bluuebunny/crossref_metadata_2025 huggingface dataset:
Relation of Pulmonary Diffusing Capacity Decline to HRCT and VQ SPECT/CT Findings at Early Follow-Up after COVID-19: A Prospective Cohort Study (The SECURe Study)
Authors: Katzenstein Terese L. , Christensen Jan , Lund Thomas Kromann , Kalhauge Anna , Rönsholt Frederikke , Podlekareva Daria , Arndal Elisabeth , Berg Ronan M. G. , Helt Thora Wesenberg , Lebech Anne-Mette , Mortensen Jann
Published: September 2022

A large proportion of patients exhibit persistently reduced pulmonary diffusion capacity after COVID-19. It is unknown whether this is due to a post-COVID restrictive lung disease and/or pulmonary vascular disease. The aim of the current study was to investigate the association between initial COVID-19 severity and haemoglobin-corrected diffusion capacity to carbon monoxide (DLco) reduction at follow-up. Furthermore, to analyse if DLco reduction could be linked to pulmonary fibrosis (PF) and/or thromboembolic disease within the first months after the illness, a total of 67 patients diagnosed with COVID-19 from March to December 2020 were included across three severity groups: 12 not admitted to hospital (Group I), 40 admitted to hospital without intensive care unit (ICU) admission (Group II), and 15 admitted to hospital with ICU admission (Group III). At first follow-up, 5 months post SARS-CoV-2 positive testing/4 months after discharge, lung function testing, including DLco, high-resolution CT chest scan (HRCT) and ventilation-perfusion (VQ) single photon emission computed tomography (SPECT)/CT were conducted. DLco was reduced in 42% of the patients; the prevalence and extent depended on the clinical severity group and was typically observed as part of a restrictive pattern with reduced total lung capacity. Reduced DLco was associated with the extent of ground-glass opacification and signs of PF on HRCT, but not with mismatched perfusion defects on VQ SPECT/CT. The severity-dependent decline in DLco observed early after COVID-19 appears to be caused by restrictive and not pulmonary vascular disease.
An Automatic Voxel-Based Method for Optimal Symmetry Plane Generation for the Maxillofacial Region in Severe Asymmetry Cases
Authors: Hsiao Yu-Ching , Fang Jing-Jing
Published: September 2022

Symmetry is representative of aesthetics and health in all kinds of vertebrates, especially the human face. Therefore, to automatically locate the appropriate symmetry plane is crucial. The aim of this study was to develop an automatic and reliable method to determine the symmetry plane of the maxillofacial region. We compared the proposed method of determining the symmetry plane by assessing landmark-based and surface-based methods by way of quantitative symmetry assessments. Statistical analysis was applied to evaluate whether significant difference existed among these three kinds of symmetry planes. Twenty cases who had a diagnosis of severe facial asymmetry were evaluated retrospectively. The results showed that searching for the symmetry plane using a voxel-based method, named the optimal symmetry plane (OSP), achieved the most representative symmetry according to the outcomes of the trials. The OSP was significantly more symmetrical than the other two planes, as determined by other methods. The paired-voxel computation method proposed in this research is a robust and reliable method for identifying the unique symmetry plane for patients with severe facial asymmetry. Symmetry is of crucial significance for all kinds of vertebrates, including its clinical implications for surgical planning in orthognathic surgery.
Quality of Life in Low-Risk MDS: An Undervalued Endpoint
Authors: Heyrman Bert
Published: September 2022

The opinion I put forward in this paper is that attention must be paid to health-related quality of life as a study endpoint in lower-risk MDS patients. At the moment therapeutic options are limited in this population. New treatments are predominantly available in clinical studies. In announcing trial publications and during manuscript introductions, quality of life is widely valued as a treatment goal. However, data on health-related quality of life during phase III studies are not published in the original publications, thereby undermining the importance of quality of life as a study endpoint. What seems to be forgotten is that quality of life comprises more than a study endpoint. It is the highest good of lower-risk MDS patients and should also be acknowledged as a safety aspect. Current phase II trials with new medications do not collect data on health-related quality of life, a practice that I consider unethical. In this opinion I demonstrate the current attitude towards health-related quality of life in lower risk MDS patients among leading journals and trial sponsors with several recent examples. I also argue that health-related quality of life should be the main treatment goal in this population. In the event that we shift our focus towards health-related quality of life as the main treatment goal, new treatments could come to a field where gains in overall survival have been marginal over the years.
Statistical and Diagnostic Properties of pRRx Parameters in Atrial Fibrillation Detection
Authors: Buś Szymon , Jędrzejewski Konrad , Guzik Przemysław
Published: September 2022

Background: We studied the diagnostic properties of the percentage of successive RR intervals differing by at least x ms (pRRx) as functions of the threshold value x in a range of 7 to 195 ms for the differentiation of atrial fibrillation (AF) from sinus rhythm (SR). Methods: RR intervals were measured in 60-s electrocardiogram (ECG) segments with either AF (32,141 segments) or SR (32,769 segments) from the publicly available Physionet Long-Term Atrial Fibrillation Database (LTAFDB). For validation, we have used ECGs from the Massachusetts Institute of Technology–Beth Israel Hospital (MIT–BIH) Atrial Fibrillation Database. The pRRx distributions in AF and SR in relation to x were studied by histograms, along with the mutual association by the nonparametric Spearman correlations for all pairs of pRRx, and separately for AF or SR. The optimal cutoff values for all pRRx were determined using the receiver operator curve characteristic. A nonparametric bootstrap with 5000 samples was used to calculate a 95% confidence interval for several classification metrics. Results: The distributions of pRRx for x in the 7–195 ms range are significantly different in AF than in SR. The sensitivity, specificity, accuracy, and diagnostic odds ratios differ for pRRx, with the highest values for x = 31 ms (pRR31) rather than x = 50 (pRR50), which is most commonly applied in studies on heart rate variability. For the optimal cutoff of pRR31 (68.79%), the sensitivity is 90.42%, specificity 95.37%, and the diagnostic odds ratio is 194.11. Validation with the ECGs from the MIT–BIH Atrial Fibrillation Database confirmed our findings. Conclusions: We demonstrate that the diagnostic properties of pRRx depend on x, and pRR31 outperforms pRR50, at least for ECGs of 60-s duration.
Impact of Cardiopulmonary Resuscitation on Emergency Medical Staff—Romanian Perspective (IRESUS-EMS)
Authors: Nedelea Paul-Lucian , Corlade-Andrei Mihaela , Kantor Cristina , Popa Ovidiu Tudor , Manolescu Emilian , Cimpoeșu Diana
Published: September 2022

Background: Unnecessary resuscitation is defined as putting in a disproportionate amount of effort compared to the patients’ prognosis and chance of survival. The primary objective of this study was to determine the number of resuscitations perceived as unnecessary by emergency medical personnel and to correlate it with the characteristics of resuscitation team members, patient particularities and organizational factors related to the professional environment. Methods: This was a prospective cross-sectional study carried out in the emergency department of a university hospital, exploring the perception of the uselessness of cardiopulmonary resuscitation (CPR) through the completion of a questionnaire. Results: In total, 70.37% of respondents are often involved in CPR attempts in which the efforts made are disproportionate compared to the patients’ expected prognosis, in terms of survival or quality of life. The presence of a non-shockable rhythm increased, by two times, the chances of medical staff finding it unnecessary to initiate CPR. Conclusions: The current study was the first in Romania to investigate the perception of unnecessary CPR, based on the recollection of the last resuscitation performed by the emergency medical staff. The objective criteria related to the patient were the most important predictors for assessing the adequacy of the decision to initiate CPR.
Technique, Feasibility, Utility, Limitations, and Future Perspectives of a New Technique of Applying Direct In-Scope Suction to Improve Outcomes of Retrograde Intrarenal Surgery for Stones
Authors: Gauhar Vineet , Somani Bhaskar Kumar , Heng Chin Tiong , Gauhar Vishesh , Chew Ben Hall , Sarica Kemal , Teoh Jeremy Yuen-Chun , Castellani Daniele , Saleem Mohammed , Traxer Olivier
Published: September 2022

Retrograde intrarenal surgery (RIRS) is accepted as a primary modality for the management of renal stones up to 2 cm. The limitations of RIRS in larger volume stones include limited visualization due to the snow-globe effect and persistence of fragments that cannot be removed. We describe a new, simple, cost-effective modification that can be attached to any flexible ureteroscope which allows simultaneous/alternating suction and aspiration during/after laser lithotripsy using the scope as a conduit to remove the fragments or dust from the pelvicalyceal system called direct in-scope suction (DISS) technique. Between September 2020 and September 2021, 30 patients with kidney stones underwent RIRS with the DISS technique. They were compared with 28 patients who underwent RIRS with a 11Fr/13Fr suction ureteral access sheaths (SUASs) in the same period. RIRS and laser lithotripsy were carried out traditionally with a Holmium laser for the SUAS group or a thulium fiber laser for the DISS group. There was no difference in age, gender, and history of renal lithiasis between the two groups. Ten (40%) patients had multiple stones in the DISS groups, whilst there were no patients with multiple stones in the SUAS group. Median stone size was significantly higher in the DISS group [22.0 (18.0–28.8) vs. 13.0 (11.8–15.0) millimeters, p < 0.001]. Median surgical time was significantly longer in the DISS group [80.0 (60.0–100) minutes] as compared to the SUAS group [47.5 (41.5–60.3) minutes, p < 0.001]. Hospital stay was significantly shorter in the DISS group [1.00 (0.667–1.00) vs. 1.00 (1.00–2.00) days, p = 0.02]. Postoperative complications were minor, and there was no significant difference between the two groups. The incidence of residual fragments did not significantly differ between the two groups [10 (33.3%) in the DISS group vs. 10 (35.7%) in the SUAS group, p = 0.99] but 10 (33.3%) patients required a further RIRS for residual fragments in the DISS group, whilst only one (3.6%) patient in the SUAS group required a subsequent shock wave lithotripsy treatment. Our audit study highlighted that RIRS with DISS technique was feasible with an acceptable rate of retreatment as compared to RIRS with SUAS.
Pleiotropic Effects of Vitamin D in Patients with Inflammatory Bowel Diseases
Authors: Szymczak-Tomczak Aleksandra , Ratajczak Alicja Ewa , Kaczmarek-Ryś Marta , Hryhorowicz Szymon , Rychter Anna Maria , Zawada Agnieszka , Słomski Ryszard , Dobrowolska Agnieszka , Krela-Kaźmierczak Iwona
Published: September 2022

The multifaceted activity of vitamin D in patients with inflammatory bowel disease (IBD) presents a challenge for further research in this area. Vitamin D is involved in the regulation of bone mineral metabolism, it participates in the regulation of the immune system, and it is an underlying factor in the pathogenesis of IBD. Additionally, vitamin D affects Th1 and Th2 lymphocytes, influencing the release of cytokines and inhibiting tumor necrosis factor (TNF) expression and the wnt/β-catenin pathway. As far as IBDs are concerned, they are associated with microbiota dysbiosis, abnormal inflammatory response, and micronutrient deficiency, including vitamin D hypovitaminosis. In turn, the biological activity of active vitamin D is regulated by the vitamin D receptor (VDR) which is associated with several processes related to IBD. Therefore, in terms of research on vitamin D supplementation in IBD patients, it is essential to understand the metabolic pathways and genetic determinants of vitamin D, as well as to identify the environmental factors they are subject to, not only in view of osteoporosis prevention and therapy, but primarily concerning modulating the course and supplementation of IBD pharmacotherapy.
The Impact of COVID-19 on Lombardy Region ST-Elevation Myocardial Infarction Emergency Medical System Network—A Three-Year Study
Authors: Stirparo Giuseppe , Bellini Lorenzo , Ristagno Giuseppe , Bonora Rodolfo , Pagliosa Andrea , Migliari Maurizio , Andreassi Aida , Signorelli Carlo , Sechi Giuseppe M. , Fagoni Nazzareno
Published: September 2022

Objectives: The COVID-19 pandemic had a significant impact on emergency medical systems (EMS). Regarding the ST-elevation myocardial infarction (STEMI) dependent time network, however, there is little evidence linked to the post-pandemic phase regarding this issue. Such information could prove to be of pivotal importance regarding STEMI clinical management, especially pre-hospital clinical protocols such as fibrinolysis. Methods: A retrospective observational cohort study of all STEMI rescues recorded in the Lombardy EMS registry from the 1st of January 2019 to the 30th of December 2021. Results: Regarding the number of STEMI diagnoses, March 2020 (first pandemic wave in Italy) saw a reduction compared to March 2019 (OR 0.76 [0.60–0.93], p = 0.011). The average time of the entire mission increased to 63.1 min in 2021, reaching 64.7 min in 2020, compared with 57.7 min in 2019. The number of HUBs for STEMI patients saw a reduction, falling from 52 HUBs in the pre-pandemic phase to 13 HUBs during the first wave. Conclusions: During the pandemic phase, there was an increase in the transportation times of STEMI patients from home to the hospital. Such changes did not alter the clinical approach in the out-of-hospital phase. Indeed, the implementation of fibrinolysis was not required.
Respiratory Subsets in Patients with Moderate to Severe Acute Respiratory Distress Syndrome for Early Prediction of Death
Authors: Villar Jesús , Fernández Cristina , González-Martín Jesús M. , Ferrando Carlos , Añón José M. , del Saz-Ortíz Ana M. , Díaz-Lamas Ana , Bueno-González Ana , Fernández Lorena , Domínguez-Berrot Ana M. , Peinado Eduardo , Andaluz-Ojeda David , González-Higueras Elena , Vidal Anxela , Fernández M. Mar , Mora-Ordoñez Juan M. , Murcia Isabel , Tarancón Concepción , Merayo Eleuterio , Pérez Alba , Romera Miguel A. , Alba Francisco , Pestaña David , Rodríguez-Suárez Pedro , Fernández Rosa L. , Steyerberg Ewout W. , Berra Lorenzo , Slutsky Arthur S. ,   The Spanish Initiative for Epidemiology, Stratification and Therapies of ARDS (SIESTA) Network
Published: September 2022

Introduction: In patients with acute respiratory distress syndrome (ARDS), the PaO2/FiO2 ratio at the time of ARDS diagnosis is weakly associated with mortality. We hypothesized that setting a PaO2/FiO2 threshold in 150 mm Hg at 24 h from moderate/severe ARDS diagnosis would improve predictions of death in the intensive care unit (ICU). Methods: We conducted an ancillary study in 1303 patients with moderate to severe ARDS managed with lung-protective ventilation enrolled consecutively in four prospective multicenter cohorts in a network of ICUs. The first three cohorts were pooled (n = 1000) as a testing cohort; the fourth cohort (n = 303) served as a confirmatory cohort. Based on the thresholds for PaO2/FiO2 (150 mm Hg) and positive end-expiratory pressure (PEEP) (10 cm H2O), the patients were classified into four possible subsets at baseline and at 24 h using a standardized PEEP-FiO2 approach: (I) PaO2/FiO2 ≥ 150 at PEEP < 10, (II) PaO2/FiO2 ≥ 150 at PEEP ≥ 10, (III) PaO2/FiO2 < 150 at PEEP < 10, and (IV) PaO2/FiO2 < 150 at PEEP ≥ 10. Primary outcome was death in the ICU. Results: ICU mortalities were similar in the testing and confirmatory cohorts (375/1000, 37.5% vs. 112/303, 37.0%, respectively). At baseline, most patients from the testing cohort (n = 792/1000, 79.2%) had a PaO2/FiO2 < 150, with similar mortality among the four subsets (p = 0.23). When assessed at 24 h, ICU mortality increased with an advance in the subset: 17.9%, 22.8%, 40.0%, and 49.3% (p < 0.0001). The findings were replicated in the confirmatory cohort (p < 0.0001). However, independent of the PEEP levels, patients with PaO2/FiO2 < 150 at 24 h followed a distinct 30-day ICU survival compared with patients with PaO2/FiO2 ≥ 150 (hazard ratio 2.8, 95% CI 2.2–3.5, p < 0.0001). Conclusions: Subsets based on PaO2/FiO2 thresholds of 150 mm Hg assessed after 24 h of moderate/severe ARDS diagnosis are clinically relevant for establishing prognosis, and are helpful for selecting adjunctive therapies for hypoxemia and for enrolling patients into therapeutic trials.
Clinical Outcomes after Bilateral Implantation of Trifocal Diffractive Intraocular Lenses and Extended Depth of Focus Intraocular Lenses
Authors: Shin Kyoung Yoon , Lim Dong Hui , Chung Tae-Young
Published: September 2022

The purpose of this retrospective study is to investigate clinical outcomes of bilateral implantation of diffractive trifocal intraocular lenses (IOLs) and extended depth of focus IOLs in Koreans. The clinical outcomes of cataract surgery with bilateral implantation of PanOptix, FineVision, Symfony, and MiniWell were evaluated. Uncorrected distant, intermediate (80 cm, 60 cm), near (40 cm) visual acuity, defocus curve, manifest refraction, contrast sensitivity, and higher-order aberrations, quality of vision, spectacle independence, and subjective satisfaction at postoperative 3 months were assessed. A total of 136 eyes in 68 patients were included in the analyses. PanOptix and FineVision performed better visual acuity compared to Symfony and MiniWell at 40 cm distance. Defocus curve showed broad range of vision in PanOptix and FineVision with visual acuity of more than 0.1 logarithm of the minimum angle of resolution at −2.5 diopter (D) of defocus power, while Symfony and MiniWell presented excellent intermediate vision without a dip at defocus power of −0.5 D to −1.0 D. Glare, halo, and starburst were significantly less in MiniWell compared to others. In conclusion, all four IOLs presented satisfactory clinical outcomes. PanOptix and FineVision provided good near and intermediate vision, while Symfony and MiniWell provided good intermediate vision. MiniWell induced little dysphotopsia.
Surface Damage in Woven Carbon Composite Panels under Orthogonal and Inclined High-Velocity Impacts
Authors: Rodriguez Veronica Marchante , Grasso Marzio , Zhao Yifan , Liu Haochen , Deng Kailun , Roberts Andrew , Appleby-Thomas Gareth James
Published: September 2022

The present research is aimed at the study of the failure analysis of composite panels impacted orthogonally at a high velocity and with an angle. Woven carbon-fibre panels with and without external Kevlar layers were impacted at different energy levels between 1.2 and 39.9 J. Sharp and smooth gravels with a mass from 3.1 to 6.7 g were used to investigate the effects of the mass and the contact area on the damage. Optical microscopy and thermography analyses were carried out to identify internal and surface damage. It was identified that sharp impactors created more damage on the impacted face of the panels, while the presence of a Kevlar layer increased the penetration limit and reduced the damage level in the panel at a higher energy.
Comparison of Structural Performance and Environmental Impact of Epoxy Composites Modified by Glass and Flax Fabrics
Authors: Koronis Georgios , Silva Arlindo , Ong Michael
Published: September 2022

Comparing the structural performance and environmental impact of parts made of natural and synthetic fibers has become increasingly important for industry and education, as the benefits of one type of fiber over another are not always clear. The current work discusses the advantages and disadvantages of using natural and synthetic fibers and compares the flexural performance of parts made of each of these fibers and their environmental impact. This paper investigates the flexural behavior of epoxy composites modified by glass and flax fabrics through experimental, numerical, and analytical studies. Specimens with various fabrics (dried and non-dried) were fabricated to test their performance. The failure of unidirectional glass and flax fiber reinforced polymer composite laminate was examined by destructive testing. A finite-element model was developed, and the mechanical behaviors of fiber-reinforced composites were predicted in a three-point bending test. Experimental results were compared to numerical analysis to validate the model’s accuracy. A life cycle assessment (LCA) was employed to determine the climate impact of composite production. The analysis revealed a decreased environmental effect of plant-based panels suggesting that they are less energy and CO2 intensive than synthetic solutions. The LCA model can be applied in further studies of products that consist of or use flax-based composites.
Comprehensive and Comparative Heat Treatment of Additively Manufactured Inconel 625 Alloy and Corresponding Microstructures and Mechanical Properties
Authors: Luna Victoria , Trujillo Leslie , Gamon Ariel , Arrieta Edel , Murr Lawrence E. , Wicker Ryan B. , Katsarelis Colton , Gradl Paul R. , Medina Francisco
Published: September 2022

This study examines and compares the microstructures, Vickers microindentation hardness, and mechanical properties for additively manufactured (AM) samples built by a variety of AM processes: wire arc AM (WAAM), electron beam powder bed fusion (EB-PBF), laser wire direct energy deposition (LW-DED), electron beam direct energy deposition (EB-DED), laser-powered direct energy deposition (LP-DED), and laser powder bed fusion (L-PBF). These AM process samples were post-processed and heat-treated by stress relief annealing at 1066 °C, HIP at 1163 °C, and solution annealing treatment at 1177 °C. The resulting microstructures and corresponding microindentation hardnesses were examined and compared with the as-built AM process microstructures and hardnesses. Fully heat-treated AM process samples were mechanically tested to obtain tensile properties and were also evaluated and compared. Principal findings in this study were that high-temperature heat treatment >1100 °C of AM process-built samples was dominant and exhibited recrystallized, equiaxed grains containing fcc {111} annealing twins and second phase particles independent of the AM process, in contrast to as-built columnar/dendritic structures. The corresponding yield stress values ranged from 285 MPa to 371 MPa, and elongations ranged from 52% to 70%, respectively. Vickers microindentation hardnesses (HV) over this range of heat-treated samples varied from HV 190 to HV 220, in contrast to the as-built samples, which varied from HV 191 to HV 304.
Machine Learning Application Using Cost-Effective Components for Predictive Maintenance in Industry: A Tube Filling Machine Case Study
Authors: Natanael David , Sutanto Hadi
Published: September 2022

Maintenance is an activity that cannot be separated from the context of product manufacturing. It is carried out to maintain the components’ or machines’ function so that no failure can reduce the machine’s productivity. One type of maintenance that can mitigate total machine failure is predictive maintenance. Predictive maintenance, along with the times, no longer relies on visuals or other senses but can be combined into automated observations using machine learning methods. It can be applied to a toothpaste factory with a tube filling machine by combining the results of sensor observations with machine learning methods. This research aims to increase the Overall equipment effectiveness (OEE) to 10% by predicting the components that will be damaged. The machine learning methods tested in this study are random forest regression and linear regression. This study indicates that the prediction accuracy of machine learning with the random forest regression method for PHM predictive is 88%of the actual data, and linear regression has an accuracy of 59% of the actual data. After implementing the system on the machine for three months, the OEE value increased by 13.10%, and unplanned machine failure decreased by 62.38% in the observed part. Implementation of the system can significantly reduce the failure factor of unplanned machines.
Numerical Investigation on Temporal Evolution Behavior for Triad Resonant Interaction Induced by Steady Free-Surface Flow over Rippled Bottoms
Authors: Fan Jun , Tao Aifeng , Zheng Jinhai , Peng Ji
Published: September 2022

Investigating the wave hydrodynamics of free-surface flow over rippled bottoms is a continuing concern due to the existence of submarine multiple sandbars and ambient flow in coastal and estuarial areas. More attention to free-surface wave stimulation has been received from the perspective of resonant wave-wave interaction, which is an intensive way for wave energy transfer and a potential way for wave component generation. However, the basic behavior of the triad resonant interaction of this problem is still limited and unclear. In this study, the triad resonant interaction induced by steady free-surface flow over rippled bottoms is numerically investigated by means of the High-Order Spectral (HOS) method. By considering the interactions among free-surface waves, ambient current, and rippled bottoms, the numerical model is applied for this situation based on Zakharov equation with ambient flow term. The temporal evolution of the triad resonant wave amplitude has been numerically investigated and compared well with multiple-scale expansion perturbation theory. Specifically, the temporal evolution behaviors of all six triad resonant wave components are confirmed by both numerical simulation and nonlinear perturbation analysis.
On the Sparse Gradient Denoising Optimization of Neural Network Models for Rolling Bearing Fault Diagnosis Illustrated by a Ship Propulsion System
Authors: Wang Shuangzhong , Zhang Ying , Zhang Bin , Fei Yuejun , He Yong , Li Peng , Xu Mingqiang
Published: September 2022

The drive rolling bearing is an important part of a ship’s system; the detection of the drive rolling bearing is an important component in ship-fault diagnosis, and machine learning methods are now widely used in the fault diagnosis of rolling bearings. However, training methods based on small batches have a disadvantage in that the samples which best represent the gradient descent direction can be disturbed by either other samples in the opposite direction or anomalies. Aiming at this problem, a sparse denoising gradient descent (SDGD) optimization algorithm, based on the impact values of network nodes, was proposed to improve the updating method of the batch gradient. First, the network is made sparse by using the node weight method based on the mean impact value. Second, the batch gradients are clustered via a distribution-density-based clustering method. Finally, the network parameters are updated using the gradient values after clustering. The experimental results show the efficiency and feasibility of the proposed method. The SDGD model can achieve up to a 2.35% improvement in diagnostic accuracy compared to the traditional network diagnosis model. The training convergence speed of the SDGD model improves by 2.16%, up to 17.68%. The SDGD model can effectively solve the problem of falling into the local optimum point while training a network.
Collision Risk Situation Clustering to Design Collision Avoidance Algorithms for Maritime Autonomous Surface Ships
Authors: Hwang Taewoong , Youn Ik-Hyun
Published: September 2022

The reliability of collision avoidance systems for Maritime Autonomous Surface Ships is one of the most critical factors for their safety. In particular, since many ship collisions occur in coastal areas, it is crucial to ensure the reliability of collision avoidance algorithms in geographically limited coastal waters. However, studies on maritime autonomous surface ships collision avoidance algorithms mainly focus on the traffic factor despite the importance of the geographic factor. Therefore, this study presents a methodology for establishing a practical collision avoidance system test bed, considering the geographic environment. The proposed methodology is a data-driven approach that objectively categorizes collision risk situations by extracting these risks using Automatic Identification System (AIS) and Electronic Navigational Chart (ENC) data, followed by clustering algorithms. Consequently, the research results present a direction for establishing test beds from the perspective of geographic and traffic factors.
Physical Mechanism for Seabed Scouring around a Breakwater—A Case Study in Mailiao Port
Authors: Tseng I-Fan , Hsu Chih-Hung , Yeh Po-Hung , Lin Ting-Chieh
Published: September 2022

According to a field survey in 2012, the bathymetry near Mailiao Port, located in central Taiwan’s west coast, has a scouring hole that extends approximately 500 m × 100 m with a maximum scour depth of 26 m (eroded from its design depth −22 m to −48 m). To investigate the scour mechanism near the breakwater head and prevent the breakwater from collapsing, this study conducts comprehensive analysis by analyzing field observed data, performing hydraulic model tests, and conducting numerical modeling for the area near the Mailiao Port. The results show that the current plays an important role in the scour process. The physical model tests and numerical simulations both can reproduce the scour phenomenon of the study site. By analyzing field observed data we validated through physical and numerical models. This study concludes that the current caused by the ebb and flood tide, as well as the steep and shallow seabed topography, together comprise the seabed scour mechanism near the Mailiao Port breakwater head.
The Drug H+ Antiporter FgQdr2 Is Essential for Multiple Drug Resistance, Ion Homeostasis, and Pathogenicity in Fusarium graminearum
Authors: Ma Tianling , Li Yiqing , Lou Yang , Shi Junrui , Sun Kewei , Ma Zhonghua , Yan Leiyan , Yin Yanni
Published: September 2022

Increased emergence of drug resistance and DON pollution pose a severe problem in Fusarium head blight (FHB) control. While the H+ antiporter (DHA) family plays crucial roles in drug resistance, the characterization of DHA transporters has not been systematically studied in pathogenetic fungi. In this study, a systematic gene deletion analysis of all putative DHA transporter genes was carried out in Fusarium graminearum, and one DHA1 transporter FgQdr2 was found to be involved in multiple drug resistance, ion homeostasis, and virulence. Further exploration showed that FgQdr2 is mainly localized in the cell membrane; its expression under normal growth conditions is comparatively low, but sufficient for the regulation of drug efflux. Additionally, investigation of its physiological substrates demonstrated that FgQdr2 is essential for the transport of K+, Na+, Cu2+, and the regulation of the membrane proton gradient. For its roles in the FHB disease cycle, FgQdr2 is associated with fungal infection via regulating the biosynthesis of virulence factor deoxynivalenol (DON), the scavenging of the phytoalexin, as well as both asexual and sexual reproduction in F. graminearum. Overall, the results of this study reveal the crucial roles of FgQdr2 in multiple drug resistance, ion homeostasis, and pathogenicity, which advance the understanding of the DHA transporters in pathogenetic fungi.
Assessment of Biofilm Formation by Candida albicans Strains Isolated from Hemocultures and Their Role in Pathogenesis in the Zebrafish Model
Authors: Pokhrel Sabi , Boonmee Nawarat , Tulyaprawat Orawan , Pharkjaksu Sujiraphong , Thaipisutikul Iyarit , Chairatana Phoom , Ngamskulrungroj Popchai , Mitrpant Chalermchai
Published: September 2022

Candida albicans, an opportunistic pathogen, has the ability to form biofilms in the host or within medical devices in the body. Biofilms have been associated with disseminated/invasive disease with increased severity of infection by disrupting the host immune response and prolonging antifungal treatment. In this study, the in vivo virulence of three strains with different biofilm formation strengths, that is, non-, weak-, and strong biofilm formers, was evaluated using the zebrafish model. The survival assay and fungal tissue burden were measured. Biofilm-related gene expressions were also investigated. The survival of zebrafish, inoculated with strong biofilms forming C. albicans,, was significantly shorter than strains without biofilms forming C. albicans. However, there were no statistical differences in the burden of viable colonogenic cell number between the groups of the three strains tested. We observed that the stronger the biofilm formation, the higher up-regulation of biofilm-associated genes. The biofilm-forming strain (140 and 57), injected into zebrafish larvae, possessed a higher level of expression of genes associated with adhesion, attachment, filamentation, and cell proliferation, including eap1, als3, hwp1, bcr1, and mkc1 at 8 h. The results suggested that, despite the difference in genetic background, biofilm formation is an important virulence factor for the pathogenesis of C. albicans. However, the association between biofilm formation strength and in vivo virulence is controversial and needs to be further studied.
The Effect of Plant Growth Promoting Rhizobacteria (PGPRs) on Yield and Some Quality Parameters during Shelf Life in White Button Mushroom (Agaricus bisporus L.)
Authors: Eren Erkan
Published: September 2022

The use of different bacteria that increase yield and quality in plant production has become common since the 1990s. However, effects of plant growth promoting rhizobacterial (PGPR) treatments during the cultivation period of white button mushroom on quality during marketing duration are not known exactly. This study was carried out to determine the effects of different PGPRs in compost medium on mushroom yield and quality. For this reason, Azospillum lipoferum, Bacillus megaterium, Frateuria aurantia and Thiobacillus thiooxidans, for promoting nitrogen, phosphorus, potassium and sulfur transport, respectively, were applied at a 3 mL per m2 concentration on the 12th day of the spawn run period. Control groups were treated with only water. Azospillum lipoferum increased yield at a rate of 33.3% by enhancing mushroom number per unit area. Shelf life characteristics were observed in mushrooms after storage at 1 °C and at 20 ± 1 °C for 2 days. Bacillus megaterium, Frateuria aurantia and Thiobacillus thiooxidans treatments decreased weight loss and loss in cap firmness, total phenolic compounds and antioxidant capacity during shelf life. However, Azospillum lipoferum for increased yield and Frateuria aurantia and Bacillus megaterium for maintaining postharvest quality were promising treatments during shelf life.
Exogenous Regulators Enhance the Yield and Stress Resistance of Chlamydospores of the Biocontrol Agent Trichoderma harzianum T4
Authors: Zhu Xiaochong , Wang Yaping , Wang Xiaobing , Wang Wei
Published: September 2022

Trichoderma strains have been successfully used in plant disease control. However, the poor stress resistance of mycelia and conidia makes processing and storage difficult. Furthermore, they cannot produce chlamydospores in large quantities during fermentation, which limits the industrialization process of chlamydospore preparation. It is important to explore an efficient liquid fermentation strategy for ensuring chlamydospore production in Trichoderma harzianum. We found that the addition of mannitol, glycine betaine, and N-acetylglucosamine (N-A-G) during liquid fermentation effectively increases the yield of chlamydospores. Furthermore, we provided evidence that chlamydospores have stronger tolerance to high temperature, ultraviolet, and hypertonic stress after the addition of mannitol and trehalose. Lipids are an important component of microbial cells and impact the stress resistance of microorganisms. We studied the internal relationship between lipid metabolism and the stress resistance of chlamydospores by detecting changes in the lipid content and gene expression. Our results showed that mannitol and trehalose cause lipid accumulation in chlamydospores and increase the unsaturated fatty acid content. In conclusion, we verified that these exogenous regulators increase the production of chlamydospores and enhance their stress resistance by regulating lipid metabolism. In addition, we believe that lipid metabolism is an important part of the chlamydospore production process and impacts the stress resistance of chlamydospores. Our findings provide clues for studying the differentiation pathway of chlamydospores in filamentous fungi and a basis for the industrial production of chlamydospores.
Identification of Dermatophyte and Non-Dermatophyte Agents in Onychomycosis by PCR and DNA Sequencing—A Retrospective Comparison of Diagnostic Tools
Authors: Pospischil Isabella , Reinhardt Charlotte , Bontems Olympia , Salamin Karine , Fratti Marina , Blanchard Gabriela , Chang Yun-Tsan , Wagner Helga , Hermann Philipp , Monod Michel , Hoetzenecker Wolfram , Guenova Emmanuella
Published: September 2022

Rapid and reliable fungal identification is crucial to delineate infectious diseases, and to establish appropriate treatment for onychomycosis. Compared to conventional diagnostic methods, molecular techniques are faster and feature higher accuracy in fungal identification. However, in current clinical practice, molecular mycology is not widely available, and its practical applicability is still under discussion. This study summarizes the results of 16,094 consecutive nail specimens with clinical suspicion of onychomycosis. We performed PCR/sequencing on all primary nail specimens for which conventional mycological diagnostics remained inconclusive. In specimens with a positive direct microscopy but negative or contaminated culture, molecular mycology proved superior and specified a fungal agent in 65% (587/898). In 75% (443/587), the identified pathogen was a dermatophyte. Positive cultures for dermatophytes, yeasts and non-dermatophyte molds (NDMs) were concordant with primary-specimen-DNA PCR/sequencing in 83% (10/12), 34% (22/65) and 45% (76/169), respectively. Among NDMs, agreement was high for Fusarium spp. (32/40; 80%), but low for Penicillium spp. (5/25; 20%) and Alternaria spp. (1/20; 5%). This study underlines the improvement in diagnostic yield by fungal primary-specimen-DNA PCR/sequencing in the event of a negative or contaminated culture, as well as its significance for the diagnosis of dermatophyte and non-dermatophyte onychomycosis. Molecular mycology methods like PCR and DNA sequencing should complement conventional diagnostics in cases of equivocal findings, suspected NDM onychomycosis or treatment-resistant nail pathologies.
LLM-PBC: Logic Learning Machine-Based Explainable Rules Accurately Stratify the Genetic Risk of Primary Biliary Cholangitis
Authors: Gerussi Alessio , Verda Damiano , Cappadona Claudio , Cristoferi Laura , Bernasconi Davide Paolo , Bottaro Sandro , Carbone Marco , Muselli Marco , Invernizzi Pietro , Asselta Rosanna ,   on behalf of The Italian PBC Genetics Study Group
Published: September 2022

Background: The application of Machine Learning (ML) to genetic individual-level data represents a foreseeable advancement for the field, which is still in its infancy. Here, we aimed to evaluate the feasibility and accuracy of an ML-based model for disease risk prediction applied to Primary Biliary Cholangitis (PBC). Methods: Genome-wide significant variants identified in subjects of European ancestry in the recently released second international meta-analysis of GWAS in PBC were used as input data. Quality-checked, individual genomic data from two Italian cohorts were used. The ML included the following steps: import of genotype and phenotype data, genetic variant selection, supervised classification of PBC by genotype, generation of “if-then” rules for disease prediction by logic learning machine (LLM), and model validation in a different cohort. Results: The training cohort included 1345 individuals: 444 were PBC cases and 901 were healthy controls. After pre-processing, 41,899 variants entered the analysis. Several configurations of parameters related to feature selection were simulated. The best LLM model reached an Accuracy of 71.7%, a Matthews correlation coefficient of 0.29, a Youden’s value of 0.21, a Sensitivity of 0.28, a Specificity of 0.93, a Positive Predictive Value of 0.66, and a Negative Predictive Value of 0.72. Thirty-eight rules were generated. The rule with the highest covering (19.14) included the following genes: RIN3, KANSL1, TIMMDC1, TNPO3. The validation cohort included 834 individuals: 255 cases and 579 controls. By applying the ruleset derived in the training cohort, the Area under the Curve of the model was 0.73. Conclusions: This study represents the first illustration of an ML model applied to common variants associated with PBC. Our approach is computationally feasible, leverages individual-level data to generate intelligible rules, and can be used for disease prediction in at-risk individuals.
Preoperative Navigated Transcranial Magnetic Stimulation: New Insight for Brain Tumor-Related Language Mapping
Authors: Natalizi Federica , Piras Federica , Vecchio Daniela , Spalletta Gianfranco , Piras Fabrizio
Published: September 2022

Preoperative brain mapping methods are particularly important in modern neuro-oncology when a tumor affects eloquent language areas since damage to parts of the language circuits can cause significant impairments in daily life. This narrative review examines the literature regarding preoperative and intraoperative language mapping using repetitive navigated transcranial magnetic stimulation (rnTMS) with or without direct electrical stimulation (DES) in adult patients with tumors in eloquent language areas. The literature shows that rnTMS is accurate in detecting preexisting language disorders and positive intraoperative mapping regions. In terms of the region extent and clinical outcomes, rnTMS has been shown to be accurate in identifying positive sites to guide resection, reducing surgery duration and craniotomy size and thus improving clinical outcomes. Before incorporating rnTMS into the neurosurgical workflow, the refinement of protocols and a consensus within the neuro-oncology community are required.
Early Sensory Profile in Autism Spectrum Disorders Predicts Emotional and Behavioral Issues
Authors: Fabbri-Destro Maddalena , Maugeri Federica , Ianni Carolina , Corsini Sofia , Di Stefano Erica , Scatigna Stefano , Crifaci Giulia , Bruzzi Gianina , Berloffa Stefano , Fantozzi Pamela , Prato Adriana , Muccio Rosy , Valente Elena , Pelagatti Susanna , Pecchini Edoardo , Zulli Filippo , Rizzo Renata , Milone Annarita , Viglione Valentina , Barone Rita , Masi Gabriele , Narzisi Antonio
Published: September 2022

Background: Abnormal sensory reactivity is considered one of the diagnostic criteria for autism spectrum disorders (ASD) and has been associated with autism severity, poorer functional outcomes, and behavioral difficulties across the lifespan. Its early characterization could provide valuable insights into the processes favoring the instantiation of maladaptive behaviors. Objectives: The present study has two aims: (1) to describe the sensory profile of preschool children with ASD compared with an age-matched population of children with a diagnosis of language disorder (DLD) and typically developing (TD) control peers; (2) to explore within each group whether the sensory alterations play a predictive role in the instantiation of emotional and behavioral issues. Methods: The parents of 42 ASD, 18 DLD, and 56 TD filled out the Sensory Processing Measure—Preschool (SPM-P). To gather information on competencies, behaviors, and emotional problems of children, the Child Behavior Checklist 1½-5 (CBCL 1½-5) was also administered. Results: On the SPM-P, ASD and DLD samples generally had scores more compromised than control peers. The contrast between ASD and DLD was reflected in a higher (and highly significant) impairment on the social participation and hearing subscales, suggesting a greater sensitivity and a possible specificity of these scores for ASD. More importantly, linear regression analyses revealed a strong and predictive association for ASD children with SPM total scores explaining more than 50% of the variance of the CBCL 1½-5 total scores (p < 0.001). Conclusions: Our findings reinforce the need to detect the abnormal sensory profiles of ASD already at an early stage and during clinical evaluations. Due to the impact on the emotional and behavioral manifestations, such a procedure has significant clinical and social implications, potentially guiding the development of new interventions relying on multisensory strategies.
Alterations in Homologous Recombination-Related Genes and Distinct Platinum Response in Metastatic Triple-Negative Breast Cancers: A Subgroup Analysis of the ProfiLER-01 Trial
Authors: Bonnet Elise , Haddad Véronique , Quesada Stanislas , Baffert Kim-Arthur , Lardy-Cléaud Audrey , Treilleux Isabelle , Pissaloux Daniel , Attignon Valéry , Wang Qing , Buisson Adrien , Heudel Pierre-Etienne , Bachelot Thomas , Dufresne Armelle , Eberst Lauriane , Toussaint Philippe , Bonadona Valérie , Lasset Christine , Viari Alain , Sohier Emilie , Paindavoine Sandrine , Combaret Valérie , Pérol David , Ray-Coquard Isabelle , Blay Jean-Yves , Trédan Olivier
Published: September 2022

Background: a specific subset of metastatic triple-negative breast cancers (mTNBC) is characterized by homologous recombination deficiency (HRD), leading to enhanced sensitivity to platinum-based chemotherapy. Apart from mutations in BRCA1/2 genes, the evaluation of other HRD-related alterations has been limited to date. As such, we analyzed data from mTNBC patients enrolled in the ProfiLER-01 study to determine the prevalence of alterations in homologous recombination-related (HRR) genes and their association with platinum sensitivity. Methods: next-generation sequencing and promoter methylation of BRCA1 and RAD51C were performed on tumors from patients with mTNBC, using a panel of 19 HRR genes. Tumors were separated into three groups based on their molecular status: mutations in BRCA1/2, mutations in other HRR genes (BRCA1/2 excluded) or BRCA1/RAD51C promoter methylation and the absence of molecular alterations in HRR genes (groups A, B and C, respectively). Sensitivity to platinum-based chemotherapy was evaluated through the radiological response. Results: mutations in BRCA1/2 were detected in seven (13.5%) patients, while alterations in other HRR genes or hypermethylation in BRCA1 or RAD51C were reported in 16 (30.7%) patients; furthermore, no alteration was found in the majority of patients (n = 29; 55.8%). Among 27 patients who received platinum-based chemotherapy, the disease control rate was 80%, 55% and 18% (groups A, B and C, respectively; p = 0.049). Regarding group B, patients with disease control exhibited mutations in FANCL, FANCA and the RAD51D genes or RAD51C methylation; Conclusion: mutations in HRR genes and epimutations in RAD51C were associated with disease control through platinum-based chemotherapy. As such, apart from well-characterized alterations in BRCA1/2, a more comprehensive evaluation of HRD should be considered in order to enlarge the selection of patients with mTNBC that could benefit from platinum-based chemotherapy.