bluuebunny/crossref_metadata_2025 huggingface dataset:
Ibrutinib Monotherapy as Bridge-to-Transplant for Relapsed/Refractory Primary Oculo-Cerebral Lymphoma
Authors: Deak-Mihaly Dalma , Iluta Sabina , Pasca Sergiu , Jitaru Ciprian , Roman Andrei , Andries Alexandra , Padurariu-Covit Monica , Petrushev Bobe , Vasilache Anca , Bojan Anca , Zdrenghea Mihnea , Dascalescu Angela , Antohe Ion , Colita Anca , Colita Andrei , Dima Delia , Tanase Alina , Tomuleasa Ciprian
Published: September 2021

Introduction. Primary central nervous system lymphoma is an uncommon form of extranodal non-Hodgkin’s lymphoma, with increasing incidence, a relatively aggressive course and a poor 5-year survival. Because of its localization, the therapeutic compounds used in this disease must be able to pass through the blood-brain barrier. Chemotherapy regimens based on high-dose methotrexate are currently the standard of care for all patients who can tolerate such drugs. Autologous stem cell transplantation is indicated for malignant lymphomas in the relapsed/refractory setting. Methods. Three patients, with a median age of 60 years, range 53–64, were diagnosed with primary CNS lymphoma, and treated with ibrutinib monotherapy in the Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania, between September 2018 and November 2020 All the patients were relapsed–refractory following high-dose methotrexate chemotherapy. We present our experience using ibrutinib monotherapy-based treatment as a bridge-to-transplant option on a single-center case series and a review of the literature in this field. Results. Two of the patients were given ibrutinib as a second line therapy, both achieving complete remission and being eligible for an autologous stem cell transplantation. The third patient achieved a short remission using six cycles of systemic chemotherapy, but was started on ibrutinib monotherapy, with limited results. Conclusion. Our data is limited, and these results should be confirmed by multicentric clinical trials and should be regarded as a single-center case series, with all its limitations. Still, it brings forward a new therapeutic option for this rare subtype of malignant lymphomas, which if left untreated has a dismal prognosis.
Comparison of the Effect of Pan-Retinal Photocoagulation and Intravitreal Conbercept Treatment on the Change of Retinal Vessel Density Monitored by Optical Coherence Tomography Angiography in Patients with Proliferative Diabetic Retinopathy
Authors: Zhao Hongkun , Yu Minzhong , Zhou Lijun , Li Cong , Lu Lin , Jin Chenjin
Published: September 2021

Background: This study compares the change of retinal vessel density (VD) after pan-retinal photocoagulation (PRP) and intravitreal conbercept (IVC) treatment in proliferative diabetic retinopathy (PDR) eyes with optical coherence tomography angiography (OCTA). Methods: A total of 55 treatment-naïve PDR eyes were included in this retrospective study. Of these, 29 eyes were divided into a PRP group, and 26 eyes were divided into an IVC group based on the treatment they received. OCTA was performed to measure macular and papillary VD at each follow-up in both groups. Results: The macular VD for superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) and papillary VD for radial peripapillary capillary (RPC) between the two groups demonstrated no significant difference at baseline and month 12 (p > 0.05). The paired t-test results showed that the macular VD for SCP, DCP, CC and papillary VD for the RPC at month 12 did not differ to the baseline in each group (p > 0.05). Conclusions: During the 12-month follow-up, there was no significant change of macular and papillary VD between the PRP and IVC treatment in PDR eyes. Additionally, compared to the baseline, there were no significant changes of macular and papillary VD after either the PRP or IVC treatment. Considering the decrease in VD as DR progress, both treatments have potential protection of macular and papillary VD loss in PDR.
An Artificial Intelligent Risk Classification Method of High Myopia Based on Fundus Images
Authors: Wan Cheng , Li Han , Cao Guo-Fan , Jiang Qin , Yang Wei-Hua
Published: September 2021

High myopia is a global ocular disease and one of the most common causes of blindness. Fundus images can be obtained in a noninvasive manner and can be used to monitor and follow up on many fundus diseases, such as high myopia. In this paper, we proposed a computer-aided diagnosis algorithm using deep convolutional neural networks (DCNNs) to grade the risk of high myopia. The input images were automatically classified into three categories: normal fundus images were labeled class 0, low-risk high-myopia images were labeled class 1, and high-risk high-myopia images were labeled class 2. We conducted model training on 758 clinical fundus images collected locally, and the average accuracy reached 98.15% according to the results of fivefold cross-validation. An additional 100 fundus images were used to evaluate the performance of DCNNs, with ophthalmologists performing external validation. The experimental results showed that DCNNs outperformed human experts with an area under the curve (AUC) of 0.9968 for the recognition of low-risk high myopia and 0.9964 for the recognition of high-risk high myopia. In this study, we were able to accurately and automatically perform high myopia classification solely using fundus images. This has great practical significance in terms of improving early diagnosis, prevention, and treatment in clinical practice.
Monitoring of Enoxaparin during Hemodialysis Covered by Regional Citrate Anticoagulation in Acute Kidney Injury: A Prospective Cohort Study
Authors: Wiegele Marion , Adelmann Dieter , Dibiasi Christoph , Pausch Andrè , Baierl Andreas , Schaden Eva
Published: September 2021

Background: Current guidelines recommend the monitoring of anti-factor Xa (anti-Xa) levels to avoid an accumulation of low-molecular-weight heparins in patients with acute kidney injury, but there is no evidence on how to proceed with such monitoring during continuous renal replacement therapy. Against this background, we investigated the potential accumulation of enoxaparin administered subcutaneously for venous thromboembolism prophylaxis in critically ill patients during continuous renal replacement therapy covered by regional citrate anticoagulation. Methods: Anti-Xa levels were measured at baseline (≤12 h before renal replacement therapy) and on three consecutive days (A to C) when enoxaparin had reached trough levels. Supplementary testing included modified assays of rotational thromboelastometry known to be highly sensitive for low-molecular-weight heparins. Results: The 16 men and 13 women included were adults comparable in age, body mass index, thromboembolism risk assessment, and clinical severity of the disease. Throughout the four examinations, the median trough levels of anti-Xa remained below the detection limit of the test (<0.1 IU mL−1), with interquartile ranges of <0.1 to 0.14 IU mL−1 at baseline and <0.1 to 0.16 IU mL−1 on days A/B/C. All rotational thromboelastometry parameters of clot initiation and clot formation dynamics did not significantly change from baseline to day C. Conclusions: Neither anti-Xa levels nor modified assays of rotational thromboelastometry revealed any accumulation of enoxaparin administered for thromboprophylaxis during continuous renal replacement therapy covered by regional citrate anticoagulation. Although generally recommended in patients with acute kidney injury, monitoring of anti-Xa levels should be questioned in this defined setting.
The Pandora’s Box of Frailty Assessments: Which Is the Best for Clinical Purposes in TAVI Patients? A Critical Review
Authors: Baritello Omar , Salzwedel Annett , Sündermann Simon H. , Niebauer Josef , Völler Heinz
Published: September 2021

Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty.
The Safety of Bilateral Simultaneous Hip and Knee Arthroplasty versus Staged Arthroplasty in a High-Volume Center Comparing Blood Loss, Peri- and Postoperative Complications, and Early Functional Outcome
Authors: Najfeld Michael , Kalteis Thomas , Spiegler Christian , Ley Christophe , Hube Robert
Published: September 2021

Purpose: In recent years, there has been increasing interest in the use of simultaneous hip and knee arthroplasty compared to staged procedures in patients with bilateral pathology. The aim of this study was to compare simultaneous and staged hip and knee arthroplasty in patients with bilateral pathology by assessing the transfusion rate, postoperative hemoglobin drop, length of stay (LOS), in-hospital complications, 30-day readmissions and early functional outcome. Methods: We conducted a retrospective cohort study that included all patients who were undergoing primary TKA, THA and UKA by a single surgeon in a high-volume arthroplasty center between 2015 and 2020 as simultaneous or staged procedures. Staged bilateral arthroplasties were performed within 12 months and were stratified by the time between procedures. Data were acquired through the electronic files at the Orthopädische Chirurgie München (OCM). For functional outcome, the ability of the patients to walk independently on the ward was compared with the ability to walk a set of stairs alone, which was recorded daily by the attending physiotherapist. Results: In total n = 305 patients were assessed for eligibility and included in this study. One hundred and forty-five patients were allocated to the staged arthroplasty group. This group was subdivided into a hip and a knee group, whereas the knee group was split into TKA and UKA. The second staged procedure was performed within 12 months of the first procedure. One hundred and sixty patients were allocated to the simultaneous arthroplasty group. This group was also subdivided into a hip and knee group, whereas the knee group was split again into a TKA and UKA group. No statistical difference was found between the two groups regarding demographic data. Primary outcome measurements: There was no significant difference in the transfusion rate or complication rate. Secondarily, no statistically significant difference was found between the postoperative hemoglobin drop and the functional outcome, or in the length of stay (LOS) between both groups. Walking the stairs showed a significant difference in the knee group. Conclusions: There were no significant differences observed in the transfusion rate in-hospital complications, or readmission rate between both groups. The early functional outcome showed no significant difference in mobility for all groups. Simultaneous arthroplasty for knee or hip is as safe as a staged procedure, with no higher risk for the patient, in a specialized high-volume center. Level of evidence: Level IV.
Predictors of Effectiveness of Platelet-Rich Plasma Therapy for Knee Osteoarthritis: A Retrospective Cohort Study
Authors: Saita Yoshitomo , Kobayashi Yohei , Nishio Hirofumi , Wakayama Takanori , Fukusato Shin , Uchino Sayuri , Momoi Yasumasa , Ikeda Hiroshi , Kaneko Kazuo
Published: September 2021

There has recently been growing interest worldwide in biological therapies such as platelet-rich plasma injection for the treatment of knee osteoarthritis. However, predicting the effectiveness of platelet-rich plasma therapy remains uncertain. Therefore, this retrospective cohort study was performed to assess a range of predictors for the effectiveness of platelet-rich plasma therapy in treating knee osteoarthritis. The study included 517 consecutive patients who underwent three injections of leucocyte-poor platelet-rich plasma therapy from 2016 to 2019 at a single institution. The treatment outcomes, including patient-oriented outcomes (visual analogue scale score and Knee Injury and Osteoarthritis Outcome Score), were analyzed and compared according to the severity of knee osteoarthritis based on Kellgren–Lawrence (KL) grading using standing plain radiographs. Fisher’s exact test, univariate regression, and multivariate regression were used for data analysis. Patient-oriented outcomes were significantly improved 6 and 12 months after platelet-rich plasma therapy. The overall responder rate in patients who met the Outcome Measures in Rheumatology (OMERACT)–Osteoarthritis Research Society International (OARSI) responder criteria was 62.1%. The responder rate was significantly lower in patients with severe knee osteoarthritis (KL4, 50.9%) than in those with mild (KL2, 75.2%) and moderate (KL3, 66.5%) knee osteoarthritis. The multivariate logistic regression analysis revealed that deterioration of the knee osteoarthritis grade (increased KL grade) was a significant predictor of a worse clinical outcome (odds ratio, 0.58; 95% confidence interval, 0.45–0.75; p < 0.001). The relative risk for non-responders in severe (KL4) KOA was 2.1 (95% CI, 1.5–3.0) at 6 months and 2.3 (1.6–3.2) at 12 months compared with mild-to-moderate (KL2-3) KOA. The efficacy of platelet-rich plasma therapy was not affected by age, sex, body weight, or platelet count. This study revealed that the effectiveness of platelet-rich plasma therapy for the treatment of knee osteoarthritis is approximately 60% and that the effectiveness depends on the severity of knee osteoarthritis. This observation is useful not only for physicians but also for patients with knee osteoarthritis.
The Effects of Some Phosphorus-Containing Fire Retardants on the Properties of Glass Fibre-Reinforced Composite Laminates Made from Blends of Unsaturated Polyester and Phenolic Resins
Authors: Krishnan Latha , Kandola Baljinder. K. , Ebdon John R.
Published: September 2021

This study investigated the effects of phosphorus fire retardants (FRs) in matrices from co-cured blends of an unsaturated polyester (UP) with inherently fire-retardant phenolic resoles (PH) on the mechanical and flammability properties of resultant glass fibre-reinforced composites. Three different phenolic resoles with UP have been used: (i) an ethanol soluble (PH-S), (ii) an epoxy-functionalised (PH-Ep), and (iii) an allyl-functionalised resin (PH-Al) with two different phosphorus FRs: resorcinol bis (diphenyl phosphate) (RDP) and 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide (DOPO). The flammabilities of the resultant composites were evaluated using cone calorimetry and the UL-94 test. Cone calorimetric results showed reductions in peak heat release rate (PHRR) and total heat released (THR) as expected compared to those of UP and respective UP/PH composite laminates without FRs. UL-94 tests results showed that while all composites had HB rating, FR containing samples self-extinguished after removal of the flame. The mechanical properties of the composites were evaluated using flexural, tensile and impact tests. All FRs reduced the mechanical properties, and the reduction in mechanical properties was more severe in UP/PH-S (least compatible blends) composites with FRs than in UP/PH-Al (most compatible blends) composites with FRs. Amongst the different composites, those from UP/PH-Al with DOPO showed the best fire retardancy with little deterioration of mechanical performance.
Semi-Supervised Domain Adaptation for Holistic Counting under Label Gap
Authors: Litrico Mattia , Battiato Sebastiano , Tsaftaris Sotirios A. , Giuffrida Mario Valerio
Published: September 2021

This paper proposes a novel approach for semi-supervised domain adaptation for holistic regression tasks, where a DNN predicts a continuous value y∈R given an input image x. The current literature generally lacks specific domain adaptation approaches for this task, as most of them mostly focus on classification. In the context of holistic regression, most of the real-world datasets not only exhibit a covariate (or domain) shift, but also a label gap—the target dataset may contain labels not included in the source dataset (and vice versa). We propose an approach tackling both covariate and label gap in a unified training framework. Specifically, a Generative Adversarial Network (GAN) is used to reduce covariate shift, and label gap is mitigated via label normalisation. To avoid overfitting, we propose a stopping criterion that simultaneously takes advantage of the Maximum Mean Discrepancy and the GAN Global Optimality condition. To restore the original label range—that was previously normalised—a handful of annotated images from the target domain are used. Our experimental results, run on 3 different datasets, demonstrate that our approach drastically outperforms the state-of-the-art across the board. Specifically, for the cell counting problem, the mean squared error (MSE) is reduced from 759 to 5.62; in the case of the pedestrian dataset, our approach lowered the MSE from 131 to 1.47. For the last experimental setup, we borrowed a task from plant biology, i.e., counting the number of leaves in a plant, and we ran two series of experiments, showing the MSE is reduced from 2.36 to 0.88 (intra-species), and from 1.48 to 0.6 (inter-species).
Fuzzy Scheduling Problem of Vessels in One-Way Waterway
Authors: Liu Dongdong , Shi Guoyou , Kang Zhen
Published: September 2021

Effective use of port waterways is conducive to enhancing port competitiveness. To minimize the waiting time of ships, improve traffic efficiency, and enhance the applicability of the model to the presence of uncertain factors, a fuzzy scheduling optimization method for ships suitable for one-way waterways is proposed based on fuzzy theory. Considering the ambiguity of the speed of ships entering and exiting the port or the time it takes to cross the channel, the previous research on vessel scheduling on one-way waterways has been extended by introducing a triangular fuzzy number and a method for determining the feasible navigable time window of a ship subject to the tide height constraint was proposed. In this study, the genetic algorithm is used to construct the mathematical model for solving fuzzy vessel scheduling problems based on time optimization, and the minimum delay strategy is used to determine the service sequence. Then, the parameters setting are discussed in detail to find the optimal settings. Finally, an experimental comparative analysis of the randomly generated cases was conducted based on the simulated data. The results show that the designed fuzzy vessel scheduling algorithm reduces the dependence on the port environment, is versatile, and can effectively improve the efficiency of ship schedules and traffic safety compared to other methods. Moreover, it can avoid the problem of the illegal solution occurring in the manual scheduling method.
Shifts in the Assemblage of Summer Mesopelagic Fish Larvae in the Gaoping Waters of Southwestern Taiwan: A Comparison between El Niño Events and Regular Years
Authors: Hsieh Hung-Yen , Lo Wen-Tseng , Liao Chien-Chun , Meng Pei-Jie
Published: September 2021

We investigated changes in the assemblages of summer mesopelagic fish larvae between El Niño events and regular years in 2014–2018 and evaluated their relationships with the hydrographic conditions of the Gaoping waters off southwestern Taiwan. Seventy-five taxa or morphotypes were identified, with five types of Benthosema pterotum (31.2%), Diaphus slender type (19.9%), Cyclothone alba (7.2%), Diaphus stubby type (5.9%), and Vinciguerria nimbaria (4.4%) being most common during the study period. The hydrographic conditions of the Gaoping waters were likely influenced by large-scale climate change via oceanic physical processes. Apparently higher seawater temperature, mixed layer depth, and lower salinity in the upper 100 m were observed at the end of the strong El Niño events (summer 2016). In addition, the certain dominant taxa exhibited contrasting patterns between El Niño events and regular years. In this study, although the abundance and composition of mesopelagic fish larvae assemblage were not influenced directly by changes in large-scale climatic conditions, the occurrence of mesopelagic fish larvae was related to seawater temperature, salinity, and chlorophyll a concentration. We speculated that despite the abundant food availability and the more mesopelagic fish larvae onto the Gaoping waters transported by the increased inflow of the South China Sea Surface Current during El Niño events, the higher temperature and lower salinity at the inshore upper waters might be unsuitable for mesopelagic fish larvae, possibly resulting in low egg and larval survival.
And…Action! Setting the Scene for Accurate Visual CFD Comparisons Using Ray Tracing
Authors: Klapwijk Maarten , Lemaire Sébastien
Published: September 2021

Increased graphical capabilities of contemporary computer hardware make ray tracing possible for a much wider range of applications. In science, and numerical fluid mechanics in particular, visual inspections still play a key role in both understanding flows, predicted by computational fluid dynamics, exhibiting features observable in real-life, such as interfaces or smoke, and when comparing such flows against experimental observations. Usually, little attention is paid to the visualisation itself, unless when the render is used solely for its eye-catching appearance. In this work, we argue that the use of ray tracing software can help make comparisons between computational and experimental fluid dynamics more robust and meaningful, and that, in some cases, it is even a necessity. Several visualisation problems which can be overcome through application of this methodology are discussed, and the use of ray tracing is exemplified for several common test cases in the maritime field. Using these examples the benefits of ray tracing are shown, and it is concluded that ray tracing can improve the reliability of scientific visual comparisons.
Research of the Influence of Marine Residual Fuel Composition on Sedimentation Due to Incompatibility
Authors: Sultanbekov Radel , Islamov Shamil , Mardashov Dmitry , Beloglazov Ilia , Hemmingsen Tor
Published: September 2021

The article shows studies of the problem of active sediment formation during mixing of residual fuels, caused by the manifestation of incompatibility. To preserve the quality and reduce sediment formation during transshipment, storage, and transportation of marine residual fuels, a laboratory method for determining the compatibility and stability of fuels has been developed, which makes it possible to determine the quantitative characteristics of the sediment formation activity. According to the method developed, laboratory studies have been carried out to determine incompatible fuel components and the influence of composition on the sedimentation process. Tests were carried out to determine the quality indicators and the individual group composition of the fuel samples. Based on the results of the studies, the dependences of the influence of normal structure paraffins in the range from 55 to 70 wt. % and asphaltenes in the range from 0.5 to 3.5 wt. % in the fuel composition on the sedimentation activity due to incompatibility were obtained. To obtain a convenient tool that is applicable in practice, a nomogram has been developed on the basis of the dependences obtained experimentally. It was also determined that, after reaching the maximum values of sediment formation with a further increase in the content of n-paraffins, saturation is observed, and the value of the sediment content remains at the same level. Maximum total sediment values have been found to depend on asphaltene content and do not significantly exceed them within 10%. The results of the research presented in this article allow laboratory and calculation to determine the possibility of incompatibility and to preserve the quality of marine residual fuels.
Coupled SPH–FEM Modeling of Tsunami-Borne Large Debris Flow and Impact on Coastal Structures
Authors: Hasanpour Anis , Istrati Denis , Buckle Ian
Published: September 2021

Field surveys in recent tsunami events document the catastrophic effects of large waterborne debris on coastal infrastructure. Despite the availability of experimental studies, numerical studies investigating these effects are very limited due to the need to simulate different domains (fluid, solid), complex turbulent flows and multi-physics interactions. This study presents a coupled SPH–FEM modeling approach that simulates the fluid with particles, and the flume, the debris and the structure with mesh-based finite elements. The interaction between the fluid and solid bodies is captured via node-to-solid contacts, while the interaction of the debris with the flume and the structure is defined via a two-way segment-based contact. The modeling approach is validated using available large-scale experiments in the literature, in which a restrained shipping container is transported by a tsunami bore inland until it impacts a vertical column. Comparison of the experimental data with the two-dimensional numerical simulations reveals that the SPH–FEM models can predict (i) the non-linear transformation of the tsunami wave as it propagates towards the coast, (ii) the debris–fluid interaction and (iii) the impact on a coastal structure, with reasonable accuracy. Following the validation of the models, a limited investigation was conducted, which demonstrated the generation of significant debris pitching that led to a non-normal impact on the column with a reduced contact area and impact force. While the exact level of debris pitching is highly dependent on the tsunami characteristics and the initial water depth, it could potentially result in a non-linear force–velocity trend that has not been considered to date, highlighting the need for further investigation preferably with three-dimensional models.
Bioleaching of Manganese Oxides at Different Oxidation States by Filamentous Fungus Aspergillus niger
Authors: Farkas Bence , Bujdoš Marek , Polák Filip , Matulová Michaela , Cesnek Martin , Duborská Eva , Zvěřina Ondřej , Kim Hyunjung , Danko Martin , Kisová Zuzana , Matúš Peter , Urík Martin
Published: September 2021

This work aimed to examine the bioleaching of manganese oxides at various oxidation states (MnO, MnO·Mn2O3, Mn2O3 and MnO2) by a strain of the filamentous fungus Aspergillus niger, a frequent soil representative. Our results showed that the fungus effectively disintegrated the crystal structure of selected mineral manganese phases. Thereby, during a 31-day static incubation of oxides in the presence of fungus, manganese was bioextracted into the culture medium and, in some cases, transformed into a new biogenic mineral. The latter resulted from the precipitation of extracted manganese with biogenic oxalate. The Mn(II,III)-oxide was the most susceptible to fungal biodeterioration, and up to 26% of the manganese content in oxide was extracted by the fungus into the medium. The detected variabilities in biogenic oxalate and gluconate accumulation in the medium are also discussed regarding the fungal sensitivity to manganese. These suggest an alternative pathway of manganese oxides’ biodeterioration via a reductive dissolution. There, the oxalate metabolites are consumed as the reductive agents. Our results highlight the significance of fungal activity in manganese mobilization and transformation. The soil fungi should be considered an important geoactive agent that affects the stability of natural geochemical barriers.
Real-Life Considerations on Antifungal Treatment Combinations for the Management of Invasive Mold Infections after Allogeneic Cell Transplantation
Authors: Glampedakis Emmanouil , Roth Romain , Masouridi-Levrat Stavroula , Chalandon Yves , Mamez Anne-Claire , Giannotti Federica , Van Delden Christian , Neofytos Dionysios
Published: September 2021

Background: Antifungal combination treatment is frequently administered for invasive mold infections (IMIs) after allogeneic hematopoietic cell transplantation (HCT). Here, we describe the indications, timing, and outcomes of combination antifungal therapy in post-HCT IMI. Methods: A single-center, 10-year, retrospective cohort study including all adult HCT recipients with proven/probable IMI between 1 January 2010 and 1 January 2020 was conducted. Results: During the study period, 515 patients underwent HCT, of whom 47 (9.1%) presented 48 IMI episodes (46 patients with one IMI episode and 1 patient with two separate IMI episodes): 33 invasive aspergillosis (IA) and 15 non-IA IMIs. Almost half (51%) of the patients received at least one course of an antifungal combination (median: 2/patient): 23 (49%), 20 (42%), and 4/47 (9%) patients received pure monotherapy, mixed monotherapy/combination, and pure combination treatment, respectively. Combination treatment was started at a median of 8 (IQR: 2, 19) days post-IMI diagnosis. Antifungal management was complex, with 163 treatment courses prescribed overall, 48/163 (29.4%) concerning antifungals in combination. The clinical reasons motivating the selection of initial combination antifungal therapy included severe IMI (18, 38%), lack of antifungal susceptibility data (14, 30%), lack of pathogen identification (5, 11%), and combination treatment until reaching a therapeutic azole serum level (6, 13%). The most common combination treatments were azole/liposomal amphotericin-B (28%) and liposomal amphotericin-B/echinocandin (21%). Combination treatment was administered cumulatively for a median duration of 28 days (IQR: 7, 47): 14 (IQR: 6, 50) days for IA and 28 (IQR: 21, 34) days for non-IA IMI (p = 0.18). Overall, 12-week mortality was 30%. Mortality was significantly higher among patients receiving ≥50% of treatment as combination (logrank = 0.04), especially those with non-IA IMI (logrank = 0.03). Conclusions: Combination antifungal treatment is frequently administered in allogeneic HCT recipients with IMI to improve clinical efficacy, albeit in an inconsistent and variable manner, suggesting a lack of relevant data and guidance, and an urgent need for new studies to improve therapeutic options.
Pipelle Endometrial Biopsy for Abnormal Uterine Bleeding in Daily Clinical Practice: Why the Approach to Patients Should Be Personalized?
Authors: Tanko Naanlep M. , Linkov Faina , Bapayeva Gauri , Ukybassova Talshyn , Kaiyrlykyzy Aiym , Aimagambetova Gulzhanat , Kenbayeva Kamila , Ibrayimov Bakytkali , Lyasova Alla , Terzic Milan
Published: September 2021

Background. Abnormal uterine bleeding (AUB) is a common gynecologic condition, and proper management is based on the histological evaluation of an adequate endometrial sample obtained via biopsy. The aims of this study were to evaluate factors influencing the reliability and success rate of Pipelle endometrial sampling for histopathological diagnosis. Methods. One hundred and eighty patients with AUB underwent endometrial sampling using both Pipelle and dilatation and curettage (D&C) procedures at the Clinical Academic Department of Women’s Health, University Medical Center between January 2019 and April 2021. We analyzed the effects of age, menopausal status, ethnicity, body mass index (BMI), provider experience, and procedure indication on the success and reliability of each procedure. Results. Pipelle sampling was successful in 144 (80.56%) women, while D&C was successful in 164 (91.11%) women. Analysis using Fisher’s exact test showed that age, menopausal status, and biopsy indication were factors affecting the success rate of both methods, while ethnicity, BMI, and physician experience had no influence. Overall concordance in the histopathological results between Pipelle and D&C was 91.72%. Conclusion. Pipelle sampling was found to be reliable for the detection of endometrial carcinoma and endometrial hyperplasia, while its reliability was low in cases of endometrial polyps. The endometrial sampling approach should be personalized in daily clinical practice for women with AUB, and Pipelle sampling is not suitable for all patients. If an endometrial polyp is suspected, the physician should consider other diagnostic tools, bearing in mind all of the factors influencing endometrial sampling success and reliability rates.
20 Hz Transcranial Alternating Current Stimulation Inhibits Observation-Execution-Related Motor Cortex Excitability
Authors: Wang Lijuan , Nitsche Michael A. , Zschorlich Volker R. , Liu Hui , Kong Zhaowei , Qi Fengxue
Published: September 2021

The present study aimed to investigate the effect of transcranial alternating current stimulation (tACS) on the primary motor cortex (M1) during action observation, and subsequent action execution, on motor cortex excitability. The participants received tACS at 10 Hz or 20 Hz, or a sham stimulation over the left M1 for 10 min while they observed a video displaying a repeated button-tapping task using the right hand, and then performed an identical task with their right hand. Motor-evoked potential (MEP) amplitudes were measured before (T0) and after the action observation paired with tACS or a sham stimulation (T1), and after the performance of the action (T2). The results showed that MEPs were significantly reduced at time point T1 (p = 0.042, Cohen’s d = 0.611) and T2 (p = 0.0003, Cohen’s d = 0.852) in the 20 Hz tACS condition, in contrast with the sham stimulation. There was a significantly smaller MEP amplitude at time point T2 in the 20 Hz tACS condition, as compared to the 10 Hz tACS condition (p = 0.01, Cohen’s d = 0.622), but the MEP amplitude did not significantly change at time point T1 between the 20 Hz and 10 Hz tACS conditions (p = 0.136, Cohen’s d = 0.536). There were no significant differences at time point T1 and T2 between the 10 Hz tACS condition and the sham stimulation. We conclude that 20 Hz tACS during action observation inhibited motor cortex excitability and subsequently inhibited execution-related motor cortex excitability. The effects of tACS on task-related motor cortex excitability are frequency-dependent.
The Khandaq Shapur: Defense, Irrigation, Boundary, Frontier
Authors: de Gruchy Michelle , Jotheri Jaafar , Alqaragholi Hayder , Al-Janabi Jassim , Alabdan Raheem , Al-Talaqani Haneen , Almamouri Ghadeer , Al-Rubaye Hajir
Published: September 2021

Khandaq Shapur has been named one of the great barriers of the ancient world, but very little is known about the monumental-scale linear feature. This interdisciplinary paper brings together archaeologists and historians to present (1) an updated history of the Khandaq Shapur drawing upon a wider range of sources, including Arabic scholarly sources, and (2) a modern map of the Khandaq Shapur produced from a ground truthed remote sensing using historic Corona satellite imagery from the 1960s and imagery available in Google Earth. This new map of the Khandaq Shapur’s ground truthed location is compared to the known locations of Sasanian sites from previous archaeological surveys to contextualise the Khandaq Shapur within the wider archaeological landscape. Together, the landscape archaeology and historical evidence provide a comprehensive picture of this unique feature: shedding light not only on its precise location, but also its nature (what was it?) and how it was used over time.
Comparison on Land-Use/Land-Cover Indices in Explaining Land Surface Temperature Variations in the City of Beijing, China
Authors: Khan Muhammad Sadiq , Ullah Sami , Chen Liding
Published: September 2021

The urban thermal environment is closely related to landscape patterns and land surface characteristics. Several studies have investigated the relationship between land surface characteristics and land surface temperature (LST). To explore the effects of the urban landscape on urban thermal environments, multiple land-use/land-cover (LULC) remote sensing-based indices have emerged. However, the function of the indices in better explaining LST in the heterogeneous urban landscape has not been fully addressed. This study aims to investigate the effect of remote-sensing-based LULC indices on LST, and to quantify the impact magnitude of green spaces on LST in the city built-up blocks. We used a random forest classifier algorithm to map LULC from the Gaofen 2 (GF-2) satellite and retrieved LST from Landsat-8 ETM data through the split-window algorithm. The pixel values of the LULC types and indices were extracted using the line transect approach. The multicollinearity effect was excluded before regression analysis. The vegetation index was found to have a strong negative relationship with LST, but a positive relationship with built-up indices was found in univariate analysis. The preferred indices, such as normalized difference impervious index (NDISI), dry built-up index (DBI), and bare soil index (BSI), predicted the LST (R2 = 0.41) in the multivariate analysis. The stepwise regression analysis adequately explained the LST (R2 = 0.44) due to the combined effect of the indices. The study results indicated that the LULC indices can be used to explain the LST of LULC types and provides useful information for urban managers and planners for the design of smart green cities.
Do Local Residents Support the Development of a National Park? A Study from Nanling National Park Based on Social Impact Assessment (SIA)
Authors: Dong Qian , Zhang Bo , Cai Xiaomei , Morrison Alastair M.
Published: September 2021

Over the past five years, the pilot establishment of national parks in China has been a major event in global biodiversity conservation. The national parks under construction and proposed account for nearly 1% of the land area, and their social impacts have attracted the attention of researchers and managers. However, most of the research has a focus on the effects of protection, and national parks do not have a sufficient understanding of the social impacts and perceptions of the local residents. This research, taking Nanling National Park in Guangdong Province as the case, used the social impact assessment research framework to explore the perceptions and support of local people for the creation of national parks. Through questionnaires and in-depth interviews, the findings were first that most residents expressed a low awareness of Nanling National Park’s development, but they still expressed conditional support. Second, ethnic minorities and less educated residents did not support the creation of national parks. Perceptions of ecological, economic, political, and cultural impacts affected whether residents supported the construction of national parks. In the initial stages of national park development, governmental administrative departments should reduce the negative impacts of national park construction by strengthening the publicity and awareness building, formulating appropriate policy guidance for different needs, and giving local residents the right to express their views, so as to enhance resident support for national park projects.
Land Use Optimization and Simulation of Low-Carbon-Oriented—A Case Study of Jinhua, China
Authors: Huang Shiqi , Xi Furui , Chen Yiming , Gao Ming , Pan Xu , Ren Ci
Published: September 2021

Land-use change is an important contributor to atmospheric carbon emissions. Taking Jinhua city in eastern China as an example, this study analyzed the effects on carbon emissions by land-use changes from 2005 to 2018. Then, carbon emissions that will be produced in Jinhua in 2030 were predicted based on the land-use pattern predicted by the CA-Markov model. Finally, a low-carbon optimized land-use pattern more consistent with the law of urban development was proposed based on the prediction and planning model used in this study. The results show that (1) from 2005 to 2018, the area of land used for construction in Jinhua continued to increase, while woodland and cultivated land areas decreased. Carbon emissions from land use rose at a high rate. By 2018, carbon emissions had increased by 1.9 times compared to 2015. (2) During the 2010–2015 period, the total concentration of carbon emissions decreased due to decreases in both the rate of growth in construction land and the rate of decline in a woodland area, as well as an adjustment of the energy structure and the use of polluting fertilizer and pesticide treatments. (3) The carbon emissions produced with an optimal land-use pattern in 2030 are predicted to reduce by 19%. The acreage of woodland in Jinhua’s middle basin occupied by construction land and cultivated land is predicted to reduce. The additional construction land will be concentrated around the main axis of the Jinhua-Yiwu metropolitan area and will exhibit a characteristic ribbon-form with more distinct clusters. The optimized land-use pattern is more conducive to carbon reduction and more in line with the strategy of regional development in the study area. The results of this study can be used as technical support to optimize the land-use spatial pattern and reduce urban land’s contribution to carbon emissions.
Social and Psychological Factors in Bilingual Speech Production: Introduction to the Special Issue
Authors: Mayr Robert , Morris Jonathan
Published: September 2021

The pronunciation patterns of bilinguals and their development have been investigated in a number of ways [...]
Diffraction Methods for Qualitative and Quantitative Texture Analysis of Ferroelectric Ceramics
Authors: Fancher Chris M.
Published: September 2021

Crystallographic textures are pervasive in ferroelectrics and underpin the functional properties of devices utilizing these materials because many macroscopic properties (e.g., piezoelectricity) require a non-random distribution of dipoles. Inducing a preferred grain texture has become a viable route to improve these functional properties. X-ray and neutron diffraction have become valuable tools to probe crystallographic textures. This paper presents an overview of qualitative and quantitative methods for assessing crystallographic textures in electroceramics (domain and grain textures) and discusses their strengths and weaknesses.
Increasing the Fatigue Resistance of Strain-Hardening Cement-Based Composites (SHCC) by Experimental-Virtual Multi-Scale Material Design
Authors: Junger Dominik , Storm Johannes , Müller Steffen , Kaliske Michael , Mechtcherine Viktor
Published: September 2021

Strain-hardening cement-based composites are a promising class of materials for a wide variety of applications due to their considerable tensile strength and pronounced ductility caused by the development of multiple fine cracks. Nevertheless, the safe use of such composites requires sound knowledge of their mechanical behaviour under different types of loading, particularly under fatigue loading, while considering distinct influences like initial crack width and fibre orientation. To deepen this knowledge, single-fibre pull-out tests on PVA-fibres from a cementitious matrix were carried out to gain information about the micro-mechanical and degradation processes of the fibre. It could be shown that the fibres tend to rupture instead of being pulled out under quasi-static loading. When changing the loading regime to alternating loading, this failure mechanism shifts to pull-out. By varying the experimental parameters such as initial crack width, inclination angle or compressive-force level a clear influence on the fibre’s crack bridging capacity could be observed associated with effects on the degradation processes. Based on the data obtained, a micro-mechanical numerical model was developed to support the assumptions and observations from single-fibre pull-out tests and to enable predictions of the performance of the material on the microscale under cyclic loading.
Influence of Tranexamic Acid on Elution Characteristics and Compressive Strength of Antibiotic-Loaded PMMA-Bone Cement with Gentamicin
Authors: Lüdemann Martin , Jakuscheit Axel , Ewald Andrea , Frühmann Leena , Hölscher-Doht Stefanie , Rudert Maximilian , von Hertzberg-Boelch Sebastian Philipp
Published: September 2021

Purpose: The topical application of tranexamic acid (TXA) into the joint space during total joint arthroplasty (TJA) with no increase of complications, has been widely reported. We investigated the influence of TXA on antibiotic release, activity of the released antibiotic against a clinical isolate of S. aureus, and compressive strength of a widely used commercially prepared gentamicin-loaded cement brand (PALACOS R + G). Method: 12 bone cement cylinders (diameter and height = 6 and 12 mm, respectively) were molded. After curing in air for at least 1 h, six of the cylinders were completely immersed in 5 mL of fetal calf serum (FCS) and the other six were completely immersed in a solution consisting of 4.9 mL of FCS and 0.1 mL (10 mg) of TXA. Gentamicin elution tests were performed over 7 d. Four hundred µL of the gentamicin eluate were taken every 24 h for the first 7 d without renewing the immersion fluid. The gentamicin concentration was determined in a clinical analyzer using a homogeny enzyme immuno-assay. The antimicrobial activity of the eluate, obtained after day 7, was tested. An agar diffusion test regime was used with Staphylococcus aureus. Bacteria were grown in a LB medium and plated on LB agar plates to get a bacterial lawn. Fifty µL of each eluate were pipetted on 12-mm diameter filter discs, which were placed in the middle of the agar gel. After 24 h of cultivation at 37 °C, the zone of inhibition (ZOI) for each specimen was measured. The compressive strength of the cements was determined per ISO 5833. Results: At each time point in the gentamicin release test, the difference in gentamicin concentration, obtained from specimens immersed in the FCS solution only and those immersed in the FCS + TXA solution was not significant (p = 0.055–0.522). The same trend was seen in each of the following parameters, after 7 d of immersion: (1) Cumulative gentamicin concentration (p < 0.297); (2) gentamicin activity against S. aureus (strongly visible); (3) ZOI size (mostly > 20 mm) (p = 0.631); and (4) compressive strength (p = 0.262). Conclusions: For the PALACOS R + G specimens, the addition of TXA to FCS does not produce significant decreases in gentamicin concentration, in the activity of the gentamicin eluate against a clinical isolate of S. aureus, the zone of inhibition of S. aureus, and in the compressive strength of the cement, after 7 d of immersion in the test solution.