bluuebunny/crossref_metadata_2025 huggingface dataset:
Extramedullary plasmacytoma with associated multiple myeloma as a presentation of the posterior mediastinal mass: a rare clinical encounter
Authors: Proskuriakova Ekaterina , Kovalenko Iuliia , Aryal Barun Babu , Shunyakov Leonid
Published: August 2024

A plasmacytoma is a single, isolated tumour of abnormal plasma cells. It can develop within the bone, known as solitary plasmacytoma of bone, or outside the bone, referred to as extraosseous (extramedullary) plasmacytoma, without spreading to other parts of the body. Plasmacytoma, an uncommon presentation in the posterior mediastinum, usually arises as solitary or multiple lesions in bone or soft tissues. The standard treatment involves definitive radiotherapy, potentially curative for extramedullary cases. The prognosis varies, being more favourable without concurrent multiple myeloma and worsening with high-risk cytogenetics. The case involves a male in his early 80s with an extensive medical history presenting with difficulty swallowing and dyspnoea. The diagnosis revealed a rare posterior mediastinal plasmacytoma associated with multiple myeloma, emphasising the importance of prompt diagnosis and treatment.
Pulmonary mucormycosis eroding the chest wall: challenges in the management
Authors: Mittal Sonali , Joshi Mohit Kumar , Jaiswal Rahul , Parshad Rajinder
Published: August 2024

Pulmonary mucormycosis is a rare, life-threatening fungal infection usually seen in immunocompromised patients. Mortality in such patients is high due to underlying immunosuppression and poor general condition of the patients. Invasion of the adjacent structures is known but, to the best of our knowledge, pulmonary mucormycosis presenting with a full thickness chest wall erosion has not been reported. We report such a case with chest wall destruction with superadded bacterial infection. The use of prosthetic materials for chest wall reconstruction was not possible due to the presence of infection. In addition, there were other intra-operative and post-operative challenges which we managed using a multidisciplinary approach. This report highlights the successful outcome of this complex situation using pre-operative optimisation, adequate surgical debridement and effective management of post-operative complications with patience and perseverance.
Understanding multicentric haemangioendothelioma: diagnostic dilemmas and treatment strategies
Authors: Amir Aashika Parveen , Raja Sam , Ram Jasvant , Sekar Aadithiyan
Published: August 2024

Epithelioid haemangioendothelioma (EH) is a rare malignant vascular tumour occurring mainly in the liver and lungs, with bones being a rare site and primarily seen in the adult population. This case presents a male patient in his 40s who presented to the outpatient department with a chief issue of a painless swelling over the inguinal region for 4 months, gradually increasing in size, along with a history of a gradually enlarging, painless mass on his left knee over the past 5 years. Despite occasional discomfort during physical activities, the mass exhibited no associated trauma, fever, weight loss or systemic symptoms. Physical examination revealed a firm mass on the left knee and a matted lymph nodal swelling in the left inguinal region. Subsequent imaging studies identified multiple soft tissue lesions, osseous involvement and pulmonary metastases, suggestive of multicentric haemangioendothelioma. The patient underwent surgical excision of the inguinal mass and fixation of a pathological fracture in the left femur. He is currently undergoing chemotherapy and is scheduled for regular follow-up appointments. This case underscores the importance of thorough diagnostic evaluation and multidisciplinary management in complex oncological conditions like multicentric haemangioendothelioma.
Late-onset vitamin K deficiency presenting as haemorrhagic shock and severe multi-system organ failure
Authors: Azar Justin M , Lambert Richard , Maffei Frank Anthony , Thomas Tessy A
Published: August 2024

Vitamin K is an essential dietary cofactor required for the synthesis of active forms of vitamin K-dependent procoagulant proteins. Vitamin K deficiency, particularly late-onset deficiency occurring between 1 week and 6 months of age, can cause a life-threatening bleeding disorder. An exclusively breastfed, full-term, 6-week-old infant male presented with severe haemorrhagic shock and multi-system organ failure related to caregiver refusal of intramuscular vitamin K after birth. Coagulation studies were normalised within 8 hours of intramuscular vitamin K administration. An increasing number of caregivers are refusing intramuscular vitamin K which has led to a rise in the incidence of vitamin K deficiency bleeding. Health policy organisations around the world emphasise the benefits of intramuscular vitamin K and risks of refusal, particularly in exclusively breastfed infants who are at higher risk due to low vitamin K levels in breast milk. This case highlights the multi-system severity of this life-threatening yet preventable disorder.
When all that should close remains open: a tale of gastroschisis, exstrophy of bladder, spina bifida and limb defects
Authors: Agarwal Nikita , Anand Rohit , Jindal Atul
Published: August 2024

A primigravida in the extremist-affected region of a third-world nation gave birth to a newborn who was remotely consulted through video rounds from the capital of the state. Unfortunately, these abnormalities are often overlooked and left untreated. The baby had multiple limb defects, gastroschisis, exstrophy of the bladder and spina bifida. Tragically, the newborn did not survive due to the lack of clinical and surgical expertise in the area. It is crucial to emphasise the importance of establishing e-clinics for expectant mothers in underserved areas, providing them with access to high-quality anomaly scans.
Subsequent musculoskeletal injury after concussion in National Football League players
Authors: Wasserman Erin B , Chretien Alexandra , Harmon Kimberly G , Putukian Margot , Okonkwo David , Solomon Gary S , Cardenas Javier , Herzog Mackenzie M , Sills Allen , Mack Christina D
Published: August 2024

Objective

To assess whether National Football League (NFL) players diagnosed with a concussion have an increased risk of injury after return to football.

Methods

A retrospective cohort study analysed the hazard of subsequent time-loss lower extremity (LEX) or any musculoskeletal injury among NFL players diagnosed with a concussion in 2015–2021 preseason or regular season games compared with: (1) all non-concussed players participating in the same game and (2) players with time-loss upper extremity injury. Cox proportional hazards models were adjusted for number of injuries and concussions in the prior year, player tenure and roster position. Additional models accounted for time lost from participation after concussion.

Results

There was no statistical difference in the hazards of LEX injury or any musculoskeletal injury among concussed players compared with non-concussed players, though concussed players had a slightly elevated hazard of injury (LEX injury: HR=1.12, 95% CI 0.90 to 1.41; any musculoskeletal injury: HR=1.08, 95% CI: 0.89 to 1.31). When comparing to players with upper extremity injuries, the hazard of injury for concussed players was not statistically different, though HRs suggested a lower injury risk among concussed players (LEX injury: HR=0.78, 95% CI: 0.60 to 1.02; any musculoskeletal injury: HR=0.82, 95% CI: 0.65 to 1.04).

Conclusion

We found no statistical difference in the risk of subsequent injury among NFL players returning from concussion compared with non-concussed players in the same game or players returning from upper extremity injury. These results suggest deconditioning or other factors associated with lost participation time may explain subsequent injury risk in concussed players observed in some settings after return to play.
Real-world study of the multimorbidity and health service utilisation among individuals with non-diabetic hyperglycemia and type 2 diabetes mellitus in North West London
Authors: Dattani Rakesh , Ul-Haq Zia , Shah Moulesh , Kamalati Tahereh , Pierce Benjamin , Lucas Amanda , Baruwa Ahmed , Bickford-Smith Livi , Chilcott Jack , Griffiths Thomas , Frankel Andrew Howard , Willis Tony , Tam Frederick Wai Keung
Published: August 2024

Introduction

The prevalence of non-diabetic hyperglycemia (NDH) and type 2 diabetes mellitus (T2DM) is increasing. While T2DM is recognised to be associated with multimorbidity and early mortality, people with NDH are frequently thought to be devoid of such complications, potentially exposing individuals with NDH to suboptimal care. We therefore used the Discover London Secure Data Environment (SDE) dataset to appreciate the relationship of NDH/T2DM with multimorbidity, healthcare usage, and clinical outcomes.

Research design and methods

The dataset was retrospectively analysed between January 1, 2015 and December 31, 2020 to understand the relationship between NDH/T2DM and multimorbidity primary/secondary healthcare usage and clinical outcomes. This was compared with a cohort of individuals with thyroid disease but no NDH/T2DM.

Results

The dataset identified 152,384 and 124,190 adults with NDH and T2DM compared with 11,626 individuals with thyroid disease (control group). Individuals with NDH and individuals with T2DM had a high burden of disease, with only 13.1% of individuals with either NDH or T2DM not found to be suffering from at least one of the disease states of interest. The three most common comorbidities experienced by individuals with NDH were hypertension (41.4%), hypercholesterolemia (37.5%), and obesity (29.8%) compared with retinopathy (68.7%), hypertension (59.4%), and obesity (45.8%) in individuals with T2DM. Comparatively, the most common comorbidities in the control group were depression (30.8%), hypercholesterolemia (24.4%), and hypertension (17.1%). 28 (control group), 12 (NDH), and 16 (T2DM) primary care contacts per individual per year were identified, with 27,881, 282,371, and 314,880 inpatient admissions for the control, NDH, and T2DM cohorts, respectively. Prescription of drugs used to treat T2DM in individuals with NDH and T2DM was 27,772 (18.2%) and 109,361 (88.1%), respectively, accounting for approximately one in five individuals with NDH developing T2DM.

Conclusion

Both NDH and T2DM were associated with significant multimorbidity alongside primary and secondary care utilisation. Given the morbidity highlighted with NDH, we highlight the need for earlier detection of NDH, recognition of multimorbidity associated with both NDH and T2DM, as well as the need for the further implementation of interventions to prevent progression to T2DM/multimorbidity.
Guidelines and regulations applicable to vitro diagnostic tests in the UK: a scoping review
Authors: Staworko Magdalena , Khawar Oscar , Sullivan Frank , Donnelly Peter D , Deeks Jon , McCartney Margaret
Published: August 2024

Objective

To describe recommendations applicable to new diagnostic and screening tests brought to market in the UK as of 01 June 2023; and extract agreements, disagreements and gaps.

Design

Extant regulations, recommendations and guidelines for new diagnostic and screening tests applicable to new products placed in the UK market as of 01 June 2023. Non-English and references not applicable to new tests seeking market access in the UK on 01 June 2023 were excluded.

Data sources

PubMed, Web of Science Core Collection and Scopus; grey literature via EuropePMC and Google, government regulations and guidelines, and relevant professional societies. References of relevant included data were scanned for includable articles. Resultant data were thematically analysed and presented as a narrative scoping review.

Eligibility for selecting studies

PubMed, Web of Science Core Collection and Scopus were searched from 1/1/2018 for regulations, guidelines or recommendations for in vitro diagnositic tests as applied to the UK on 1/6/23. Relevant papers also had references searched.

Results

943 items were initially identified with 892 excluded. Reference searching located a further 31 papers and 82 items were analysed. Seven themes were identified: regulation, companion diagnostics and lab developed tests, safety and evidence, test specific recommendations, data, innovation and recommendations for patients/the public. Wide agreement included the need to reduce bureaucracy and duplication; to mitigate to avoid unintended consequences of In Vitro Diagnostic Regulation. Disagreement over whether high-quality evidence should precede regulatory approval, or could be gathered as part of postmarketing surveillance emerged.

Conclusions

Industry, regulators, academics, patients representing a variety of views, should collaborate to work through areas of disagreement.
Association of pre-existing cardiovascular disease with administration of fluoropyrimidine chemotherapy in patients with gastrointestinal malignancies
Authors: Abiodun Aderonke Temilade , Ju Chengsheng , Welch Catherine A , Lai Jennifer , Tyrer Freya , Chambers Pinkie , Paley Lizz , Vernon Sally , Deanfield John , de Belder Mark , Rutherford Mark , Lambert Paul C , Slater Sarah , Shiu Kai Keen , Wei Li , Peake Michael D ,   The VICORI collaborative, Adlam David , Manisty Charlotte
Published: August 2024

Objective

Fluoropyrimidine chemotherapy is a first-line treatment for many gastrointestinal (GI) cancers, however, cardiotoxicity concerns may limit administration in patients with pre-existing cardiovascular disease (CVD). This study investigated the association of pre-existing CVD with use of fluoropyrimidine chemotherapy in tumour-eligible GI cancer patients.

Methods and analysis

National cancer registry data from the Virtual Cardio-Oncology Research Initiative from England between 2014 and 2018 was used to identify GI cancer patients eligible to receive fluoropyrimidine chemotherapy. Linkage to Hospital Episode Statistics and CVD registry data were used to ascertain prior CVD and outcomes. Primary outcome was first administration of fluoropyrimidine chemotherapy following cancer diagnosis. Cox proportional hazard models determined HR and 95% CIs for the association between initiation of fluoropyrimidine treatment and prior CVD.

Results

112 726 eligible patients were identified (median age 71 years (IQR 62–80), 39.7% female). 33 026 (29.3%) had pre-existing CVD. 73 392 (65.1%) patients had a diagnosis of colorectal, 23 208 (20.6%) oesophageal, 14 788 (13.1%) gastric and 1338 (1.2%) small bowel cancer. Individuals with pre-existing CVD had a 27% reduced rate of receiving fluoropyrimidine chemotherapy (HR, 0.73; 95% CI 0.70 to 0.75) on multivariable analysis. Significantly reduced rates of fluoropyrimidine administration were found across all subtypes of pre-existing CVD.

Conclusions

GI cancer patients with all types of pre-existing CVD are less likely to receive fluoropyrimidine chemotherapy despite eligibility. This suggests widespread caution regarding administration of fluoropyrimidines across this population; further research is needed to assess whether such conservatism is justified.
Environmental impact of single-use versus reusable gastroscopes
Authors: Pioche Mathieu , Pohl Heiko , Cunha Neves João A , Laporte Arthur , Mochet Mikael , Rivory Jérôme , Grau Raphaelle , Jacques Jérémie , Grinberg Daniel , Boube Mathilde , Baddeley Robin , Cottinet Pierre-Jean , Schaefer Marion , Rodríguez de Santiago Enrique , Berger Arthur
Published: August 2024

Introduction

The environmental impact of endoscopy is a topic of growing interest. This study aimed to compare the carbon footprint of performing an esogastroduodenoscopy (EGD) with a reusable (RU) or with a single-use (SU) disposable gastroscope.

Methods

SU (Ambu aScope Gastro) and RU gastroscopes (Olympus, H190) were evaluated using life cycle assessment methodology (ISO 14040) including the manufacture, distribution, usage, reprocessing and disposal of the endoscope. Data were obtained from Edouard Herriot Hospital (Lyon, France) from April 2023 to February 2024. Primary outcome was the carbon footprint (measured in Kg CO
2
equivalent) for both gastroscopes per examination. Secondary outcomes included other environmental impacts. A sensitivity analysis was performed to examine the impact of varying scenarios.

Results

Carbon footprint of SU and RU gastroscopes were 10.9 kg CO
2
eq and 4.7 kg CO
2
eq, respectively. The difference in carbon footprint equals one conventional car drive of 28 km or 6 days of CO
2
emission of an average European household. Based on environmentally-extended input-output life cycle assessment, the estimated per-use carbon footprint of the endoscope stack and washer was 0.18 kg CO
2
eq in SU strategy versus 0.56 kg CO
2
eq in RU strategy. According to secondary outcomes, fossil eq depletion was 130 MJ (SU) and 60.9 MJ (RU) and water depletion for 6.2 m
3
(SU) and 9.5 m
3
(RU), respectively.

Conclusion

For one examination, SU gastroscope have a 2.5 times higher carbon footprint than RU ones. These data will help with the logistics and planning of an endoscopic service in relation to other economic and environmental factors.
Australian parental decisions about transitioning children from booster seats in a randomised trial: greater support may be needed
Authors: Powell Stacie , Dai Wennie , Ho Catherine , Albanese Bianca , Keay Lisa , Whyte Tom , Bilston Lynne E , Brown Julie
Published: August 2024

Background

Premature graduation to an adult seatbelt is common and detrimental to optimal crash protection. While there is an existing tool (the5-step test) to support a parent’s decision to graduate their child, its effectiveness is unknown. The aim of this study was to evaluate the5-step test.

Method

A randomised controlled design was used. Participants were parents of children aged 7–12 years. After exposure to information about the5-step testor control material, participants assessed belt fit in three seating conditions and ‘thought aloud’ while making their assessment. Seating conditions provided a good, poor and partially good seatbelt fit based on the child’s anthropometry. Participants were also assessed on their knowledge of good seatbelt fit criteria.

Results

Participants exposed to the5-step test(n=18) had significantly improved their knowledge of the criteria required to achieve good seatbelt with, on average, 1.0 higher score in the 6-point assessment (95% CI 0.23 to 1.7, p=0.012) than those in the control group. There was also a greater percentage of participants in this group (44.4% intervention vs 27.8% control) who made accurate decisions about seatbelt fit, but this difference did not reach significance (OR 2.08, 95% CI 0.52 to 8.34).

Conclusion

The results demonstrate that the5-step testis effective in improving knowledge but are inconclusive about its effectiveness in promoting accurate decision-making. However, the proportion of participants making accurate decisions in the intervention group remained low. This suggests that parents may require greater assistance than what is currently provided.
Bridging thrombolysis before endovascular therapy is associated with better outcomes in patients with large infarction core
Authors: Guo Yu , Xu Yong-Gang , Liu Chao , Zhang Heng-Zhu , Luo Wenmiao
Published: August 2024

Background

This study investigates the efficacy and safety of bridging intravenous thrombolysis (IVT) before endovascular therapy (EVT) compared with EVT alone in patients with large infarction core.

Methods

We conducted a comprehensive search of PubMed, EMBASE, and the Cochrane Library from January 2015 to June 2024. Included studies involved patients with acute ischemic stroke with an Alberta Stroke Program Early CT Score of ≤5 or an ischemic core volume of ≥50 mL. Studies were required to provide either 90-day modified Rankin Scale (mRS) score, reperfusion, symptomatic intracranial hemorrhage (sICH), or 90-day mortality.

Results

Nine observational studies with 2641 patients were analyzed. The IVT+EVT group had a higher rate of 90-day functional independence (mRS 0–2; OR 1.56, 95% CI 1.31 to 1.87; adjusted OR (aOR) 1.43, 95% CI 1.21 to 1.68) and 90-day functional outcome (mRS 0–3; OR 1.34, 95% CI 1.11 to 1.62; aOR 1.18, 95% CI 1.02 to 1.37) compared with EVT alone. There was no significant difference in successful reperfusion (OR 1.01, 95% CI 0.62 to 1.64; aOR 1.07, 95% CI 0.74 to 1.54) and 90-day mortality (OR 0.86, 95% CI 0.73 to 1.02; aOR 0.89, 95% CI 0.77 to 1.04) between the two groups. Moreover, patients who received IVT+EVT had a higher rate of sICH (OR 1.30, 95% CI 1.03 to 1.64; aOR 2.21, 95% CI 1.22 to 4.01).

Conclusions

In patients with large infarction core, bridging IVT before EVT is associated with favorable functional outcomes compared with EVT, even though bridging therapy entails a higher risk of sICH. Further trials are needed to confirm these findings.
Neck apposition is a key factor for aneurysm occlusion after Woven EndoBridge device embolization
Authors: Cortese Jonathan , Juhasz Julia , Rodriguez-Erazú Fernanda , Ghozy Sherief , Bayraktar Esref Alperen , Mihalea Cristian , Zarrintan Armin , Ueki Yasuhito , Caroff Jildaz , Kallmes David F , Spelle Laurent , Kadirvel Ramanathan
Published: August 2024

Background

Sealing of the aneurysm neck with a Woven EndoBridge (WEB) device is recommended for disrupting the blood flow inside the aneurysm. This study investigates the relationship between WEB neck apposition and aneurysm occlusion rates.

Methods

Aneurysms treated with a WEB from March 2017 to May 2022 at a single center were included. WEB neck apposition (poor/good) and WEB protrusion (yes/no) were evaluated on post-detachment high resolution cone beam CT images. Angiographic occlusion was assessed with the Bicêtre Occlusion Scale score (BOSS). Univariate and multivariable analysis tested the association between neck apposition and occlusion rates.

Results

The study included 159 aneurysms in 141 patients (mean age 55.8±11.2 years; 64.2% women). Good neck apposition and protrusion were noted in 123 (77.4%) and 30 (18.9%) cases, respectively. Inter-rater agreements were good for neck apposition (κ=0.75) and protrusion (κ=0.78). Complete and adequate occlusion was achieved in 104 (65%) and 130 (82%) cases, respectively (median follow-up 18 months). Good neck apposition was a strong independent predictor for both adequate (adjusted OR (aOR)=5.9, 95% CI 2.4 to 14.9; P<0.001) and complete occlusion (aOR=7.1, 95% CI 3.0 to 18.1; P<0.001). Protrusion was more frequent in the adequate occlusion group versus the aneurysm recurrence group without reaching statistical significance (P=0.06), but was associated with more thromboembolic complications (9/30 (30%) vs 12/129 (9%); P<0.01). WEB shape modification was significantly greater in poor apposition cases (P=0.03).

Conclusions

Achieving good neck apposition of the WEB strongly predicts aneurysm occlusion during follow-up. WEB protrusion should be minimized due to the increase in thromboembolic risk with limited impact on aneurysm occlusion.
From othering to belonging: a framework for DEI history-telling and strategising
Authors: Edwell April , Edwell Jennifer
Published: August 2024

The medical profession in the USA is—and has long been—a segregated workforce. Currently, just 5.0% of all US physicians are black. Understanding the origins and mechanisms of this disparity is essential to creating a future where black healing and healers are supported by our medical system. In pursuit of this future, this article offers ‘othering’ and ‘belonging’ as frames of analysis and intervention for diversity and equity initiatives.

Building on previous historical studies of racism in medicine, this project reveals how the figure of the ‘American physician’ was created through exclusionary/othering tactics. In part 1, we analyse antebellum historical sources to demonstrate the role of medicine in creating and promulgating racial categories and hierarchies. Next, in part 2, we explore the historical conditions that produced the American physician as a significant professional identity by analysing texts by the American Medical Association and affiliated state medical societies. Then, we turn towards solutions in part 3. To redress inequities produced by othering, particularly the continued exclusion of black people from the medical profession, we argue that medical leaders should cultivate a professional culture of belonging. As we will explain, belonging goes beyond tolerating and respecting difference; it entails shared culture, equal rights and inclusive structures.
Understanding the dynamics of fish spawning phenology and habitat in a changing ecosystem using a long-term ichthyoplankton monitoring dataset
Authors: Hunt Noah , Rokosz Katrina , Chen Yong
Published: August 2024

As ecosystems change, understanding the consequences for fish population dynamics and habitat use is essential for resource management. Using white perch ( Morone americana) survey data on early life stages collected during a long-term ichthyoplankton monitoring program in the Hudson River (New York, USA), an ecosystem under immense pressure from climate change, ecological shifts, and anthropogenic activities, we evaluated the drivers of changes in egg abundance and spawning habitat between 1980 and 2017. Results indicated that egg abundance is associated nonlinearly with temperature, conductivity, discharge, depth, location, and the week of year. We also found that egg abundance has declined within the river over time. Additionally, shifts in hotspots of spawning activity were identified, including evidence that the lower extent of spawning habitat has moved upriver since 1980. This study indicates that the dynamics of white perch early life histories and spawning habitat are changing. It also highlights the utility of a long-term monitoring program for broadening our understanding of fish ecology in the age of big data in changing ecosystems.
Capacity modelling for UAM
Authors: Kleczatský Adam , Kraus Jakub
Published: August 2024

The management of the operation of unmanned aircraft systems and their integration into the common airspace faces various challenges, among which those associated with determining the airspace capacity can also be included. This paper focuses on this challenge and proposes an approach to determine the airspace capacity through the utilization of mathematical modelling, algorithmization, and statistical methods. The constructed model accurately determines airspace capacity, considering factors such as aircraft size, control methods, and potential conflicts resolved at the strategic level of traffic management. Results from simulations demonstrate the model’s validity and effectiveness, highlighting its potential application in planning and evaluating services that are provided to unmanned aircraft.
Interval Shading: using Mesh Shaders to generate shading intervals for volume rendering
Authors: Tricard Thibault
Published: August 2024

We propose to use tetrahedrons as primitives for volume rendering and a pipeline to rasterize them. Our work relies on the recently introduced mesh shaders to encode each tetrahedron such that the rasterizer computes the depths of the front and back faces at the same time when interpolating vertices attributes. Then, the fragment shader receives the two depths and can compute its shading in the interval. Our method is simple to implement, efficient, and opens new possibilities for the rasterization pipeline.
Optimizing Path Termination for Radiance Caching Through Explicit Variance Trading
Authors: Kandlbinder Lukas , Dittebrandt Addis , Schipek Alexander , Dachsbacher Carsten
Published: August 2024

Radiance caching allows to amortize the cost of path tracing by sharing contributions of path suffices in a spatial data structure. This sharing generally introduces bias, but it can be traded with variance by terminating into the cache at deeper path vertices. We develop a framework to implicitly reduce bias by optimizing path termination towards a chosen variance bound. Importantly, this bound can be chosen large enough while still being amenable to denoising. This results in longer paths being sampled with unbiased path tracing as permitted by the estimator variance and variance bound. To that end, we reformulate the variance of a path tracing estimator as a quantity that can be expressed locally for a path, relying on auxiliary statistics that are shared through the radiance cache structure independently of the path prefix. This allows to perform the optimization locally during path construction, while still translating to a global bound. Our method is capable of maintaining the variance bound in complex scenes, resulting in lower bias compared to other techniques such as heuristics based on ray differentials. We additionally present first findings on directly optimizing the bias-variance tradeoff based on local bias estimates of individual cache records, although the optimization is only approximate, resulting in suboptimal termination decisions.
Fast orientable aperiodic ocean synthesis using tiling and blending
Authors: Lutz Nicolas , Schoentgen Arnaud , Gilet Guillaume
Published: August 2024

The simulation and rendering of the surface of a deep ocean are typically carried by computing a mesh displacement through an Inverse Fast Fourier Transform (IFFT) of an animated ocean spectrum. This process generates a spatially periodic ocean displacement that can be tiled to pave a large ocean surface. However, this creates tiling artifacts for large oceans. This effect can be toned down by mixing the displacement with noise, which disturbs the appearance of the ocean, or by overlapping the result of several IFFT at different scales, which increases computation times, all while not fully removing the periodic aspect. We propose to instead use tiling and blending, a procedural generation algorithm popular for real-time texture synthesis, in order to generate variations of the mesh displacement. This method also enables us to author the direction of the waves using a flow map. We show that this method is especially fast and can create a fully aperiodic ocean with minimal downsides.
The Evolution of Kin Discrimination Across the Tree of Life
Authors: Green Jonathan P. , Biernaskie Jay M. , Mee Milo C. , Leedale Amy E.
Published: August 2024

Kin discrimination, the differential treatment of conspecifics based on kinship, occurs across the tree of life, from animals to plants to fungi to bacteria. When kin and nonkin interact, the ability to identify kin enables individuals to increase their inclusive fitness by helping kin, harming nonkin, and avoiding inbreeding. For a given species, the strength of selection for kin discrimination mechanisms is influenced by demographic, ecological, and life-history processes that collectively determine the scope for discrimination and the payoffs from kin-biased behavior. In this review, we explore how these processes drive variation in kin discrimination across taxa, highlighting contributions of recent empirical, comparative, and theoretical work to our understanding of when, how, and why kin discrimination evolves.
Neural Stem Cell Regulation in Zebrafish
Authors: Foley Tanya , Thetiot Melina , Bally-Cuif Laure
Published: August 2024

Neural stem cells (NSCs) are progenitor cell populations generating glial cells and neurons and endowed with long-lasting self-renewal and differentiation potential. While some neural progenitors (NPs) in the embryonic nervous system are also long-lived and match this definition, the term NSC classically refers to such progenitor types in the adult. With the discovery of extensive NSC populations in the adult brain of Danio rerio (zebrafish) and of their high neurogenic activity, including for neuronal regeneration, this model organism has become a powerful tool to characterize and mechanistically dissect NSC properties. On these bases, this article will consider NSCs in the adult zebrafish brain, with a focus on its most extensively characterized domain, the telencephalon (notably its dorsal part, the pallium). Whenever necessary, we will also refer to other brain subdivisions, embryonic processes, and the mouse adult brain, whether for comparative purposes or because more information is available in these other systems.
Revealing the Role of Lithium Carbonate at Lithium Metal Anodes Through Study of Gas-Reacted Interphases
Authors: Steinberg Katherine , Gallant Betar M.
Published: August 2024

A stable, ionically-conductive solid electrolyte interphase (SEI) is vital to lithium (Li) metal anodes, yet key properties of common SEI phases remain unknown. Among these, Li2CO3, central to foundational SEI models, has been difficult to probe given its metastability on Li. To address this, we adopted two approaches: (i) synthesis and study of model Li2CO3-based SEI and (ii) cycling and titration-based analysis of SEI from Li–Cu cells with or without additive CO2, with the aim of modulating Li2CO3 content natively. In (i), reductive instability of Li2CO3 led to co-formation of Li2O and Li2C2 in a multiphasic film with a Li+ conductivity (∼8 × 10−9 S cm−1) more than 4x higher than previously-measured Li2O or LiF films. Li2CO3 content in native interphases from (ii) was found to correlate with decreased inactive Li0 accumulation and improved Coulombic efficiency (CE) across diverse electrolytes having moderate CE. In high CE electrolytes, however, capacity losses become dominated by SEI formation rather than inactive Li0, and Li2CO3 enrichment had negligible impact. This work updates understanding of SEI Li2CO3 formed in modern electrolytes, reveals a leading mechanism by which Li2CO3 can boost CE despite its metastability, and indicates the potential and limitations of enriching this phase through electrolyte design.
High-Entropy Prussian Blue Analogues as High-Capacity Cathode Material for Potassium Ion Batteries
Authors: Yan Wenlong , Feng Xi , Min Xin , Ma Bin , Liu Yangai , Mi Ruiyu , Wu Xiaowen , Wang Wei , Huang Zhaohui , Fang Minghao
Published: August 2024

Potassium ion batteries, due to their similar electrochemical principles to lithium-ion batteries and the abundance of metal sources, are considered one of the alternatives to lithium-ion batteries. The development of new cathode materials has always been a research focus in this field. Among them, Prussian blue materials, with their three-dimensional open and flexible metal framework structure, can efficiently and reversibly store potassium ions. However, Prussian blue cathode materials still face issues such as poor reversibility and low capacity, which limit their application scope. This study investigates the preparation of high-entropy Prussian blue analogues materials to enhance electrochemical performance. The doping of five different transition metals (Fe2⁺, Co2⁺, Cu2+, Ni2+, and Mn2+) sharing the same nitrogen coordination sites results in a configurational entropy greater than 1.5 R for the material. HEPB-1 cathode material (K1.75Mn0.26Fe0.01Ni0.01Cu0.08Co0.09 [Fe(CN)6]0.66·0.83H2O) shows better electrochemical performance, with the initial discharge capacity of 86.69 and 74.51 mAh g−1 (capacity retention is 75.2% after 100 cycles) at 20 and 100 mA g−1, respectively. The research results have provided new insights for the further development and application of potassium ion batteries.
A Hybrid Solid-State Electrolyte with High Lithium-Ion Conductivity and Thermal Stability for Highly Stable Long-Cycle Lithium-Oxygen Batteries
Authors: Li Jie , He Xinlong , Ding Yuhang , Yu Mingfu , Li Qiang , Yuan Wei , Xu Luyan , Sun Hong
Published: August 2024

Solid-state electrolytes in lithium-oxygen batteries have garnered attention due to their high energy density and stability. Traditional electrolytes suffer from high interfacial resistance and poor ionic conductivity. We have developed a novel hybrid solid electrolyte by optimizing the ratio of inorganic to polymer electrolytes, incorporating doped and modified PVDF-HFP-SO3 as the polymer electrolyte in lithium-air batteries for the first time. The crystallinity and performance of this hybrid electrolyte improve with increasing LATP content. Notably, the HSE-SO3-3 electrolyte with 60% LATP exhibits exceptionally high conductivity (4.76 × 10−4 S∙cm−1 at room temperature) and a stability window exceeding 5 V, with stable operation in lithium symmetric cells for over 3500 h. Thermal stability tests indicate that the material does not ignite or deform under flame exposure. In quasi-solid-state lithium-oxygen batteries, using manganese dioxide as a catalyst and HSE-SO3-3 as the electrolyte, the battery demonstrates high discharge capacity, long-term cyclability, and stable charging performance at high rates. Therefore, this novel hybrid solid electrolyte shows great potential for high-voltage solid-state lithium-oxygen batteries.
Aging reveals a sex-dependent susceptibility of sarcospan-deficient mice to cardiometabolic disease
Authors: Rahimi Kahmini Aida , Valera Isela C. , Crawford Rhiannon Q. , Samarah Luaye , Reis Gisienne , Elsheikh Salma , Kanashiro-Takeuchi Rosemeire M. , Mohammadipoor Nazanin , Olateju Bolade S. , Matthews Aaron R. , Parvatiyar Michelle S.
Published: August 2024

Young and aged sarcospan (SSPN)-deficient mice were examined to assess the role of SSPN in obesity and cardiometabolic disease. Both sexes displayed a “leaner” phenotype in response to high-fat diet (HFD). Notably, several sex differences were identified in aged SSPN-deficient mice: 1) females developed glucose intolerance (control and HFD) and 2) males exhibited increased left ventricular mass (control) and diastolic dysfunction (HFD). Therefore, we conclude that SSPN exerts a sex-dependent influence on obesity-associated diseases.
TLR2 Derangements Likely Play a Significant Role in the Inflammatory Response and Thrombosis in Patients with Ph(−) Classical Myeloproliferative Neoplasm
Authors: Wang Jen Chin , Shi Guanfang , Chen Chi , Wong Ching , Gotlieb Vladimir , Joseph Gardith , Nair Kiron V , Boyapati Lakshmi , Ladan Enayati , Symanowski James T. , Sun Lishi
Published: August 2024

We investigated the role of toll‐like receptors (TLRs) in inflammatory pathways in Philadelphia chromosome‐negative myeloproliferative neoplasms (Ph(−)MPNs). TLR2 expression was increased in ET, PV, and MPN (grouped as (PV + (ET) + MF)), whereas TLR4 was elevated only in MPN. TLR3, 7, and 9 were not elevated. Cultured monocyte‐derived dendritic cells and plasma assays in TLR2‐elevated patients were found to secrete more cytokines than those from TLR2‐normal patients. These facts suggest that TLR2 is the major inflammatory pathways in MPN. We also measured S100A9 and reactive oxygen species (ROS), revealing increased S100A9 in PV, MF, and MPN, while ROS were only increased in MF. These data suggests that MPNs initially involve TLR2, with minor contributions from TLR4, and with S100A9, leading to ROS formation, JAK2 mutation, and progression to MF or leukemia. Furthermore, patients with JAK2 mutations or leukocytosis exhibited higher TLR2 expression. In leukocyte–platelet interactions, cells from MPN patients displayed a stronger response to a TLR2 agonist than TLR4 agonist. A TLR2 inhibitor (but not a TLR4 inhibitor) attenuated this response. Thrombosis incidence was higher in TLR2‐elevated patients (29%) than in TLR2‐normal patients (19%). These findings suggest that TLR2 likely contributes to thrombosis in MPN.
A Fault Diagnosis Method for Avionics Equipment Based on SMOTEWB‐LGBM
Authors: Li Gen , Li Wenhai , Wen Tianzhu , Sun Weichao , Tang Xi
Published: August 2024

To tackle the common issue of imbalanced data classes in the fault diagnosis of avionics equipment, this study proposes a method that integrates the Synthetic Minority Oversampling Technique (SMOTE) with Boosting (SMOTEWB) and the Light Gradient Boosting Machine (LGBM). Initially, SMOTEWB is refined through a “successive one‐vs‐many balancing strategy,” which effectively addresses multiclass sample balance issues. The enhanced data is then employed for pattern recognition and classification using LGBM. Additionally, this study utilizes the Tree‐structured Parzen Estimator (TPE) method and five‐fold cross‐validation to optimize the model’s hyperparameters, thus improving diagnostic accuracy. Experimental validation using University of California Irvine (UCI) public datasets and real‐world avionics equipment fault data shows that the proposed SMOTEWB‐LGBM method outperforms other common methods in handling multiclass imbalanced datasets. This new approach not only enhances fault diagnosis efficiency but also offers a potent solution for similar multiclass imbalance challenges.
Establishing the Safety and Efficacy of Bedaquiline‐Containing Regimen for the Treatment of Drug‐Resistant Tuberculosis: A Systematic Review and Meta‐Analysis of Randomized Clinical Trials
Authors: Jihwaprani Muhammad Candragupta , Sun Yipeng , Rizky Wahyu Choirur , Sula Idris , Saquib Nazmus
Published: August 2024

The risks and benefits of bedaquiline (BDQ) for treatment of drug‐resistant tuberculosis (DR‐TB) have not been firmly established. We aimed to assess the safety and efficacy of BDQ‐containing regimens for the treatment of DR‐TB as evidenced in available randomized controlled trials (RCTs). In this systematic review and meta‐analysis, five databases (i.e., ClinicalTrials.gov, Cochrane CENTRAL, PubMed, ScienceDirect, and SinoMed) were searched. RCTs among DR‐TB patients that had a control arm were eligible. The safety endpoints were all‐cause mortality and serious adverse effects (SAEs). Efficacy outcomes were sputum culture conversion rate at 8–12 weeks and 24–26 weeks, treatment success, and time to culture conversion. A total of 476 records were screened; 18 met the eligibility criteria. The pooled analysis included 2520 participants (55.8% received BDQ‐containing regimens, n = 1408). Pooled safety outcomes showed no significant reduction in all‐cause mortality (relative risk [RR] [95%confidence interval (CI)] = 0.94 [0.41–2.20]) or SAEs (RR [95%CI] = 0.91 [0.67–1.23]) in the BDQ‐regimen group. Pooled efficacy outcomes showed significantly superior culture conversion rates at 8–12 weeks (RR [95%CI] = 1.35 [1.10–1.65]) and 24–26 weeks (RR [95%CI] = 1.25 [1.15–1.36]), more treatment success (RR [95%CI] = 1.30 [1.17–1.44]), and a 17‐day reduction in the time to culture conversion (standardized mean difference [SMD] [95%CI] = −17.46 [−34.82 to −0.11]) in the BDQ‐regimen group (reference: non‐BDQ regimen). Overall, BDQ regimens showed significant treatment effect against DR‐TB but did not reduce mortality or SAEs.
Prediction of Tobacco Moisture Content Based on Improved Support Vector Regression Model
Authors: Zhao Shuaibo , Shi Nianfeng , Sun Shibao , Wang Guoqiang , Wang Xilong
Published: August 2024

Drying plays a pivotal role in the production of tobacco. Unlike many other drying processes, tobacco drying exhibits significant nonlinearity and is influenced by numerous factors, rendering accurate predictions challenging. In light of these characteristics, in order to improve the accuracy of tobacco moisture content prediction, in this study, an improved support vector machine regression model was used to simulate the complex dynamic process in the tobacco drying process. Addressing the inherent limitations of differential particle swarm optimization (DPSO), we introduce the chemotaxis operation of bacterial compartmentalization algorithm to guide particles to move to optimal positions during searching. Additionally, we propose particle rotation to improve diversity of search space by changing particle position to facilitate their escape from local optimization and avoid premature convergence of particles. Ultimately, the SVR–QBDPSO model is established by integrating support vector regression (SVR) and Quaternion bacteria‐specific chemotaxis differential particle swarm optimization (QBDPSO). The experimental results demonstrate that this model outperforms other models when applied to the production data of tobacco.
Supplementary Fig. 4 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: August 2024

Supplementary Fig. 4
Adverse Events after Different Endoscopic Resection Procedures for Small and Intermediate-Sized Colorectal Polyps
Authors: Toyosawa Junki , Yamasaki Yasushi , Aoyama Yuki , Takei Kensuke , Igawa Shoko , Inokuchi Toshihiro , Kinugasa Hideaki , Takahara Masahiro , Hiraoka Sakiko , Okada Hiroyuki , Otsuka Motoyuki
Published: August 2024

Introduction: Cold snare polypectomy (CSP) and underwater endoscopic mucosal resection (UEMR) have been developed recently, in addition to conventional methods, but adverse events of each method have not been fully clarified. We compared the outcomes of each method for the appropriate choice. Methods: Patients who underwent CSP, endoscopic mucosal resection (EMR)/hot snare polypectomy (HSP), or UEMR for small and intermediate-sized colorectal polyps between April 2017 and June 2020 were retrospectively examined. The rate of adverse events and recurrences due to each method were determined as the main outcomes. Clinical factors related to adverse events were examined. Results: A total of 1,025 patients with 3,163 polyps underwent polypectomy using any of the methods. CSP, EMR/HSP, and UEMR were performed for 704 (22.2%), 2,145 (67.8%), and 314 polyps (9.9%), and the median size for each method was 4, 6, and 7 mm, respectively. Delayed bleeding for CSP, EMR/HSP, and UEMR was 0%, 0.2%, and 0.6% (p = 0.15), and perforation was 0%, 0.1%, and 0%, respectively (p = 0.62). Recurrence after CSP, EMR/HSP, and UEMR was 0.3%, 0.09%, and 1.3%, respectively (p < 0.01). Recurrence for UEMR was significantly higher in the early stage of procedure introduction (p = 0.015). Oral anticoagulants were the risk factor for delayed bleeding (p < 0.01, respectively). Conclusion: There was no significant difference regarding adverse events among each method for small and intermediate-sized polyps, although the recurrence rate after UEMR was higher than other methods.
Assessing power quality in individual circuits of industrial electrical system
Authors: Angarita Eliana Noriega , Santos Vladimir Sousa , Donolo Pablo Daniel , Quispe Enrique Ciro
Published: August 2024

This article evaluates energy quality in individual circuits within an industrial electrical system and its impact on common connection point parameters. The research is crucial due to rising challenges in power quality arising from increased nonlinear electrical loads in industrial processes. The study involves sequential steps, covering the industrial electrical system´s description, power quality parameters analysis, and issue identification. A comprehensive assessment was conducted on a 3,000 kVA, 13.8 kV/460 V point of common coupling (PCC) transformer, and 10 transformers (10 to 250 kVA) supplying individual circuits. Findings indicated load factors below 70% in all transformers and a power factor below 0.9 in eight. Issues like voltage variation, current imbalance, and harmonic distortion were identified in nine transformers supplying individual circuits, while the PCC exhibited no power quality problems. The research emphasizes the importance of including individual circuits in power quality assessments, as compliance with regulatory limits at the PCC may not guarantee the absence of power quality issues in individual circuits, affecting equipment lifespan and increasing energy losses.