bluuebunny/crossref_metadata_2025 huggingface dataset:
Artificial Intelligence Image Recognition System for Preventing Wrong-Site Upper Limb Surgery
Authors: Wu Yi-Chao , Chang Chao-Yun , Huang Yu-Tse , Chen Sung-Yuan , Chen Cheng-Hsuan , Kao Hsuan-Kai
Published: December 2023

Our image recognition system employs a deep learning model to differentiate between the left and right upper limbs in images, allowing doctors to determine the correct surgical position. From the experimental results, it was found that the precision rate and the recall rate of the intelligent image recognition system for preventing wrong-site upper limb surgery proposed in this paper could reach 98% and 93%, respectively. The results proved that our Artificial Intelligence Image Recognition System (AIIRS) could indeed assist orthopedic surgeons in preventing the occurrence of wrong-site left and right upper limb surgery. At the same time, in future, we will apply for an IRB based on our prototype experimental results and we will conduct the second phase of human trials. The results of this research paper are of great benefit and research value to upper limb orthopedic surgery.
Clinical Evaluation of Direct Reverse Transcription PCR for Detection of SARS-CoV-2 Compared to Conventional RT-PCR in Patients with Positive Rapid Antigen Test Results during Circulation of Emerging Viral Variants
Authors: Jian Ming-Jr , Chen Chi-Sheng , Chung Hsing-Yi , Chang Chih-Kai , Perng Cherng-Lih , Shang Hung-Sheng
Published: December 2023

The emergence of the Omicron (B.1.1.529) variant of SARS-CoV-2 has precipitated a new global wave of the COVID-19 pandemic. The rapid identification of SARS-CoV-2 infection is imperative for the effective mitigation of transmission. Diagnostic modalities such as rapid antigen testing and real-time reverse transcription polymerase chain reaction (RT-PCR) offer expedient turnaround times of 10–15 min and straightforward implementation. This preliminary study assessed the correlation between outcomes of commercially available rapid antigen tests for home use and conventional reverse transcription polymerase chain reaction (RT-PCR) assays using a limited set of clinical specimens. Patients aged 5–99 years presenting to the emergency department for SARS-CoV-2 testing were eligible for enrollment (n = 5652). Direct PCR and conventional RT-PCR were utilized for the detection of SARS-CoV-2. The entire cohort of 5652 clinical specimens was assessed by both modalities to determine the clinical utility of the direct RT-PCR assay. Timely confirmation of SARS-CoV-2 infection may attenuate viral propagation and guide therapeutic interventions. Additionally, direct RT-PCR as a secondary confirmatory test for at-home rapid antigen test results demonstrated sensitivity comparable to conventional RT-PCR, indicating utility for implementation in laboratories globally, especially in resource-limited settings with constraints on reagents, equipment, and skilled personnel. In summary, direct RT-PCR enables the detection of SARS-CoV-2 with a sensitivity approaching that of conventional RT-PCR while offering expedient throughput and shorter turnaround times. Moreover, direct RT-PCR provides an open-source option for diagnostic laboratories worldwide, particularly in low- and middle-income countries.
Computer-Aided Diagnosis of Laryngeal Cancer Based on Deep Learning with Laryngoscopic Images
Authors: Xu Zhi-Hui , Fan Da-Ge , Huang Jian-Qiang , Wang Jia-Wei , Wang Yi , Li Yuan-Zhe
Published: December 2023

Laryngeal cancer poses a significant global health burden, with late-stage diagnoses contributing to reduced survival rates. This study explores the application of deep convolutional neural networks (DCNNs), specifically the Densenet201 architecture, in the computer-aided diagnosis of laryngeal cancer using laryngoscopic images. Our dataset comprised images from two medical centers, including benign and malignant cases, and was divided into training, internal validation, and external validation groups. We compared the performance of Densenet201 with other commonly used DCNN models and clinical assessments by experienced clinicians. Densenet201 exhibited outstanding performance, with an accuracy of 98.5% in the training cohort, 92.0% in the internal validation cohort, and 86.3% in the external validation cohort. The area under the curve (AUC) values consistently exceeded 92%, signifying robust discriminatory ability. Remarkably, Densenet201 achieved high sensitivity (98.9%) and specificity (98.2%) in the training cohort, ensuring accurate detection of both positive and negative cases. In contrast, other DCNN models displayed varying degrees of performance degradation in the external validation cohort, indicating the superiority of Densenet201. Moreover, Densenet201’s performance was comparable to that of an experienced clinician (Clinician A) and outperformed another clinician (Clinician B), particularly in the external validation cohort. Statistical analysis, including the DeLong test, confirmed the significance of these performance differences. Our study demonstrates that Densenet201 is a highly accurate and reliable tool for the computer-aided diagnosis of laryngeal cancer based on laryngoscopic images. The findings underscore the potential of deep learning as a complementary tool for clinicians and the importance of incorporating advanced technology in improving diagnostic accuracy and patient care in laryngeal cancer diagnosis. Future work will involve expanding the dataset and further optimizing the deep learning model.
AI/ML-Based Medical Image Processing and Analysis
Authors: Alghazo Jaafar , Latif Ghazanfar
Published: December 2023

The medical field is experiencing remarkable advancements, notably with the latest technologies—artificial intelligence (AI), big data, high-performance computing (HPC), and high-throughput computing (HTC)—that are in place to offer groundbreaking solutions to support medical professionals in the diagnostic process [...]
Development of Quality Indicators for the Ultrasound Department through a Modified Delphi Method
Authors: Zeng Aiping , Gu Yang , Ma Li , Tao Xixi , Gao Luying , Li Jianchu , Wang Hongyan , Jiang Yuxin
Published: December 2023

This study aims to establish precise quality indicators for evaluating and enhancing ultrasound performance, employing a methodology based on a comprehensive review of the literature, expert insights, and practical application experiences. We conducted a thorough review of both the domestic and international literature on ultrasound quality control to identify potential indicators. A dedicated team was formed to oversee the complete indicator development process. Utilizing a three-round modified Delphi method, we sought expert opinions through personalized email correspondence. Subsequently, data from diverse hospital indicators were collected to validate and assess feasibility. A novel set of seven indicators was compiled initially, followed by the convening of a 36-member nationally representative expert panel. After three rounds of meticulous revisions, consensus was reached on 13 indicators across three domains. These finalized indicators underwent application in various hospital settings, demonstrating their initial validity and feasibility. The development of thirteen ultrasound quality indicators represents a significant milestone in evaluating ultrasound performance. These indicators empower hospitals to monitor changes in quality effectively, fostering efficient quality management practices.
Towards a ‘Community for Practice’—A Narrative Analysis of the Evolution of Higher Education Scholars
Authors: Scott Jennifer , Pryce Josephine , Reinke Nicole B. , Li Dongmei , Shuker Mary-Ann , Singleton Rachelle , Tsai Angela , Parkinson Ann L.
Published: December 2023

In higher education (HE), collaborative activities that revolve around a core idea, practice, or knowledge base, such as learning circles, communities of practice or inquiry, peer observation, and peer-assisted teaching, are known to support professional learning. This paper explores the experiences of eight HE scholars from Australia and New Zealand, across four years, as they recognized a new means of collaborative professional development that transcends known approaches and extends beyond an immediate focal point. The group originally formed to support the development of HE fellowship applications, but evolved to what they now consider a community for practice (CfP), where the purpose of collaboration has changed to meet the unique learning needs of each member. During their four years of collaboration, meeting discussions were recorded, and individual and community narrative reflections about participation in the group were created. A thematic analysis of these collective data sources revealed the group’s evolution, and the authors draw on their experiences to tell their story with an aim to enhance professional learning in HE. The study highlights that individuals’ distinct and varied needs can be developed and supported through scholarly, collegial engagements such as a CfP, which does not necessarily require an immediate point of practice.
Using Cooperative Learning to Enhance Students’ Learning and Engagement during Inquiry-Based Science
Authors: Gillies Robyn M.
Published: December 2023

Much attention over the last two decades has been given to inquiry-based learning in science as a way of capturing students’ interest and participation in learning. However, while the research on inquiry-based learning consistently demonstrates that students do attain higher learning outcomes than peers who are taught by traditional transmission approaches, little research has been attached to researching the key elements of this approach that contribute to its success. This review focuses on the role of inquiry-based learning where students work in cooperative groups to investigate topics that challenge their curiosity, encouraging them to ask questions to clarify their understandings, evaluate evidence that may help to explain phenomena, and predict potential solutions to the problems at hand. The key role teachers play in inducting students into ways of thinking and reasoning and providing opportunities for them to work with others in the context of inquiry-based learning will also be discussed.
An Accuracy Enhanced Vision Language Grounding Method Fused with Gaze Intention
Authors: Zhang Junqian , Tu Long , Zhang Yakun , Xie Liang , Xu Minpeng , Ming Dong , Yan Ye , Yin Erwei
Published: December 2023

Visual grounding aims to recognize and locate the target in the image according to human intention, which provides a new intelligent interaction idea and method for augmented reality (AR) and virtual reality (VR) devices. However, existing vision language grounding adopts language modals for visual grounding, but it performs ineffectively for images containing multiple similar objects. Gaze interaction is an important interaction mode in AR/VR devices, and it provides an advanced solution to the inaccurate vision language grounding cases. Based on the above questions and analysis, a vision language grounding framework fused with gaze intention is proposed. Firstly, we collect the manual gaze annotations using the AR device and construct a novel multi-modal dataset, RefCOCOg-Gaze, combining it with the proposed data augmentation methods. Secondly, an attention-based multi-modal feature fusion model is designed, providing a baseline framework for vision language grounding with gaze intention (VLG-Gaze). Through a series of precisely designed experiments, we analyze the proposed dataset and framework qualitatively and quantitatively. Comparing with the state-of-the-art vision language grounding model, our proposed scheme improves the accuracy by 5.3%, which indicates the significance of gaze fusion in multi-modal grounding tasks.
SOINN Intrusion Detection Model Based on Three-Way Attribute Reduction
Authors: Ren Jing , Liu Lu , Huang Haiduan , Ma Jiang , Zhang Chunying , Wang Liya , Liu Bin , Zhao Yingna
Published: December 2023

With a large number of intrusion detection datasets and high feature dimensionality, the emergent nature of new attack types makes it impossible to collect network traffic data all at once. The modified three-way attribute reduction method is combined with a Self-Organizing Incremental learning Neural Network (SOINN) algorithm to propose a self-organizing incremental neural network intrusion detection model based on three-way attribute reduction. Attribute importance is used to perform attribute reduction, and the data after attribute reduction are fed into a self-organized incremental learning neural network algorithm, which generalizes the topology of the original data through self-organized competitive learning. When the streaming data are transferred into the model, the inter-class insertion or node fusion operation is performed by comparing the inter-node distance and similarity threshold to achieve incremental learning of the model streaming data. The inter-node distance value is introduced into the weight update formulation to replace the traditional learning rate and to optimize the topological structure adjustment operation. The experimental results show that T-SOINN achieves high precision and recall when processing intrusion detection data.
Impact of Trade Restrictions on the Russian Forest Industry: Evidence from Siberian Timber Producers
Authors: Gordeev Roman V. , Pyzhev Anton I.
Published: December 2023

In 2022, the Russian forest sector was severely affected by the government’s ban on the export of unprocessed timber and trade sanctions imposed by several countries. It is generally recognized that the regions of the Russian North-West are the most affected by trade barriers that have emerged. Against this background, the impact of bilateral trade restrictions on timber companies in the Asian part of Russia is not discussed. Nevertheless, the forest industry is an important sector of the Siberian economy that has an economic, social and environmental impact on the life of local communities. This paper analyzes the differences among Siberian timber companies in their response to the crisis depending on three factors: industrial specialization, scale of revenue and regional location. The results show that in 2022 the highest median revenues and net profits were generated by small firms that were focused on the domestic market and benefited from reduced competition due to sanctions. There is also evidence that spatial heterogeneity in the response to the crisis may be due to the different support measures of regional authorities and the proximity of the region to border points. We argue that the current conditions may become a new driver for the timber industry development, aimed at the growth of added value and expansion of domestic demand for wood products.
Fractal Features in kHz Electromagnetic Observations Preceding Near-Field Earthquakes in Ilia, Greece
Authors: Nikolopoulos Dimitrios , Petraki Ermioni , Rafique Muhammad , Alam Aftab , Cantzos Demetrios , Yannakopoulos Panayiotis
Published: December 2023

This paper reports kHz EM observations recorded by the Kardamas station in Ilia, Greece a few days before four near-field earthquakes occurred within a 24 km radius, with epicentral depths below 29 km. This work investigated the fractal features hidden in the EM observations via power-law analysis. All EM signals exhibited characteristic fractal epochs with organisation in space and time. A significant number of accurate fractal segments were delineated in the majority of the EM observations. A significant number of fractal areas corresponded to predictable Class I fBm category with 1 ≤ b ≤ 3 (0 ≤ H ≤ 1). Numerous persistent key-periods are reported with 2 < b ≤ 3 (0.5 ≤ H ≤ 1) which are deemed as signs of impeding earthquakes according to the literature. Numerous segments were found with strong persistent b-values in the range (2.3 ≤ b ≤ 3) (0.65 ≤ H ≤ 1) and b-values corresponding to switching between antipersistency and persistency with (1.7 ≤ b < 2.3) (0.35 ≤ H < 0.65). These are deemed as the most significant precursory signs. Interpretations are given via the asperity model.
Implementation of the Lean Healthcare System in the Emergency Room of the Clinical Hospital of the Federal University of Uberlândia: A Case Study
Authors: Freitas Paulo Sergio de , de Mendonça Guilherme Silva , Resende Elmiro Santos
Published: December 2023

The objective of this study was to analyze the effectiveness of the implementation of the lean healthcare system at the emergency room of the Clinical Hospital of the Federal University of Uberlândia, based on a comparison of hospital indicators obtained over the three phases corresponding to the period of one year before the implementation (T1), the year during the implementation (T2) and one year after implementation (T3). The methodology applied through this study can be classified as a case study that is exploratory and descriptive and developed in stages. Based herein on the search for hospital indicators, as occurred in the implementation of a lean process at the Clinical Hospital Emergency Department, along with a description of the implemented lean system. During the collection period of data relevant to the National Emergency Department Overcrowding Score and Length of Stay Indicator, the motivation of the teams grew, but with a notable tension between municipal management and hospital management. It was found that, despite the fluctuations, the patient length of stay in the Emergency Room remained high. With the exception of the variable of female deaths before 24 h of hospitalization, all other variables showed percentage increases before and after the intervention. This study reported the difficulties encountered by HC-UFU in implementing the lean project in an emergency room, thus ensuring that other institutions that intend to implement this project do not make the same types of mistakes.
A Review of Slipping Rib Syndrome: Diagnostic and Treatment Updates to a Rare and Challenging Problem
Authors: Madeka Isheeta , Alaparthi Sneha , Moreta Marisa , Peterson Shawn , Mojica Jeffrey J. , Roedl Johanes , Okusanya Olubenga
Published: December 2023

Slipping rib syndrome (SRS) is a disorder that occurs when one or more of the eighth through tenth ribs become abnormally mobile. SRS is a poorly understood condition leading to a significant delay in diagnosis and therapeutic management. History and a physical exam are usually sufficient for a diagnosis of SRS. The utility of dynamic ultrasounds has also been studied as a useful diagnostic tool. Multiple surgical techniques for SRS have been described within the literature. Cartilage rib excision (CRE) has been the most common technique utilized. However, the literature has shown a high rate of recurrence and associated risks with the procedure. More recently, minimally invasive rib fixation and costal cartilage excision with vertical rib plating have been shown as successful and safe alternative techniques. This may be an effective, alternative approach to CRE in adult and pediatric populations with SRS.
Primary Localized Cutaneous Amyloidosis in Central Europe: A Retrospective Monocentric Study on Epidemiology and Therapy
Authors: Pálla Sára , Kuroli Enikő , Tóth Eszter Alexa , Hidvégi Bernadett , Holló Péter , Medvecz Márta
Published: December 2023

Amyloid deposits can be the cause of many chronic diseases. Primary localized cutaneous amyloidosis (PLCA) is a chronic dermatologic condition with amyloid deposits in the papillary dermis. The most common types of the keratinocyte-derived form of PLCA include macular (MA), lichen (LA), and biphasic (BA) amyloidosis. The estimated prevalence of PLCA in the Asian population is 0.98/10,000, which is higher than in the European population; thus, epidemiologic data on PLCA in the Caucasian population are limited. We performed a retrospective single-center study analyzing epidemiologic characteristics of a Central European PLCA population. Epidemiologic data regarding age, sex, skin phototype (Fitzpatrick scale I–VI), disease duration, comorbidities, history of atopy, and family history of PLCA were collected. Clinical characteristics, localization of PLCA lesions, applied therapies and treatment outcomes were also analyzed. Dermoscopic characteristics were also evaluated. A total of 41 patients diagnosed with PLCA were included, with 22 presenting with macular, 18 with lichen, and 1 with biphasic amyloidosis. The male/female ratio was 16/25, and mean age at diagnosis was 54.6 ± 15.2 years (range 27–87 years). The mean age at the onset of PLCA was 53 ± 16.1 years (range 19–79 years) in MA, 46.7 ± 18.2 years (range 14–73 years) in LA, and 26 years in BA. The interscapular region in MA and the extensor surface of the lower extremities in LA proved to be localization-related areas. In our center, a wide range of therapeutic options was applied, with the most prescribed being topical corticosteroids in all types of PLCA. We presented a retrospective, monocentric study on the epidemiology of PLCA in the Central European region. By examining the medical data of a significant number of PLCA patients, we compared our epidemiologic data with that of the Asian PLCA population. Due to the rarity of the condition, further randomized controlled trials and guidelines are needed to improve therapeutic outcomes.
The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department
Authors: Turcato Gianni , Zaboli Arian , Sibilio Serena , Mian Michael , Brigo Francesco
Published: December 2023

Background: The Sequential Organ Failure Assessment (SOFA) score is currently the primary prognostic tool used in patients with infections to predict sepsis and mortality, although its predictive role remains debated. Serum albumin values have been recently found to correlate with the severity of sepsis. The purpose of this study is to evaluate the clinical usefulness of albumin dosage on SOFA score prediction in infected patients. Methods: This prospective single-centre observational study was performed in 2021. We used the net reclassification improvement (NRI) technique to evaluate the additional prognostic value of serum albumin used together with the SOFA score in infected patients. The discriminatory abilities of the SOFA score alone, of albumin levels alone, and of the albumin levels together with (but not incorporated into) the SOFA score was evaluated by comparing the area under the curve of the corresponding receiver operating characteristic (ROC) curves. Results: We included 949 patients with an infectious status; 8.9% (84/949) died within 30 days of ED admission. The AUROC for the SOFA score was 0.802 (95% CI: 0.756–0.849) and the albumin level was 0.813 (95% CI: 0.775–0.852). The NRI found that serum albumin improved SOFA score predictions of 30-day mortality by 24.3% (p < 0.001), yielding an AUROC of 0.881 (95% CI: 0.848–0.912; p < 0.001). Conclusions: Using serum albumin values together with the SOFA score can improve prognostic prediction in patients with infections evaluated in the ED.
Use of Virtual Reality in Patients with Acquired Brain Injury: A Systematic Review
Authors: Calderone Andrea , Carta Diamante , Cardile Davide , Quartarone Angelo , Rifici Carmela , Calabrò Rocco Salvatore , Corallo Francesco
Published: December 2023

Background and Objectives: ABI is found in all societies as the most severe, disabling neurological disorder. A cognitive rehabilitation program is essential for the clinical recovery of these patients, improving functional outcomes and quality of life. Modern technologies such as virtual reality (VR) offer several advantages over traditional therapies, including the ability to engage people in simulated performance of functional tasks. This review will examine the studies in which virtual reality has been used as an aid, technique, or intervention in patients with acquired brain injury. Materials and Methods: Studies were identified from an online search of PubMed, Cochrane Library, and Web of Science databases. Results: We found that TBI patients responded positively to VR treatment depending on the damaged or impaired cognitive and motor functions they acquired. It is now a tool that is available in the rehabilitation of these patients and supports the recovery of various motor and cognitive functions. Conclusions: This review has shown that VR is an intervention technique that increasingly exists in clinical rehabilitation practice for ABI patients. The device uses advanced technologies that can cause general changes in cognitive, motor, and psychological aspects and create a simulated environment that can partially restore these functions and behaviors, as well as the behaviors of everyday life.
Chronic Stress in Pregnancy Is Associated with Low Birth Weight: A Meta-Analysis
Authors: Matsas Alkis , Panopoulou Panagiota , Antoniou Neofyta , Bargiota Alexandra , Gryparis Alexandros , Vrachnis Nikolaos , Mastorakos George , Kalantaridou Sophia N. , Panoskaltsis Theodoros , Vlahos Nikos F. , Valsamakis Georgios
Published: December 2023

Background and objectives: Chronic activation of the stress system has cumulative effects on the body, and it places individuals at risk for adverse health outcomes. Chronic stress has been assessed by health questionnaires in pregnancy. During the perinatal period, mothers experience increased physical and emotional demands. Chronic stress interferes with hormonal functions in mothers and infants. This meta-analysis studies the effect of maternal chronic stress during pregnancy, as assessed by established stress questionnaires, on the birth weight of their full-term infants. Design and methods: According to our criteria and after research collection, we obtained 107 studies and we conducted two types of analyses: a logistic (N = 22,342) and linear regression analysis (N = 7431). Results: Our results show that chronic stress is associated with a statistically significant risk of low birth weight (OR = 1.50, CI 95% = [1.13; 1.99], p ≤ 0.02).Conclusions: Increased maternal chronic stress, as assessed by questionnaires, in pregnancy is associated with a low-birth-weight baby. The above meta-analysis indicates that maternal high chronic stress questionnaire scores could be used as a clinical tool in order to assess low-birth-weight risk.
Radiomics-Assisted Computed Tomography-Based Analysis to Evaluate Lung Morphology Characteristics after Congenital Diaphragmatic Hernia
Authors: Virlan Silviu-Viorel , Froelich Matthias F. , Thater Greta , Rafat Neysan , Elrod Julia , Boettcher Michael , Schoenberg Stefan O. , Weis Meike
Published: December 2023

Purpose: Children with congenital diaphragmatic hernia suffer from long-term morbidity, including lung function impairment. Our study aims to analyze lung morphology characteristics via radiomic-assisted extraction of lung features in patients after congenital diaphragmatic hernia repair. Materials and Methods: 72 patients were retrospectively analyzed after approval by the local research ethics committee. All the image data were acquired using a third-generation dual-source CT (SOMATOM Force, Siemens Healthineers, Erlangen, Germany). Dedicated software was used for image analysis, segmentation, and processing. Results: Radiomics analysis of pediatric chest CTs of patients with status after CDH was possible. Between the ipsilateral (side of the defect) and contralateral lung, three shape features and two higher-order texture features were considered statistically significant. Contralateral lungs in patients with and without ECMO treatment showed significant differences in two shape features. Between the ipsilateral lungs in patients with and without the need for ECMO 1, a higher-order texture feature was depicted as statistically significant. Conclusions: By adding quantitative information to the visual assessment of the radiologist, radiomics-assisted feature analysis could become an additional tool in the future to assess the degree of lung hypoplasia in order to further improve the therapy and outcome of CDH patients.
Intestinal Microbiome Changes and Clinical Outcomes of Patients with Ulcerative Colitis after Fecal Microbiota Transplantation
Authors: Tikunov Artem Y. , Fedorets Valeria A. , Shrainer Evgenia V. , Morozov Vitaliy V. , Bystrova Valeria I. , Tikunova Nina V.
Published: December 2023

Background and Aims: Ulcerative colitis (UC) is a chronic inflammatory disease that affects many people. One of the possible ways to treat UC is fecal microbiota transplantation (FMT). In this study, changes in the intestinal microbiome and clinical outcomes of 20 patients with UC after FMT were estimated. Methods: FMT enemas were administrated ten times, once a day, and fecal microbiota from three donors was used for each enema. The clinical outcomes were assessed after eight weeks and then via a patient survey. The 16S rRNA profiles of the gut microbiota were compared between three samplings: samples from 20 patients with UC before and after FMT and samples from 18 healthy volunteers. Results: Clinical remission was achieved in 19 (95%) patients at week 8. Adverse events occurred in five patients, including one non-responder. A significant increase in average biodiversity was shown in samples after FMT compared to samples before FMT, as well as a decrease in the proportion of some potentially pathogenic bacteria. Conclusion: The efficacy of FMT for UC treatment was confirmed; however, the duration of remission varied substantially, possibly due to different characteristics of the initial microbiota of patients. Targeted analysis of a patient’s microbiome before FMT could increase the treatment efficacy.
Extrapulmonary Neuroendocrine Carcinomas: Current Management and Future Perspectives
Authors: Stumpo Sara , Formelli Maria Giovanna , Persano Irene , Parlagreco Elena , Lauricella Eleonora , Rodriquenz Maria Grazia , Guerrera Luigi Pio , Zurlo Ina Valeria , Campana Davide , Brizzi Maria Pia , Cives Mauro , La Salvia Anna , Lamberti Giuseppe
Published: December 2023

Neuroendocrine carcinomas (NECs) are poorly differentiated and highly aggressive epithelial neuroendocrine neoplasms. The most common primary site is the lung, but they may arise in every organ. Approximately 37% of extrapulmonary NECs (EP-NECs) occur in the gastroenteropancreatic (GEP) tract, followed by the genitourinary (GU) system and gynecological tract. As a result of their rarity, there is scant evidence to guide treatment recommendations, and a multidisciplinary approach is essential for the management of such patients. Platinum-based chemotherapy currently represents the standard of care for EP-NECs of any site, mirroring the management of small-cell lung cancer (SCLC), but further approaches are still under investigation. Indeed, ongoing trials evaluating targeted therapies, immune checkpoint inhibitors (ICIs), and radionuclide therapy could provide potentially breakthrough therapeutic options. Given the relative dearth of evidence-based literature on these orphan diseases, the aim of this review is to provide an overview of the pathology and current treatment options, as well as to shed light on the most pressing unmet needs in the field.
Photochemical Modification of the Extracellular Matrix to Alter the Vascular Remodeling Process
Authors: Anderson Blake , Blair Dylan , Huff Kenji , Wisniewski John , Warner Kevin S. , Kauser Katalin
Published: December 2023

Therapeutic interventions for vascular diseases aim at achieving long-term patency by controlling vascular remodeling. The extracellular matrix (ECM) of the vessel wall plays a crucial role in regulating this process. This study introduces a novel photochemical treatment known as Natural Vascular Scaffolding, utilizing a 4-amino substituted 1,8-naphthimide (10-8-10 Dimer) and 450 nm light. This treatment induces structural changes in the ECM by forming covalent bonds between amino acids in ECM fibers without harming vascular cell survival, as evidenced by our results. To further investigate the mechanism of this treatment, porcine carotid artery segments were exposed to 10-8-10 Dimer and light activation. Subsequent experiments subjected these segments to enzymatic degradation through elastase or collagenase treatment and were analyzed using digital image analysis software (MIPAR) after histological processing. The results demonstrated significant preservation of collagen and elastin structures in the photochemically treated vascular wall, compared to controls. This suggests that photochemical treatment can effectively modulate vascular remodeling by enhancing the resistance of the ECM scaffold to degradation. This approach shows promise in scenarios where vascular segments experience significant hemodynamic fluctuations as it reinforces vascular wall integrity and preserves lumen patency. This can be valuable in treating veins prior to fistula creation and grafting or managing arterial aneurysm expansion.
Fracture Resistance of a Two-Piece Zirconia Implant System after Artificial Loading and/or Hydrothermal Aging—An In Vitro Investigation
Authors: Kohal Ralf-Joachim , Schikofski Tim , Adolfsson Erik , Vach Kirstin , Patzelt Sebastian Berthold Maximilian , Nold Julian , Wemken Gregor
Published: December 2023

The purpose of the present study was to assess the fracture resistance of a two-piece alumina-toughened zirconia implant system with a carbon-reinforced PEEK abutment screw. Methods: Thirty-two implants with screw-retained zirconia abutments were divided into four groups of eight samples each. Group 0 (control group) was neither loaded nor aged in a chewing simulator; group H was hydrothermally aged; group L was loaded with 98 N; and group HL was subjected to both hydrothermal aging and loading in a chewing simulator. One sample of each group was evaluated for t-m phase transformation, and the others were loaded until fracture. A one-way ANOVA was applied to evaluate differences between the groups. Results: No implant fracture occurred during the artificial chewing simulation. Furthermore, there were no statistically significant differences (p > 0.05) between the groups in terms of fracture resistance (group 0: 783 ± 43 N; group H: 742 ± 43 N; group L: 757 ± 86 N; group HL: 740 ± 43 N) and bending moment (group 0: 433 ± 26 Ncm; group H: 413 ± 23 Ncm; group L: 422 ± 49 Ncm; group HL: 408 ± 27 Ncm). Conclusions: Within the limitations of the present investigation, it can be concluded that artificial loading and hydrothermal aging do not reduce the fracture resistance of the investigated implant system.
Influence of Otolaryngological Subspecialties on Perception of Transoral Robotic Surgery: An International YO-IFOS Survey
Authors: Maniaci Antonino , Chiesa Estomba Carlos , Fakhry Nicolas , Vaira Luigi Angelo , Remacle Marc , Cammaroto Giovanni , Barillari Maria Rosaria , Iannella Giannicola , Mayo-Yanez Miguel , Saibene Alberto Maria , Baudouin Robin , Maza-Solano Juan , Mendelsohn Abie H. , Holsinger Floyd Christopher , Ceccon Fabio P. , Haddad Leonardo , Hans Stephane , La Mantia Ignazio , Cocuzza Salvatore , Gulinello Federica , Ayad Tareck , Lechien Jerome R.
Published: December 2023

Background: To investigate perception, adoption, and awareness on the part of otolaryngology and head and neck surgeons (OTO-HNS) of transoral robotic surgery (TORS). Methods: Several items assessed: awareness/perception; access to TORS; training; indications and advantages/hurdles to TORS practice. A subanalysis was performed to assess differences according to the identified otolaryngological subspecialties. Results: A total of 359 people completed the survey. Among subspecialties, while for otolaryngologists 30/359 (8.4%) and H&N surgeons 100/359 (27.9%) TORS plays an effective role in hospital stay, laryngologists frequently disagreed (54.3%). There was a lower incidence among rhinologists and otologists (1.9%). Pediatric surgeons (0.8%) reported a positive response regarding the adoption of robotic surgery, and head and neck specialists expressed an even greater response (14.2%). Low adherence was related to perceived cost-prohibitive TORS, by 50% of H&N surgeons. Conclusions: Perception, adoption, and knowledge about TORS play a key role in the application of the robotic system, significantly varying across subspecialties.
Tribological Synergism of Anodic Aluminum Oxide Surface Containing Micro-Holes and Nanopores under Lubricated Reciprocation
Authors: Cho Minhaeng
Published: December 2023

Micro-drilled aluminum surfaces containing micro-holes were anodized to produce nanopores over the machined and lapped surfaces. The anodized nanopores had an approximate diameter of 30–40 nm and a depth distribution of 20–30 μm from the surface. The diameter and depth of the machined micro-holes were 125 μm and 300 μm, respectively. Anodization itself did not change the surface roughness because the nanopores were very small. Ball-on-disk reciprocating tests were performed under lubricated conditions for 2 h using a frequency of 2 Hz, a load of 2 N, and a travel distance of 5 mm. The results showed that both the micro-drilled and anodized surfaces greatly reduced the coefficient of friction compared with the lapped bare surface; however, the coefficient of friction of the hole-textured specimen was not maintained till the end. Contrary to expectations, the lubricant retention capability of the textured structure declined because of hole failure that occurred during oscillation. This gradually increased friction until the end of the reciprocating test. When the micro-drilled surface was anodized, the coefficient of friction decreased again, implying that non-anodized micro-holes alone were ineffective for reducing friction. The surface hardness of Al increased owing to anodization, and thus the micro-holes remained intact. Therefore, it is concluded in this study that a prerequisite for friction reduction in Al is to increase the hardness to minimize the failure of micro-holes, which can be achieved by anodization. The synergistic lubricant retention capability can be maintained by the presence of both nanopores and micro-holes.
Comparison of the Incidence of Nd:YAG Laser Capsulotomy Based on the Type of Intraocular Lens
Authors: Lee Yuri , Kim Jae Suk , Kim Bum Gi , Hwang Je Hyung , Kang Min Ji , Lee Jee Hye
Published: December 2023

Background and Objectives: Posterior capsular opacification (PCO) is the most common long-term complication of successful cataract surgery and can cause visual impairment. We aimed to investigate the effects of intraocular lens (IOL) characteristics on PCO by comparing the incidence of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy for different types of intraocular lenses. Materials and Methods: A retrospective analysis was performed on 2866 eyes that underwent cataract surgery between January 2010 and December 2017, with at least 5 years of follow-up. The IOLs used for surgery were the hydrophobic lenses SN60WF (Alcon, Fort Worth, TX, USA), ZCB00 (Johnson & Johnson Vision, Santa Ana, CA, USA), and MX60 (Bausch & Lomb, Rochester, NY, USA), and the hydrophilic lens MI60 (Bausch & Lomb, Rochester, NY, USA). We analyzed the incidence of Nd:YAG laser capsulotomy according to the type of IOL used. Results: The incidence of Nd:YAG laser capsulotomy was significantly higher with MI60 lenses (31.70%, 175/552 eyes) compared to SN60WF (7.90%, 113/1431 eyes), ZCB00 (10.06%, 64/636 eyes), and MX60 (10.57%, 13/123 eyes; p < 0.001) lenses. The incidence of Nd:YAG laser capsulotomy was significantly lower with the hydrophobic IOLs (8.68%, 190/2190 eyes) than with the hydrophilic IOL (31.70%, 175/552 eyes; p < 0.001). Over time, the rate of increase in the cumulative number of Nd:YAG laser capsulotomy cases was the highest with MI60. The cumulative rate of Nd:YAG laser capsulotomy during the first 3 years was 4.90% with SN60WF (70/1431 eyes), 6.76% with ZCB00 (43/636 eyes), 8.94% with MX60 (11/123 eyes), and 26.10% with MI60 (144/552 eyes) lenses. Conclusions: The incidence of PCO is influenced by the material of the IOLs. The hydrophilic IOL was associated with a higher rate of Nd:YAG laser capsulotomy than the hydrophobic IOLs, with a shorter time to Nd:YAG laser capsulotomy.
Estimation of Activity and Molar Excess Gibbs Energy of Binary Liquid Alloys Al-Cu, Al-Ni, and Al-Fe from the Partial Radial Distribution Function Simulated by Ab Initio Molecular Dynamics
Authors: Lu Yi , Chen Xiumin , Zhang Tianao , Hang Jiulong , Tao Dongping
Published: December 2023

To accurately and conveniently obtain the thermodynamic data of binary liquid alloys, a new method is proposed in this study. It combines ab initio molecular dynamics (AIMD) simulation with a thermodynamic model to estimate the activity and molar excess Gibbs energy of binary liquid alloys. Additionally, two methods of grouping the partial radial distribution function (PRDF) of 5000 steps obtained by simulation are proposed for the first time. The PRDF of Al50Cu50, Al50Ni50, and Al50Fe50 is obtained by AIMD simulation. These PRDF are combined with four thermodynamic models to estimate the activity and molar excess Gibbs energy. Furthermore, the estimation results of the four models are compared with those of the Miedema model. The results show that when the first peak of the PRDF is obtained by the symmetric method, the average relative deviation (ARD) of the activity and molar excess Gibbs energy of the four models are, respectively: 28% and 32% for Molecular Interaction Volume Model (MIVM); 162% and 38% for Regular Solution Model (RSM); 508% and 65% for Wilson model; 562% and 67% for Non-Random Two-Liquid (NRTL). When the first peak of PRDF is obtained by non-symmetric method, the average ARD of the activity and molar excess Gibbs energy of the four models are, respectively: 64% and 20% for MIVM; 115% and 26% for RSM; 661% and 70% for Wilson; 727% and 72% for NRTL. In addition, the average ARD of the activity and molar excess Gibbs energy of the Miedema model are 113% and 33%. These data indicate that the estimation performance of the MIVM model is superior to the other four models, and the symmetric method performs better than the non-symmetric method. The grouping treatment of PRDF data effectively improves estimation performance.
Dynamic Mechanical Behavior and Energy Release Effect of a Novel Nb17Zr33Ti17W33 High-Entropy Alloy under Impact Load
Authors: Ji Wensu , Zou Qiang , Yin Xiaoyun , Zhu Zhengwang
Published: December 2023

The present study successfully demonstrates the fabrication of a novel class of high-entropy alloy, namely Nb17Zr33Ti17W33, through suspension melting and casting technique. To investigate the dynamic mechanical behavior and energy release effects of the alloy under high-speed impact loads, various techniques were employed, including split Hopkinson pressure bar (SHPB), X-ray diffractometer (XRD), scanning electron microscope (SEM), and high-speed photography. These methods were utilized to acquire crucial data, such as crystal structure analysis, stress–strain curves, and microstructural examination of failed specimens. The modified Johnson–Cook (J-C) model was employed to elucidate the dynamic flow behavior of the alloy, while investigating the failure mechanism and energy release phenomenon during the process of dynamic compression. The experimental results demonstrate that the alloy material exhibits a dual-phase (BCC1 + BCC2) structure, exhibiting ductile fracture behavior under dynamic compression conditions. On the fracture surface, typical dimple structures along with evidence of shear slip and melting traces were observed, indicating an energy-releasing failure process. The newly developed alloy exhibited exceptional strength, high density, remarkable plasticity, and outstanding energy release properties, rendering it highly promising for applications under extreme loads.
The Challenge of Impurities (Fe, Si) to Recycling in the Rolled Aluminum Industry in the Coming Years in Relation to Their Influence on Ultimate Tensile Strength
Authors: Vicent Fanconi Mateo M. , Gil Fernández-Marcote Ignacio , Ruiz-Bustinza Íñigo
Published: December 2023

The increased recycling in aluminum production has raised the impurity content in the industry, thus increasing its effect on mechanical characteristics and making it difficult for recycled products to meet the properties’ goals as their effect is not yet sufficiently known. Therefore, the two main impurities (Fe and Si) in standard aluminum rolling mill products of alloy 5754 were investigated to determine their effects on the ultimate tensile strength (UTS). After analyzing the composition, mechanical properties, and microstructure, the relationship of both impurities with the UTS in fully annealed products was estimated by statistical analysis, obtaining a strong influence of Si and Fe.
Microstructure Features and Mechanical Properties of Modified Low-Activation Austenitic Steel in the Temperature Range of 20 to 750 °C
Authors: Litovchenko Igor , Akkuzin Sergey , Polekhina Nadezhda , Spiridonova Kseniya , Osipova Valeria , Kim Anna , Moskvichev Evgeny , Chernov Vyacheslav , Kuznetsov Alexey
Published: December 2023

A new low-activation austenitic steel with a modified composition and high austenite stability is proposed. The features of its microstructure after solution treatment (ST) and cold rolling (CR) are studied. The mechanical properties and features of the fracture behavior of this steel under tensile tests in the temperature range of 20–750 °C are discussed. After ST, an austenitic structure with stacking faults and dispersed carbide particles of the MC and M23C6 types is observed in the steel. After CR, the grains are refined, and the average grain size decreases from 41.4 µm (after ST) to 33.9 µm. High-density microtwin packets form in the material, and the dislocation density increases relative to that after ST. As the test temperature increases from 20 to 750 °C, the yield strength of the steel decreases by approximately two times, from ≈300 to 150 MPa (for ST) and from ≈700 to 370 MPa (for CR). In the studied temperature range, the steel demonstrates up to 2.6 times higher values of elongation to failure, ≈40–80% (for ST) and ≈13–27% (for CR), compared to steels of similar compositions and lower manganese content. Mechanical twinning contributes to the high steel ductility up to 300 °C. Signs of discontinuous flow in the tensile curves after ST in the temperature range of 500–600 °C and a decrease in the elongation to failure in the close temperature range indicate dynamic strain aging (DSA). Steel fracture after tension at all test temperatures mainly occurs via a ductile dimple transcrystalline mechanism with elements of ductile intercrystalline fracture. It is shown that cracks nucleate on clusters of dispersed second-phase particles. The mechanisms of plastic deformation, fracture, and strengthening of the proposed modified low-activation austenitic steel are discussed.
Study of the Mining Waste in the Production of Calcined Aggregate for Use in Pavement
Authors: Friber Marcio Aurelio , Guimarães Antonio Carlos Rodrigues , Martins Camila Antunes , Soares Jefferson Santos
Published: December 2023

The aim of the present study was to evaluate the technical feasibility of using a calcined aggregate with mining residue in different pavement layers, including the base, subbase, and wearing course layers. For this purpose, physical characterizations of the residue and clay and the production of calcined aggregates at temperatures ranging from 800 °C to 1100 °C were performed. Additionally, the suitability levels of these aggregates in pavement layers were assessed, considering the present standards. The physical characterization results indicated that the studied clay was suitable for manufacturing calcined clay aggregates since the particle size distribution showed ceramic potential according to the Winkler diagram, and it presented a plasticity index (PI) higher than 15%. In the tests of boiling-induced mass loss and unit mass, the values obtained were within the limits established by the standards, being lower than 10% and 0.88 g/cm3, respectively. Regarding the abrasion loss test, the M1100 aggregate showed Los Angeles abrasion values lower than the limit established by the standard, demonstrating its potential as an artificial aggregate in pavement applications.