cancers: implications for our reliance on PFS, DFS, ORR, MRD and more
Authors: Olivier Timothée , Haslam Alyson , Ochoa Dagney , Fernandez Eduardo , Prasad Vinay
Published: October 2024

Clinical endpoints, such as overall survival, directly measure relevant outcomes. Surrogate endpoints, in contrast, are intermediate, stand-in measures of various tumour-related metrics and include tumour growth, tumour shrinkage, blood results, etc. Surrogates may be a time point measurement, that is, tumour shrinkage at some point (eg, response rate) or biomarker-assessed disease status, measured at given time points (eg, circulating tumour DNA, ctDNA). They can also be measured over time, as with progression-free survival, which is the time until a patient presents with either disease progression or death. Surrogates are increasingly used in trials supporting the marketing authorisation of novel oncology drugs. Yet, the trial-level correlation between surrogates and clinical endpoints—meaning to which extent an improvement in the surrogate predicts an improvement in the direct endpoint—is often moderate to low. Here, we provide a comprehensive classification of surrogate endpoints: time point measurements and time-to-event endpoints in solid and haematological malignancies. Also, we discuss an overlooked aspect of the use of surrogates: the limitations of surrogates outside trial settings, at the bedside. Surrogates can result in the inappropriate stopping or switching of therapy. Surrogates can be used to usher in new strategies (eg, ctDNA in adjuvant treatment of colon cancer), which may erode patient outcomes. In liquid malignancies, surrogates can mislead us to use novel drugs and replace proven standards of care with costly medications. Surrogates can lead one to intensify treatment without clear improvement and possibly worsening quality of life. Clinicians should be aware of the role of surrogates in the development and regulation of drugs and how their use can carry real-world, bedside implications.
War crimes, sexual assault and medical confidentiality in Israel
Authors: Lederman Zohar
Published: October 2024

Hamas militants have raped and mutilated the bodies of dozens of men and women in Israel during their attack and captivity in Gaza. The exact extent of these atrocities, however, is unknown. For reasons of this sort and others, prosecuting sexual abusers during armed conflicts is notoriously difficult. In an attempt to make a legal case against Hamas militants, the Israeli authorities have recently ordered civilian hospitals to breach medical confidentiality and report unidentified data of patients who have suffered bodily mutilation and sexual abuse during the Hamas attack or during captivity in Gaza. Patients were not informed about this policy. This article first establishes a case for why medical confidentiality is such an important existential and normative value. In this light, it then argues that the Israeli policy is morally unjustified.
Mechanisms and implications of phenotypic switching in bacterial pathogens
Authors: Byrne Alexander Stephen , Bissonnette Nathalie , Tahlan Kapil
Published: October 2024

Bacteria encounter various stressful conditions within a variety of dynamic environments, which they must overcome for survival. One way they achieve this is by developing phenotypic heterogeneity to introduce diversity within their population. Such distinct subpopulations can arise through endogenous fluctuations in regulatory components, wherein bacteria can express diverse phenotypes and switch between them, sometimes in a heritable and reversible manner. This switching may also lead to antigenic variation, enabling pathogenic bacteria to evade the host immune response. Therefore, phenotypic heterogeneity plays a significant role in microbial pathogenesis, immune evasion, antibiotic resistance, host niche tissue establishment, and environmental persistence. This heterogeneity can result from stochastic and responsive switches, as well as various genetic and epigenetic mechanisms. The development of phenotypic heterogeneity may create clonal populations that differ in their level of virulence, contribute to the formation of biofilms, and allow for antibiotic persistence within select morphological variants. This review delves into the current understanding of the molecular switching mechanisms underlying phenotypic heterogeneity, highlighting their roles in establishing infections caused by select bacterial pathogens.
A Research Review and Perspective Toward Plant Leaf Disease Detection Using Image Processing Techniques
Authors: Kindalkar Amrita Arjun
Published: October 2024

Plant Leaf Disease (PLD) detection is helpful for several fields like Agriculture Institute and Biological Research. The country’s economic growth depends on the productivity of the agricultural field. Recently developed models based on deep learning give more accurate and precise results over the detection and classification of PLD while evolving through image processing approaches. Many image-processing approaches are used for the identification and classification of PLD. The quality of agricultural products is mainly affected by several factors like fungi, bacteria, and viruses. These factors severely destroy the entire growth of the plant. Hence, some outperformed models are needed to detect and identify the severity level of plant diseases yet, the identification requires more time and has a struggle to identify the appropriate type of disease based on its symptoms. Therefore, several automatic detection and classification models are developed to avoid the time complexity. Computerized image processing approaches are utilized for crop protection, which analyzes the color information of leaves from the collected images. Hence, image processing techniques play an important role in the identification and classification of PLD. It gives more advantages by lowering the task of illustrating crops on large farms and detecting the leaf diseases at the initial stage itself based on the symptoms of the plant leaves. While implementing a new model, there is a need to study various machine and deep learning-based structures for PLD detection approaches. This research work provides an overview of various heuristic approaches, machine learning, and deep learning models for the detection and classification of PLD. This research work also covers the various constraints like PLD detection tools, performance measures, datasets used, and chronological review. Finally, the research work explores the research findings and also the research gaps with future scope.
BentoMuseum: 3D and Layered Interactive Museum Map for Blind Visitors
Authors: Wang Xiyue , Kayukawa Seita , Takagi Hironobu , Asakawa Chieko
Published: October 2024

Obtaining information before a visit is one of the priority needs and challenges for blind museum visitors. We propose BentoMuseum, a layered, stackable, and three-dimensional museum map that makes complex structural information accessible by allowing explorations on a floor and between floors. Touchpoints are embedded to provide audio-tactile interactions that allow a user to learn the museum’s exhibits and navigation when one floor is placed on a touch screen. Using a tour design task, we invited 12 first-time blind visitors to explore the museum building, choose exhibits that attracted them, and build a mental map with exhibit names and directions. The results show that the system is useful in obtaining information that links geometric shapes, contents, and locations to then build a rough mental map. The connected floors and spatial structures motivated users to explore. Moreover, having a rough mental map enhanced orientation and confidence while traveling in the museum.
Evidence for interacting but decoupled controls of decisions and movements in nonhuman primates
Authors: Saleri Clara , Thura David
Published: October 2024

The mechanism by which the integrated control of decisions and actions occurs, coupled or interactive but decoupled, is debated. In the present study, we show in monkeys that decisions and actions influence each other in a decoupled way. For the first time, we also demonstrate that this control can evolve depending the subject’s experience, allowing the trade of movement time for decision time and limiting the temporal discounting of reward value.
Nonlinear Seepage Mechanism and Evolution Law of CO2 Enhancing Coalbed Methane Recovery
Authors: Xu Yanhui , Cheng Xiaojiao , Fan Shixing , Wen Hu , Liu Yin , Mi Wansheng
Published: October 2024

China’s coal seam permeability is low, and the original coal seam gas extraction is difficult. CO2 displacement of coal seam CH4 technology is an effective gas extraction technology. CO2 is injected into the coal seam under pressure, and competitive adsorption occurs with CH4 in the pores. The gas composition is nonuniformly distributed, and its viscosity μ is the dynamic parameter. As the gas is compressible, the pressure drops, and migration distance does not satisfy a linear relationship. Therefore, the gas transport does not conform to Darcy’s law. The mass transfer process and a multicomponent gas competitive adsorption were investigated theoretically and experimentally. The adsorption characteristics and gas compressibility determine the distribution of the gas components in pores and change the gas dynamic viscosity in different regions. The change in the gas dynamic viscosity in the channel is the direct reason for the nonlinear pressure gradient and gas flow curve. The permeability and gas component affect the degree of nonlinear deviation of the gas flow and pressure gradient curve. This affects the nonlinear deviation degree of the curve by changing the gas dynamic viscosity in the pore channel during displacement. The reasonable displacement pressure is the critical pressure (PO) through experimental and theoretical analysis.
The Influence of the New Charcoal Toothbrush and Toothpaste on Esthetic Restoration Properties
Authors: Farghal Nancy Soliman , Sheikh Debis Mohammed Nadim , Abou Baker Tema , Mahmoud Okba
Published: October 2024

Aim: To investigate the effects of the new charcoal toothbrush and toothpaste on stain removal and surface roughness of two esthetic restorative materials.

Materials and Methods: Forty disk‐shaped specimens (10 × 2 mm) were prepared from giomer (Beautifil II LS) and resin‐modified glass ionomer (Fuji II LC) and immersed in instant coffee solution for 12 days. Specimens were split into 4 groups, 10 specimens each, according to the brushing protocols: group 1, regular toothbrush + regular toothpaste (RR); group 2, regular toothbrush + charcoal‐based toothpaste (RC); group 3, charcoal toothbrush + regular toothpaste (CR); and group 4, charcoal toothbrush + charcoal toothpaste (CC). Color change (ΔE00), luminosity changes (ΔL), and surface roughness (Ra) were recorded before and after brushing. The data were analyzed with KrusKal–Wallis, Dunn–Bonferroni post hoc, and Wilcoxon signed rank test using SPSS software at 5% significance level.

Results: Charcoal toothpaste and toothbrush had similar stain removal effects to regular toothbrush and toothpaste on both giomer and RMGI (P  < 0.001). All the ΔE00 values after brushing exceeded the perceptibility threshold. The surface roughness increased significantly after the brushing in all the groups except in giomer groups CR (P = 0.575) and CC (P = 0.221) and RMGI group RR (P = 0.415).

Conclusion: Charcoal and regular toothbrushes with both types of toothpaste can reduce, but not eliminate, coffee stains. Surface roughness increased in all groups except for the charcoal toothbrush with Beautifil II LS restorations and the regular toothbrush and toothpaste with Fuji II LC restorations.
Bidirectional Two‐Sample Mendelian Randomization Analysis Unveils a Causal Correlation of Mitochondrial Function‐Related Proteins with the Risk of Diabetic Nephropathy
Authors: Song Siyuan , Yu Jiangyi
Published: October 2024

Objective. The genuine causal nexus between mitochondrial function‐related proteins and diabetic nephropathy remains enigmatic and arduous to delineate conclusively. In this study, we employed a bidirectional two‐sample Mendelian randomization analysis, a robust approach, to scrutinize and discern the causal interplay between them. Methods. In this investigation, the datasets pertaining to diabetic nephropathy and mitochondrial function‐related proteins were meticulously extracted from the comprehensive IEU OpenGWAS Project database. The principal analytical method employed was the inverse variance weighted approach. In addition, MR‐Egger regression, simple median, and weighted median methodologies were utilized as supplementary tools to interrogate the causal associations of mitochondrial function‐related proteins with the risk of diabetic nephropathy. Semsitivity analyses were conducted using the Cochran’s Q test and MR‐Egger regression intercept. The significance level, as indicated by the P value, was employed as the pivotal metric for interpreting the findings. Result. A total of 90 single nucleotide polymorphisms associated with mitochondrial function‐related proteins were meticulously screened as instrumental variables. The inverse variance weighted analysis unveiled a positive causal nexus between mitochondrial glutamate carrier 2, 2,4‐dienoyl‐CoA reductase mitochondrial levels, 39S ribosomal protein L52 mitochondrial, ATP synthase subunit beta mitochondrial, Serine‐‐tRNA ligase mitochondrial, itochondrial sodium/hydrogen exchanger 9B2, and Esseential MCU regulator mitochondrial, and diabetic nephropathy. Conversely, pyruvate dehydrogenase (acetyl‐transferring) kinase isozyme 1 mitochondrial exhibited a negative causal relationship with diabetic nephropathy., the MR‐Egger intercept test yielded non‐multiplicative results (P  >  0.05), affirming the robustness and validity of Mendelian randomization as an effective method for causal inference in this investigation. Furthermore, the reverse Mendelian randomization analysis failed to demonstrate any causal link between diabetic nephropathy and an augmented risk associated with positively identified mitochondrial function‐related proteins. Conclusion. Pyruvate dehydrogenase (acetyl‐transferring) kinase isozyme 1 mitochondrial stands out as an independent protective factor against diabetic nephropathy. The findings bear significant clinical implications, offering pivotal insights into the development of targeted preventive and therapeutic interventions, tailored specifically for combating diabetic nephropathy.
Intervention Characteristics and Mechanisms and Their Relationship with the Influence of Social Prescribing: A Systematic Review
Authors: Dubbeldeman Eveline M. , Kiefte-de Jong Jessica C. , Ardesch Frank H. , Boelens Mirte , van der Velde Laura A. , van der Steen Sophie G. L. , Heijnders Miriam L. , Crone Mathilde R.
Published: October 2024

Introduction. Social prescribing (SP) is an integrated care program aimed to improve individuals’ health and wellbeing. Understanding the influence of SP and determining best practices and processes are challenging due to variability in its delivery, implementation, and intervention characteristics between different studies and countries. This study aimed to identify the intervention characteristics, mechanisms, and outcomes associated with SP research and explore how these factors relate to the influence of SP on health and wellbeing, healthcare utilization, and care experiences. Method. A comprehensive search was conducted in twelve databases, Google Scholar, and reference lists of relevant studies published from January 2010 up to April 2023. Searches were limited to literature written in English or Dutch. We utilized ASReview, an open‐source machine learning tool, to conduct title and abstract screening. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool, and the risk of bias was evaluated using the Cochrane RoB2 and the ROBINS‐I. We coded all intervention characteristics, mechanisms, and relevant outcomes. Quantitative data were visually presented using Harvest Plots, and qualitative data were narratively summarized. Results and Discussion. In total, 49 papers were included, of which seven qualitative, seventeen quantitative, and 25 mixed method studies. The findings highlight the importance of social‐related mechanisms, including loneliness and social connectedness, in contributing to the observed positive influence of SP on mental health and wellbeing. The observed outcomes seem to be influenced by various characteristics, including gender, age, the presence of a link worker, and the use of behavior change techniques. However, we should be cautious when interpreting these results due to limitations in study designs, such as the lack of controlled trials and statistical considerations. Further rigorous research is needed to comprehensively understand the impact and potential benefits of SP.
Cross‐Regional Energy Dispatch and Firm Energy Intensity: A Quasi‐Natural Experiment from China’s West‐To‐East Natural Gas Pipeline Project
Authors: Jiang Yaohui , Xiao Qian , Zhou Hanzhu
Published: October 2024

Cross‐regional energy dispatch project is a crucial strategy for countries to reduce energy transportation costs and achieve optimal energy allocation. This research constructs a quasi‐natural experiment based on the West‐to‐East Natural Gas Pipeline Project in China. It finds that cross‐regional energy dispatch significantly reduces firms’ energy intensity, and that firms in economically developed regions and high‐polluting firms benefit more from it. The mechanism test shows that cross‐regional energy dispatching reduces enterprises’ coal consumption, increases the proportion of cleaner energy consumption, and optimizes their energy consumption structure. Cross‐regional energy dispatch accelerates the exit of inefficient enterprises and the development of efficient enterprises. Cross‐regional energy dispatch enhances the green innovation activities of enterprises and accelerates the renewal of production equipment. Governments should encourage cross‐regional energy cooperation and dispatch to achieve efficient use and distribution of energy resources.
Intestinal Ligation Mimicking Ureteral Ligation After Ovariohysterectomy in an 11‐Month‐Old Chihuahua
Authors: Fisher Corey J. , Piedrahita Cristina , Choe Olivia , James Amanda , Scheuermann Logan M. , Huguet Elodie , Southern Carl
Published: October 2024

Intestinal ligation during ovariohysterectomy has not been previously reported in dogs. Risk factors for this complication appear to be the same as those for ureteral injury, namely decreased surgical visualization due to small patient size and small incision size. This case report describes how the presentation of intestinal ligation in a 2‐kg, 11‐month‐old chihuahua can mimic that of iatrogenic ureteral injury with vomiting, anorexia, and severe azotemia. Ultrasound served as a key diagnostic to visualize intestinal mechanical obstruction, an encircling ligature around a segment of jejunum with no blood flow on Doppler interrogation, and normal appearance and blood flow of the ureters and kidneys. The treatment consisted of aggressive fluid therapy, circulatory support, and emergent resection and anastomosis of the necrotic portion of the intestines. Within 48 h, the dog’s azotemia was resolved, and it was reported to be doing well at 1‐month follow‐up.
Triple‐Rectangular Band Rejection Monopole Ultrawide‐Band Antenna with Spiral Electromagnetic Band‐Gap Structures
Authors: Arora Sapna , Sharma Sharad , Anand Rohit , Mittal Manisha , Malik Praveen Kumar , Singh Rajesh
Published: October 2024

A printed ultrawideband (UWB) monopole antenna with triple‐rectangular band rejection characteristics at WiMAX, WLAN, and satellite band is presented in this paper. The frequency selectivity of each rejection band is improved by employing the mutual coupling of two spiral‐shaped electromagnetic band‐gap (EBG) structures. The proposed design consists of the modified rectangular patch with a compact size of 23.5 × 23 mm2 having a partial ground plane and three pairs of spiral EBGs. To mitigate the interference from the WiMAX band, one pair of the spiral is coupled with the microstrip line, which exhibits band rejection of 3.3–3.7 GHz (11.42%). WLAN band from 5.1 to 5.9 GHz (14.5%) is notched by another pair of spiral EBGs designed on the opposite side of the radiating patch, and for satellite band rejection, two spiral EBGs are embedded on the opposite side of the microstrip line which ranges from 7.25 to 7.8 GHz (7.3%). Moreover, peak gain, radiation pattern, and time domain behavior of the proposed design are also investigated in Ansys Electronics Desktop 17.0 to find its suitability in UWB applications.
Figure S3 from FLT3/CD99 Bispecific Antibody–Based Nanoparticles for Acute Myeloid Leukemia
Authors: Ali Atham , Phan Alvin , Vaikari Vijaya , Park Mincheol , Pospiech Mateusz , Chu Ryan , Meng Yiting , MacKay J. Andrew , Alachkar Houda
Published: October 2024

Figure S3 – Western Blot data from USC100 following treatment with FLT3-A192, CD99-A192 and Co-Assembled CD99-A192 and FLT3-A192.
Supplementary Fig.1 from Tumor Vessel Normalization via PFKFB3 Inhibition Alleviates Hypoxia and Increases Tumor Necrosis in Rectal Cancer upon Radiotherapy
Authors: Edelmann Marcus , Fan Shuang , De Oliveira Tiago , Goldhardt Tina , Sartorius Dorothée , Midelashvili Teona , Conrads Karly , Paul Niels B. , Beißbarth Tim , Fleischer Johannes R. , Blume Moritz L. , Bohnenberger Hanibal , Josipovic Natasa , Papantonis Argyris , Linnebacher Michael , Dröge Leif H. , Ghadimi Michael , Rieken Stefan , Conradi Lena-Christin
Published: October 2024

Supplementary Fig.1
Supplementary Fig. 7 from Tumor Vessel Normalization via PFKFB3 Inhibition Alleviates Hypoxia and Increases Tumor Necrosis in Rectal Cancer upon Radiotherapy
Authors: Edelmann Marcus , Fan Shuang , De Oliveira Tiago , Goldhardt Tina , Sartorius Dorothée , Midelashvili Teona , Conrads Karly , Paul Niels B. , Beißbarth Tim , Fleischer Johannes R. , Blume Moritz L. , Bohnenberger Hanibal , Josipovic Natasa , Papantonis Argyris , Linnebacher Michael , Dröge Leif H. , Ghadimi Michael , Rieken Stefan , Conradi Lena-Christin
Published: October 2024

Supplementary Fig. 7
Supplementary Fig. 3 from Tumor Vessel Normalization via PFKFB3 Inhibition Alleviates Hypoxia and Increases Tumor Necrosis in Rectal Cancer upon Radiotherapy
Authors: Edelmann Marcus , Fan Shuang , De Oliveira Tiago , Goldhardt Tina , Sartorius Dorothée , Midelashvili Teona , Conrads Karly , Paul Niels B. , Beißbarth Tim , Fleischer Johannes R. , Blume Moritz L. , Bohnenberger Hanibal , Josipovic Natasa , Papantonis Argyris , Linnebacher Michael , Dröge Leif H. , Ghadimi Michael , Rieken Stefan , Conradi Lena-Christin
Published: October 2024

Supplementary Fig. 3
Use of Preoperative Immunotherapy in Locally Advanced Unresectable Cutaneous Squamous Cell Carcinoma: A Case Report
Authors: Cabral Sara Cerqueira , Gouveia Emanuel , Nunes Hugo , Pereira Patricia M.
Published: October 2024

Introduction: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer. Surgery is the standard of care with curative intent of localized disease; however, for large head and neck cSCCs, it is associated with high morbidity. Cemiplimab, an antibody anti programmed cell death-1 (PD-1) protein, is effective in locally advanced unresectable or metastatic cSCC. A pilot study demonstrated a high rate of pathologic complete response using cemiplimab in the neoadjuvant setting. Case Presentation: Here, we report the case of an 84-year-old man with two locally advanced unresectable cSCCs (a nasolabial lesion and a retroauricular lesion) treated with cemiplimab, for whom closer follow-up revealed a complete response of the retroauricular lesion and a partial response of the nasolabial lesion after 4 cycles. Patient will be submitted to nasolabial lesion resection. Conclusion: This illustrates the efficacy of the use of cemiplimab as preoperative therapy in advanced unresectable cSCC, facilitating a definitive surgical treatment.
Sustained Response to Anti-PD-1 Therapy in Combination with Nab-Paclitaxel in Metastatic Testicular Germ Cell Tumor Harboring the KRAS-G12V Mutation: A Case Report
Authors: Pan Jinfeng , Yin Weiqi , Chen Yingzhi , Wang Hui , Wu Wei , Wang Suying , Li Da , Ma Qi
Published: October 2024

Introduction: Cisplatin-based standardized therapy has been established for metastatic testicular germ cell tumors (TGCTs). However, the patient prognosis is considerably less favorable if the disease recurs following failure of first-line therapies. There is a need for novel treatment options for patients with recurrent or metastatic TGCTs, notably for those that are not sensitive to first-line chemotherapy. With the development of next-generation sequencing technologies, an increasing number of gene mutations has been identified in TGCTs. Previously published research studies have established a link between KRAS mutations and chemotherapy resistance, and have demonstrated that KRAS mutations are associated with inflammatory tumor microenvironment and tumor immunogenicity, leading to an improved response to inhibition of programmed death (PD-1) protein expression. Previous studies have reported that the tumor immune microenvironment of TGCT influences therapeutic efficacy. Case Presentation: A 65-year-old metastatic patient with TGCT and a KRAS-12 valine-for-glycine gene mutation was described. This patient initially underwent inguinal orchiectomy and received two prior chemotherapeutic regimens. Following the rapid progression of the disease, the patient was treated with anti-PD-1 therapy and nab-paclitaxel chemotherapy, and his condition was successfully controlled by this combination treatment. Conclusion: To the best of our knowledge, this is the first successful case of KRAS-mutation patient with TGCT who achieved partially and sustained disease remission by combining immune checkpoint inhibitors with chemotherapy. This case provides an excellent example for personalized treatment of metastatic TGCTs.
Frühe Erhaltungstherapie bei MOGAD: Ein Schlüssel zur Reduktion des Rückfallrisikos
Authors: Tsaktanis Thanos , Nickel Florian T. , Rothhammer Veit
Published: October 2024

Background and Objectives: Because myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently identified autoimmune disorder, the natural history of MOGAD is still not well described. The objective of this study was to describe the long-term outcomes of adult patients with MOGAD. In addition, we aimed to identify factors affecting relapse risk and neurologic outcomes. Methods: Clinical and biological data were obtained from patients with a first event of MOGAD and included in the French nationwide incident cohort between February 2014 and March 2017. Only patients aged 18 years or older at disease onset and with observation period of at least 3 months were included. Data were collected prospectively until July 2023 and registered in the dedicated French nationwide database. This form includes every relapse with phenotype description during follow-up, date of last assessment, final clinical outcome with Expanded Disability Status Scale score and visual acuity, and maintenance therapy. The probability of recurrence-free survival was assessed using the Kaplan-Meier method. Results: We included 128 patients. The onset phenotype was isolated optic neuritis in 81 patients (63.3%) and isolated myelitis in 25 patients (19.5%). The median follow-up duration was 77.8 months (range 3.2–111.2), with 49 patients (38.3%) experienced at least one relapse. Median times from onset to second and third attacks were 3.2 (1.0–86.2) and 13.0 (2.6–64.4) months, respectively. At the last assessment, Expanded Disability Status Scale Score was ≥3 and ≥6 in 22 (17.2%) and 6 (4.7%) patients, respectively. Eighty patients received at least one maintenance treatment. This treatment was initiated after the first attack in 47 patients (36.7% of the whole cohort) and at the time of a second attack in 25 (19.5%). Multivariate analysis revealed that initiating maintenance treatment after the first attack was associated with a lower relapse risk (OR = 0.26 [95% CI 0.11–0.62], p = 0.002). In patients receiving maintenance therapy after first attack, the 2-year, 4-year, 6-year, and 8-year relapse risks were 11%, 15%, 20%, and 20%, respectively. In other patients, the risks were 41%, 46%, 51%, and 56%. Discussion: The highest risk of a relapse in MOGAD occurs early, and initiating maintenance therapy from the first attack substantially reduced the relapse risk.
Frailty and Early Mortality following Intracerebral Hemorrhage
Authors: Lewis Benjamin , Dohle Esmee , Warburton Elizabeth A. , Evans Nicholas R.
Published: October 2024

Introduction: Prognostication in spontaneous intracerebral hemorrhage (ICH) is vital for effective clinical decision-making but can be challenging. Frailty – the loss of physiological reserve to withstand stressor events – is a risk factor for poor outcomes after ischemic stroke, yet its role in ICH remains poorly understood. This study investigates whether frailty is independently associated with 28-day mortality following ICH. Methods: A validated pre-stroke frailty index (FI) was measured for individuals presenting with ICH, yielding a FI of 0–1. The relationship between 28-day mortality and FI was assessed using multivariable logistic regression adjusting for age, neurosurgical intervention, National Institutes of Health Stroke Scale (NIHSS), Glasgow Coma Score (GCS), and ICH volume. Results: Forty (34.5%) of 116 individuals with ICH died within 28 days. Frailty was independently associated with 28-day mortality, with each 0.1 increase in FI independently associated with an adjusted odds ratio of death of 1.09 (95% CI: 1.01–1.18). ICH volume was also independently associated with mortality (aOR 1.04, 95% CI: 1.02–1.06 per 10 mL increase). In contrast, age and neurosurgical intervention were not independently associated with mortality in our cohort. Conclusion: Higher pre-stroke frailty is independently associated with early mortality following spontaneous ICH, indicating the potential of frailty evaluation to inform prognostication and clinical decision-making.
Associations between Type of Bariatric Surgery and Obstructive Sleep Apnoea, Employment Outcomes, and Body Image Satisfaction: A Systematic Review and Meta-Analysis
Authors: Leyaro Beatrice , Boakye Daniel , Howie Lyz , Ali Abdulmajid , Carragher Raymond
Published: October 2024

Introduction: Bariatric surgery has been shown to provide significant patient benefits in terms of weight loss and mitigation of obesity-linked comorbidities, as well as providing improvements in occupational productivity and patient quality of life. However, the choice of which bariatric surgery procedure provides the most patient benefit in each of these cases is still in question. In this review, we provide a systematic review, with the objective of evaluating associations between different bariatric surgery procedures and mitigation of obesity-linked comorbidities, improvement in occupational productivity, and patient quality of life, concentrating on three areas: obstructive sleep apnoea (OSA), employment prospects, and body image. Methods: The CINAHL, PubMed, Web of Science, and CENTRAL databases were searched for eligible studies. Summary risk ratio (RR) and 95% confidence intervals were estimated using random-effects models. Thirty-three studies were included in this review, including 29 cohort studies and 4 randomised clinical trials (RCTs). Results: Pooled analysis of the observational studies showed significantly lower OSA remission in sleeve gastrectomy (SG) compared to Roux-en-Y gastric bypass (RYGB) across both short-term (1–2 years) and longer term (3+ years) follow-up periods (RR = 0.91, 95% CI = 0.84–0.99, p = 0.02; and RR = 0.88, 95% CI = 0.65–0.99, p = 0.03, respectively). In contrast, a meta-analysis of the RCT studies found no difference in OSA remission between SG and RYGB (RR = 1.01, 95% CI = 0.81–1.25, p = 0.93). An analysis of four studies showed significantly higher OSA remission for SG versus adjustable gastric banding (RR = 1.83, 95% CI = 1.57–2.14, p < 0.001). No significant difference was observed regarding improvement in employment status between SG and RYGB (RR = 0.77, 95% CI = 0.32–1.87, p = 0.57). A narrative synthesis of studies on body image reported no significant differences between body image scores and surgery types. Conclusion: This review found significantly lower OSA remission in SG as compared to RYGB across different follow-up periods, while no significant statistical difference was observed in RCT studies. Further studies are recommended to assess the effectiveness of the various bariatric surgeries in relation to improving employment status and body image, where primary studies are lacking.
A novel approach for imbalanced instance handling toward better preterm birth classification
Authors: Deshpande Himani , Ragha Leena
Published: October 2024

Preterm birth (PTB) is a major cause of child and mother mortality, a PTB classification model can assist in assessing the health condition ahead of time and help avoid complications during childbirth. Mother’s significant feature (MSF) dataset created for this study has features derived from mother’s physical, lifestyle, social and stress attributes. MSF dataset consists of 119 features of 1,000 mothers with 172 preterm and 828 full-term deliveries, resulting in issues of dataset imbalance namely class inseparability and classification bias. To overcome the imbalance issue, a novel algorithm named majority penalizing minority upsampling (MPMU) is proposed. MPMU forms clusters looking into the degree of dataset imbalance, it analyses the composition of each cluster individually and computes the varied penalty for majority class instances. It further balances dataset composition by oversampling minority class instances. MPMU processed dataset is further used to train the proposed 6L-ANN network which finds the probability of occurrence of PTB. The proposed model has shown efficient results on MSF sub-datasets with precision values ranging from 0.90 to 0.97, area under the curve (AUC) between 0.86 to 0.99, and prediction accuracy ranging from 93.04% to 99.47%. Experiment results show that a mother’s lifestyle and stress features have a strong influence on the childbirth outcome.
A passive sonar based underwater acoustic channel model for improved search and rescue operations in deep sea
Authors: Abbas Afsar Ali Mohamed , Mohideen Kaja Mohideen Sultan , Narayanaswamy Vedachalam
Published: October 2024

Active and passive sonar are the two types of empirical underwater acoustic channel models (UWACMs). Passive sonar UWACMs have applications in military, ocean exploration, and search and rescue (SAR) activities. However, high transmission loss (TL), multipath propagation, and ambient noise pose significant challenges to signal-to-noise ratio (SNR) and communication effectiveness. To address these challenges, this paper develops a UWACM based on the passive sonar equation method to determine SNR in deep-sea environments, specifically for SAR operations. Determining SNR involves characterizing signal propagation in terms of TL. Existing models lack analysis of TL and SNR for various deep-sea multipath propagation scenarios relevant to SAR applications. Therefore, this paper analyses TL and SNR for both direct and various multipath propagation modes, including surface reflection (SR), surface duct (SD), bottom bounce (BB), convergence zone (CZ), deep sound channel (DSC), and reliable acoustic paths (RAPs) in the deep sea. This work aims to quantify the detection capabilities of underwater location beacons (ULBs) under various deep-sea scenarios and configurations. By analyzing ULB signal propagation characteristics, this research seeks to address key challenges related to ULB performance and ultimately improve SAR operations. The results of the proposed model significantly correlate with existing literature, confirming its accuracy.
Investigation of duty cycle controlled inductive wireless power transfer converter using series-series compensation for electric vehicle application
Authors: Bhukya Bhavsingh , Gotluru Suresh Babu , Bhukya Mangu , Bhukya Ravi Kumar , Dongari Vaani
Published: October 2024

This paper presents series-series (SS) compensation topologies that include both primary side duty cycle control (PSDCC) and secondary side duty cycle control (SSDCC) methods. The main challenge for noncontact charging (NCC) for electric vehicles (EVs) batteries, the power transfer capability and efficiency in primary side proved to be unproductive. The investigation considers the primary side control duty cycle control (transmitter and receiver) and the secondary side duty cycle control (transmitter and receiver) in terms of compensation capacitor voltage, coil voltage, load side voltage, current, and power. By adjusting the duty cycle within the range of 0.1 to 0.5, it is possible to control power without significantly decreasing the system's efficiency, by using the SSDCC method. The evaluated parameters, including 1.5 kW output power, 85 kHz resonance frequency, and 120 mm ground clearance, are suitable for three-wheeler auto rickshaws. These findings are verified through MATLAB/Simulink software and compared with experimental results.
Comparison of algorithms for the detection of marine vessels with machine vision
Authors: Rodríguez-Gonzales José , Niquin-Jaimes Junior , Paiva-Peredo Ernesto
Published: October 2024

The detection of marine vessels for revenue control has many tracking deficiencies, which has resulted in losses of logistical resources, time, and money. However, digital cameras are not fully exploited since they capture images to recognize the vessels and give immediate notice to the control center. The analyzed images go through an incredibly detailed process, which, thanks to neural training, allows us to recognize vessels without false positives. To do this, we must understand the behavior of object detection; we must know critical issues such as neural training, image digitization, types of filters, and machine learning, among others. We present results by comparing two development environments with their corresponding algorithms, making the recognition of ships immediately under neural training. In conclusion, it is analyzed based on 100 images to measure the boat detection capability between both algorithms, the response time, and the effectiveness of an image obtained by a digital camera. The result obtained by YOLOv7 was 100% effective under the application of processing techniques based on neural networks in convolutional neural network (CNN) regions compared to MATLAB, which applies processing metrics based on morphological images, obtaining low results.
A comprehensive verification of the header format and bandwidth utilization to detect distributed denial of service attack in vehicular ad hoc network
Authors: Kaurav Arun Singh , Srinivas K.
Published: October 2024

Vehicular ad hoc network (VANET) is a promising technology for controlling traffic on roads. Nowadays, heavy traffic is a major issue, and the presence of attackers exacerbates the situation. The most important challenge in VANET is its security from malicious vehicles. In order to defend against distributed denial of service DDoS attacks, we propose a comprehensive verification header format bandwidth detection (CVHB) in VANET. The behavior of a DDoS attack is unknown for all the other normal nodes in network. The header format of packer contains all the information of nodes that are actively participating in routing. The attacker infection probability measured by 𝑃𝑏 and 𝑃𝑚 or (𝑃𝑏 > 0.9). If both the parameters are high means attacker presence confirm in network. The CVHB scheme checks the packet header format of the attacker node, and only the attacker is one of the nodes whose sequence number is frequently changing. So, CVHB blocks the flooding of unwanted packets that consume the limited bandwidth of a wireless link and identify packets that contain no useful information. To measure the performance of the network, the basic performance metrics that are used are dropping percentage, packet delivery ratio (PDR), throughput and delay. The result of CVHB is showing improvement as compared to multilayer distributed self-organizing maps (MSOM) in VANET.
Revolutionizing brain tumor diagnoses: a ResNet18 and focal loss approach to magnetic resonance imaging-based classification in neuro-oncology
Authors: Kempanna Shashi Raj , Rangappa Aswatha Anoor , Maheshappa Shruthi , Kumar Siddaraju Druva , Gowda Kumar Puttaswamy , Ramachandragowda Santhosh Kumar , Tagare Trupti Shripad
Published: October 2024

Brain tumor diagnosis remains a critical challenge in neuro- oncology, where accurate and timely identification of malignancies can significantly impact patient outcomes. This research explores the integration of deep learning techniques, specifically leveraging the ResNet18 architecture coupled with focal loss, to enhance the classification accuracy of magnetic resonance imaging (MRI)-based brain tumor diagnoses. ResNet18, known for its powerful feature extraction capabilities, was employed to analyze MRI scans, while focal loss was utilized to address class imbalance issues prevalent in medical datasets. The model was trained on a comprehensive dataset, achieving an accuracy of 95.54%. These results demonstrate the potential of this approach in providing robust and precise diagnostic support in clinical settings, potentially revolutionizing the current methodologies in brain tumor detection and classification. The integration of advanced neural networks with specialized loss functions presents a significant advancement in the field, paving the way for more reliable and automated neuro-oncological diagnostics.
Mobile application for the prevention and self-care of varicose veins
Authors: Andrade-Arenas Laberiano , Retuerto Margarita Giraldo , Yactayo-Arias Cesar
Published: October 2024

Details the process of creating a prototype of a mobile application designed to promote prevention and self-care of varicose veins in patients at high vascular risk. The objective is to investigate the experience of patients at high vascular risk when using a mobile application created for the prevention and self-care of varicose veins. The methodology used is design thinking, a user-centered approach that seeks to solve complex challenges through creativity, design and problem solving. The results obtained from the expert judgment, based on ATLAS.ti 23, provide valuable insight into the feasibility and potential of the technological tools as the interface has the highest variability among the criteria evaluated, followed by interaction and quality, while usability presents the lowest variability. This suggests that usability evaluations tend to be more consistent compared to the other criteria. In conclusion, the present work analyzes how mobile applications can play a crucial role in promoting prevention and self-care of varicose veins in patients at high vascular risk. The good reception of the prototype confirms the importance of technology in the field of vascular health and highlights the value of this approach to improve quality of life and health management in this demographic group.
Enhancing sentiment analysis in Kannada texts by feature selection
Authors: Eshwarappa Sunil Mugalihalli , Shivasubramanyan Vinay
Published: October 2024

In recent years, there has been a noticeable surge in research activities focused on sentiment analysis within the Kannada language domain. The existing research highlights a lack of labelled datasets and limited exploration in feature selection for Kannada sentiment analysis, hindering accurate sentiment classification. To address this gap, the study aims to introduce a novel Kannada dataset and develop an effective classifier for improved sentiment analysis in Kannada texts. The study presents a new Kannada dataset from SemEval 2014 Task4 using Google Translate. It then introduces a modified bidirectional encoder representation from transformers BERT for Kannada dataset called as Kannada-BERT (K-BERT). Further, a probability-clustering (PC) approach is presented to extract the topics and its related aspects. Both the K-BERT classifier and PC approach were merged to attain a K-BERT-PC classifier, integrating a modified BERT model and probability clustering approach for achieving better results. Experimental results demonstrate that K-BERT-PC achieves superior performance in polarity and sentiment analysis accuracy, with an impressive accuracy rate of 91%, surpassing existing classifiers. This work contributes by providing a solution to the scarcity of labelled datasets for Kannada sentiment analysis and introduces an effective classifier, K-BERT-PC, for enhanced sentiment analysis outcomes in Kannada texts.
A comparative study of machine learning tools for detecting Trojan horse infections in cloud computing environments
Authors: Kanaker Hasan , Tarawneh Monther , Karim Nader Abdel , Alsaaidah Adeeb , Abuhamdeh Maher , Qtaish Osama , Alhroob Essam , Alhalhouli Zaid
Published: October 2024

Cloud computing offers several advantages, including cost savings and easy access to resources, it is also could be vulnerable to serious security attacks such as cloud Trojan horse infection attacks. To address this issue, machine learning is a promising approach for detecting these threats. Thus, different machine learning tools and models have been employed to detect Trojan horse infection such as Weka and Python Colab. This study aims to compare the performance of Weka and Python Colab, as popular tools for building machine learning models. This study evaluates the recall, accuracy, and F1-score of machine learning models built with Weka and Python Colab and compares their computational resources required employing several machine learning algorithms. The dataset collected and analyzed using dynamic analysis of Trojan horse infection in control lab environment. The findings of this study can help determine the decision about which tool to use to detect Trojan horse infections and provide insights into the strengths and limitations of Weka and Python Colab for building machine-learning models in general.
Aspect-based sentiment-analysis using topic modelling and machine-learning
Authors: Dhanal Radhika Jinendra , Ghorpade Vijay Ram
Published: October 2024

This study addresses the critical need for an accurate aspect-based sentiment-analysis (ABSA) model to understand sentiments effectively. The existing ABSA models often face challenges in accurately extracting aspects and determining sentiment polarity from textual data. Therefore, we propose a novel approach leveraging latent-Dirichlet-allocation (LDA) for aspect extraction and transformer-based bidirectional-encoder-representations from transformers (TF-BERT) for sentiment-polarity evaluation. The experiments were carried out on SemEval 2014 laptop and restaurant datasets. Also, a multi-domain dataset was generated by combining SemEval 2014, Amazon, and hospital reviews. The results demonstrate the superiority of the LDA-TF-BERT model, achieving 82.19% accuracy and 79.52% Macro-F1 score for the laptop task and 86.26% accuracy of 87.26% and 81.27% for Macro-F1 score for the restaurant task. This showcases the model's robustness and effectiveness in accurately analyzing textual data and extracting meaningful insights. The novelty of our work lies in combining LDA and TF-BERT, providing a comprehensive and accurate ABSA solution for various industries, thereby contributing significantly to the advancement of sentiment analysis techniques.