bluuebunny/crossref_metadata_2025 huggingface dataset:
Speech, Gait, and Vestibular Function in Cerebellar Ataxia with Neuropathy and Vestibular Areflexia Syndrome
Authors: Di Rauso Giulia , Castellucci Andrea , Cavallieri Francesco , Tozzi Andrea , Fioravanti Valentina , Monfrini Edoardo , Gessani Annalisa , Rossi Jessica , Campanini Isabella , Merlo Andrea , Ronchi Dario , Napoli Manuela , Pascarella Rosario , Grisanti Sara , Ferrulli Giuseppe , Sabadini Rossella , Di Fonzo Alessio , Ghidini Angelo , Valzania Franco
Published: October 2023

(1) Background: Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is characterized by late-onset cerebellar ataxia, bilateral vestibulopathy, and sensory neuronopathy mostly due to biallelic RFC1 expansion. (2) Objectives: The aim of this case series is to describe vestibular, gait, and speech alterations in CANVAS via a systematic approach. (3) Methods: All patients (n = 5) underwent a standardized clinical–instrumental examination, including the perceptual and acoustic analysis of speech, instrumental gait, and balance analysis (posturographic data were acquired using a force plate [Kistler, Winterthur, Switzerland] while 3D gait analysis, inclusive of surface electromyography, was acquired using a motion capture system [SMART DX, BTS Bioengineering, Milan, Italy], a wireless electromyograph [FreeEMG, BTS Bioengineering, Milan, Italy]), and vestibular assessment with video-oculography. (4) Results: Five patients were included in the analysis: three females (patients A, B, C) and two males (patients D and E) with a mean age at evaluation of 62 years (SD ± 15.16, range 36–74). The mean age of symptoms’ onset was 55.6 years (SD ± 15.04, range 30–68), and patients were clinically and instrumentally evaluated with a mean disease duration of 6.4 years (SD ± 0.54, range 6–7). Video-Frenzel examination documented spontaneous downbeat nystagmus enhanced on bilateral gaze in all patients, except for one presenting with slight downbeat nystagmus in the supine position. All patients exhibited different degrees of symmetrically reduced VOR gain for allsix semicircular canals on the video-head impulse test and an unexpectedly normal (“false negative”) VOR suppression, consistent with combined cerebellar dysfunction and bilateral vestibular loss. Posturographic indices were outside their age-matched normative ranges in all patients, while 3D gait analysis highlighted a reduction in ankle dorsiflexion (limited forward rotation of the tibia over the stance foot during the stance phase of gait and fatigue of the dorsiflexor muscles) and variable out-of-phase activity of plantar flexors during the swing phase. Finally, perceptual-acoustic evaluation of speech showed ataxic dysarthria in three patients. Dysdiadochokinesis, rhythm instability, and irregularity were observed in the oral diadochokinesis task. (5) Conclusions: CANVAS is a recently discovered syndrome that is gaining more and more relevance within late-onset ataxias. In this paper, we aimed to contribute to a detailed description of its phenotype.
Exploring the Limitations of Pedestrian Route Directness: A Correlation between Sensitivity and Radius Variability
Authors: Daghash Farah , Anabtawi Rim , Byon Young-Ji , Alawadi Khaled
Published: October 2023

Amid the growing emphasis on the environmental and health benefits of walking, enhanced network connectivity emerges as a significant determinant in promoting pedestrian activity, as proven by scholars statistically and theoretically. Recent academic endeavors have introduced metrics such as pedestrian route directness (PRD) to measure connectivity, which maps the directness of routes between critical origins and destinations of the urban layout. However, there have been concerns from scholars about the limitations of PRD in theory, especially its sensitivity to larger radii of analysis. Addressing this theoretical inconsistency, this paper employs Pearson’s correlation and linear regression analysis to explore the correlation between the radius of analysis and variance of results, the significance of this correlation for subsequent research, and the geographical context’s influence on metric selection. The findings have revealed an r-value of −0.82, suggesting a strong and negative correlation. Moreover, the p-value of 0.0003 demonstrates the significance of the correlation and the rejection of the null hypothesis. These results bridge the gap between theoretical discussions and empirical analysis, revealing that, as the analysis radius expands, the sensitivity of results diminishes. The findings of this study hold significant implications for policy development and regulation of PRD, offering crucial insights that particularly advance the field of street connectivity.
The Carcinogenic Potential of Bisphenol A in the Liver Based on Transcriptomic Studies
Authors: Wiszpolska Marta , Lepiarczyk Ewa , Maździarz Mateusz A. , Paukszto Łukasz , Makowczenko Karol G. , Lipka Aleksandra , Łopieńska-Biernat Elżbieta , Makowska Krystyna , Gonkowski Sławomir , Correia-de-Sá Paulo , Majewska Marta
Published: October 2023

Bisphenol A (BPA) is an environmental toxin widely used in the production of polycarbonate plastics. A correlation exists between BPA tissue contamination and the occurrence of pathological conditions, including cancer. First-passage detoxification of high BPA amounts in the liver promotes hepatotoxicity and morphological alterations of this organ, but there is a lack of knowledge about the molecular mechanisms underlying these phenomena. This prompted us to investigate changes in the liver transcriptomics of 3-month-old female mice exposed to BPA (50 mg/kg) in drinking water for 3 months. Five female mice served as controls. The animals were euthanized, the livers were collected, and RNA was extracted to perform RNA-seq analysis. The multistep transcriptomic bioinformatics revealed 120 differentially expressed genes (DEGs) in the BPA-exposed samples. Gene Ontology (GO) annotations indicated that DEGs have been assigned to many biological processes, including “macromolecule modification” and “protein metabolic process”. Several of the revealed DEGs have been linked to the pathogenesis of severe metabolic liver disorders and malignant tumors, in particular hepatocellular carcinoma. Data from this study suggest that BPA has a significant impact on gene expression in the liver, which is predictive of the carcinogenic potential of this compound in this organ.
Targeting KRAS in Pancreatic Ductal Adenocarcinoma: The Long Road to Cure
Authors: de Jesus Victor Hugo Fonseca , Mathias-Machado Maria Cecília , de Farias João Paulo Fogacci , Aruquipa Marcelo Porfirio Sunagua , Jácome Alexandre A. , Peixoto Renata D’Alpino
Published: October 2023

Pancreatic ductal adenocarcinoma (PDAC) remains an important cause of cancer-related mortality, and it is expected to play an even bigger part in cancer burden in the years to come. Despite concerted efforts from scientists and physicians, patients have experienced little improvement in survival over the past decades, possibly because of the non-specific nature of the tested treatment modalities. Recently, the discovery of potentially targetable molecular alterations has paved the way for the personalized treatment of PDAC. Indeed, the central piece in the molecular framework of PDAC is starting to be unveiled. KRAS mutations are seen in 90% of PDACs, and multiple studies have demonstrated their pivotal role in pancreatic carcinogenesis. Recent investigations have shed light on the differences in prognosis as well as therapeutic implications of the different KRAS mutations and disentangled the relationship between KRAS and effectors of downstream and parallel signaling pathways. Additionally, the recognition of other mechanisms involving KRAS-mediated pathogenesis, such as KRAS dosing and allelic imbalance, has contributed to broadening the current knowledge regarding this molecular alteration. Finally, KRAS G12C inhibitors have been recently tested in patients with pancreatic cancer with relative success, and inhibitors of KRAS harboring other mutations are under clinical development. These drugs currently represent a true hope for a meaningful leap forward in this dreadful disease.
Topical and Intralesional Immunotherapy for the Management of Skin Cancer in Special Locations: Lips and Eyelids
Authors: Buján Bonino Cecilia , Rodríguez-Blanco Isabel , Sánchez-Aguilar Rojas Dolores , Vázquez Veiga Hugo A. , Flórez Ángeles
Published: October 2023

The use of topical and intralesional immunotherapy in the treatment of cutaneous malignant neoplasia in sensitive areas such as the lips and eyelids is discussed. Surgery may not be feasible or may result in deformities in these areas, making alternative treatment options necessary. A narrative literature review was conducted using MEDLINE (PubMed) as the main literature database, collecting available evidence of experiences with various topical and intralesional therapies in the aforementioned anatomical locations, ranging from case reports to clinical trials. The clearance rates and potential adverse reactions of therapeutic options such as imiquimod 5%, 5-fluorouracil (5-FU), photodynamic therapy (PDT), ingenol mebutate (IM), diclofenac, intralesional methotrexate, and interferon are reviewed. Although limited by their heterogeneity and the scarcity of clinical trials, these studies point towards promising response rates and minimal adverse effects, making these treatments viable options in selected cases.
Identification of Gut Microbiota Profile Associated with Colorectal Cancer in Saudi Population
Authors: Alhhazmi Areej A. , Almutawif Yahya A. , Mumena Walaa A. , Alhazmi Shaima M. , Abujamel Turki S. , Alhusayni Ruba M. , Aloufi Raghad , Al-Hejaili Razan R. , Alhujaily Rahaf , Alrehaili Lama M. , Alsaedy Ruya A. , Khoja Rahaf H. , Ahmed Wassal , Abdelmohsen Mohamed F. , Mohammed-Saeid Waleed
Published: October 2023

Colorectal cancer (CRC) is a significant global health concern. Microbial dysbiosis and associated metabolites have been associated with CRC occurrence and progression. This study aims to analyze the gut microbiota composition and the enriched metabolic pathways in patients with late-stage CRC. In this study, a cohort of 25 CRC patients diagnosed at late stage III and IV and 25 healthy participants were enrolled. The fecal bacterial composition was investigated using V3-V4 ribosomal RNA gene sequencing, followed by clustering and linear discriminant analysis (LDA) effect size (LEfSe) analyses. A cluster of ortholog genes’ (COG) functional annotations and the Kyoto Encyclopedia of Genes and Genomes (KEGG) were employed to identify enrichment pathways between the two groups. The findings showed that the fecal microbiota between the two groups varied significantly in alpha and beta diversities. CRC patients’ fecal samples had significantly enriched populations of Streptococcus salivarius, S. parasanguins, S. anginosus, Lactobacillus mucosae, L. gasseri, Peptostreptococcus, Eubacterium, Aerococcus, Family XIII_AD3001 Group, Erysipelatoclostridium, Escherichia-Shigella, Klebsiella, Enterobacter, Alistipes, Ralstonia, and Pseudomonas (Q < 0.05). The enriched pathways identified in the CRC group were amino acid transport, signaling and metabolism, membrane biogenesis, DNA replication and mismatch repair system, and protease activity (Q < 0.05). These results suggested that the imbalance between intestinal bacteria and the elevated level of the predicated functions and pathways may contribute to the development of advanced CRC tumors. Further research is warranted to elucidate the exact role of the gut microbiome in CRC and its potential implications for use in diagnostic, prevention, and treatment strategies.
Carbon Ion Radiotherapy: An Evidence-Based Review and Summary Recommendations of Clinical Outcomes for Skull-Base Chordomas and Chondrosarcomas
Authors: Holtzman Adam L. , Seidensaal Katharina , Iannalfi Alberto , Kim Kyung Hwan , Koto Masashi , Yang Wan-Chin , Shiau Cheng-Ying , Mahajan Anita , Ahmed Safia K. , Trifiletti Daniel M. , Peterson Jennifer L. , Koffler Daniel M. , Vallow Laura A. , Hoppe Bradford S. , Rutenberg Michael S.
Published: October 2023

Skull-base chordoma and chondrosarcoma are rare radioresistant tumors treated with surgical resection and/or radiotherapy. Because of the established dosimetric and biological benefits of heavy particle therapy, we performed a systematic and evidence-based review of the clinical outcomes of patients with skull-base chordoma and chondrosarcoma treated with carbon ion radiotherapy (CIRT). A literature review was performed using a MEDLINE search of all articles to date. We identified 227 studies as appropriate for review, and 24 were ultimately included. The published data illustrate that CIRT provides benchmark disease control outcomes for skull-base chordoma and chondrosarcoma, respectively, with acceptable toxicity. CIRT is an advanced treatment technique that may provide not only dosimetric benefits over conventional photon therapy but also biologic intensification to overcome mechanisms of radioresistance. Ongoing research is needed to define the magnitude of benefit, patient selection, and cost-effectiveness of CIRT compared to other forms of radiotherapy.
MicroRNAs in Prostate Cancer: Implications for Treatment Response and Therapeutic Targets
Authors: Hussein Mohamed Ali , Munirathinam Gnanasekar
Published: October 2023

Cancer resistance to treatment is very common, represents one of the most significant challenges in the last few decades, and continues to impede all efforts to cure cancer [...]
Surveillance for Metastasis in High-Risk Uveal Melanoma Patients: Standard versus Enhanced Protocols
Authors: Yeşiltaş Yağmur Seda , Zabor Emily C. , Wrenn Jacquelyn , Oakey Zackery , Singh Arun D.
Published: October 2023

Purpose: to evaluate the effectiveness of enhanced surveillance protocols (EP) utilizing high frequency (HF) or enhanced modality (EM) compared to the standard protocol (SP) in detecting metastasis and determining their impact on overall survival (OS) in high-risk uveal melanoma (UM) patients. Methods: A total of 87 consecutive patients with Class 2 (high risk) primary UM were enrolled, with negative baseline systemic staging. The patients underwent systemic surveillance with either SP (hepatic ultrasonography [US] every 6 months) or EP (either HF [US every 3 months] or EM [incorporation hepatic computed tomography/magnetic resonance imaging]) following informed discussion. The main outcome measures were largest diameter of largest hepatic metastasis (LDLM), number of hepatic metastatic lesions, time to detection of metastasis (TDM), and OS. Results: This study revealed significant differences in LDLM between surveillance protocols, with the use of EP detecting smaller metastatic lesions (HF, EM, and SP were 1.5 cm, 1.6 cm, and 6.1 cm, respectively). Patients on the EM protocol had a lower 24-month cumulative incidence of >3 cm metastasis (3.5% EM vs. 39% SP; p = 0.021), while those on the HF protocol had a higher 24-month cumulative incidence of ≤3 cm metastasis compared to SP (31% HF vs. 10% SP; p = 0.017). Hazard of death following metastasis was significantly reduced in the EP (HR: 0.25; 95% CI: 0.07, 0.84), HF (HR: 0.23; 95% CI: 0.06, 0.84), and EM (HR: 0.11; 95% CI: 0.02, 0.5) groups compared to SP. However, TDM and OS did not significantly differ between protocols. Conclusions: Enhanced surveillance protocols improved early detection of hepatic metastasis in UM patients but did not translate into a survival advantage in our study cohort. However, early detection of metastasis in patients receiving liver-directed therapies may lead to improved overall survival.
A Prognostic Model to Predict Ruxolitinib Discontinuation and Death in Patients with Myelofibrosis
Authors: Palandri Francesca , Palumbo Giuseppe A. , Bonifacio Massimiliano , Elli Elena M. , Tiribelli Mario , Auteri Giuseppe , Trawinska Malgorzata M. , Polverelli Nicola , Benevolo Giulia , Tieghi Alessia , Cavalca Fabrizio , Caocci Giovanni , Beggiato Eloise , Binotto Gianni , Cavazzini Francesco , Miglino Maurizio , Bosi Costanza , Crugnola Monica , Bocchia Monica , Martino Bruno , Pugliese Novella , Venturi Marta , Isidori Alessandro , Cattaneo Daniele , Krampera Mauro , Pane Fabrizio , Cilloni Daniela , Semenzato Gianpietro , Lemoli Roberto M. , Cuneo Antonio , Abruzzese Elisabetta , Branzanti Filippo , Vianelli Nicola , Cavo Michele , Heidel Florian , Iurlo Alessandra , Breccia Massimo
Published: October 2023

Most patients with myelofibrosis (MF) discontinue ruxolitinib (JAK1/JAK2 inhibitor) in the first 5 years of therapy due to therapy failure. As the therapeutic possibilities of MF are expanding, it is critical to identify patients predisposed to early ruxolitinib monotherapy failure and worse outcomes. We investigated predictors of early ruxolitinib discontinuation and death on therapy in 889 patients included in the “RUX-MF” retrospective study. Overall, 172 patients were alive on ruxolitinib after ≥5 years (long-term ruxolitinib, LTR), 115 patients were alive but off ruxolitinib after ≥5 yrs (short-term RUX, STR), and 123 patients died while on ruxolitinib after <5 yrs (early death on ruxolitinib, EDR). The cumulative incidence of the blast phase was similar in LTR and STR patients (p = 0.08). Overall survival (OS) was significantly longer in LTR pts (p = 0.002). In multivariate analysis, PLT < 100 × 109/L, Hb < 10 g/dL, primary MF, absence of spleen response at 3 months and ruxolitinib starting dose <10 mg BID were associated with higher probability of STR. Assigning one point to each significant variable, a prognostic model for STR (STR-PM) was built, and three groups were identified: low (score 0–1), intermediate (score 2), and high risk (score ≥ 3). The STR-PM may identify patients at higher risk of failure with ruxolitinib monotherapy who should be considered for alternative frontline strategies.
Antisolvent Effects of C1–C4 Primary Alcohols on Solid-Liquid Equilibria of Potassium Dihydrogen Phosphate in Aqueous Solutions
Authors: Le Tam Minh , Nguyen Tan Dzung , Nguyen Giang Tien , Tran Nhung Thi
Published: October 2023

The focus of this study was to examine antisolvent effects, which hold significance in particulate processes, such as crystallization and precipitation. In the first section, an experimental investigation revealed that C1–C4 primary alcohols significantly reduced the solubility of potassium dihydrogen phosphate (KDP) in water. The solid–liquid equilibria of KDP solutions were determined using an innovative polythermal method, demonstrating time and labor efficiency compared to the traditional isothermal method while maintaining solubility determination quality. This achievement established an efficient tool for high-throughput solvent screening, a crucial aspect of particulate process development. In addition to the experimental approach, in the second part, the influence of these alcohols on KDP solubility was analyzed using the eNRTL thermodynamics model. The model’s estimated parameters confirmed that the addition of these alcohols induced strong non-ideal behavior in the solutions, altered interactions between solute species and solvent components, and reduced KDP solubility. Under the effects of these alcohols, KDP solubility generally increased with the length of the alkyl chain in the added alcohols, although methanol deviated from this observation. Furthermore, the present work also discussed the limitation of the well-known Bromley’s equation, particularly when applied for KDP in alcohol–water mixed solvents. Consequently, binary and ternary systems consisting of KDP, water, and C1–C4 primary alcohols were successfully modeled using eNRTL. Furthermore, it was determined that the obtained model was insufficient for quaternary systems with a higher alcohol content, particularly when high-order interactions were neglected as in the cases of binary and ternary systems. In short, these investigated alcohols have potential for future applications in the design of particulate processes, with a particular emphasis on antisolvent crystallization.
Metal–Organic Frameworks–Based Surface–Enhanced Raman Scattering Substrates for Gas Sensing
Authors: Xiong Weiqing , Wang Xiaoyan , Liu Haiquan , Zhang Yue
Published: October 2023

Gas sensing holds great significance in environment monitoring, real–time security alerts and clinical diagnosis, which require sensing technology to distinguish various target molecules with extreme sensitivity and selectivity. Surface–enhanced Raman spectroscopy (SERS) has great potential in gas sensing for its single molecule sensitivity and fingerprint specificity. However, different from molecule sensing in solutions, SERS detection of gas often suffers from low sensitivity as gas molecules usually display a low Raman cross–section and poor affinity on traditional noble metal nanoparticle (NMNP)–based substrates. Therefore, much effort has been made to solve these problems. Fortunately, the appearance of metal–organic frameworks (MOFs) has shed new light on this direction. Due to the unique functional characteristics of MOFs, such as controllable pore size/shape, structural diversity and large specific surface area, SERS substrates based on MOFs can achieve high sensitivity, excellent selectivity and good stability. Although several reviews on MOF–based SERS substrates have been reported, few focus on gas sensing, which is a great challenge. Here, we mainly review the latest research progress on SERS substrates based on different MOFs. Sensitive and active SERS substrates can be prepared according to the unique advantages of MOFs with different metal centers. Then, we focus on composite SERS substrates based on different MOFs and NMNPs and summarize the application of composite SERS substrates in gas sensing. Finally, the future difficulties and potential possibilities of SERS substrates based on MOFs and NMNPs for gas sensing are discussed.
Formwork Engineering for Sustainable Concrete Construction
Authors: Nilimaa Jonny , Gamil Yaser , Zhaka Vasiola
Published: October 2023

This study provides a comprehensive review of the engineering challenges of formwork in concrete construction. The paper investigates different formwork systems, their design based on form pressure, and the difficulties of form stripping. Alternative binders are gaining more and more interest by opening new opportunities for sustainable concrete materials and their impact on form pressure and concrete setting is also investigated in this paper. The discussion involves several engineering challenges such as sustainability, safety, and economy, while it also explores previous case studies, and discusses future trends in formwork design. The findings pinpoint that choosing an appropriate formwork system depends significantly on project-specific constraints and that the development of innovative materials and technologies presents significant benefits but also new challenges, including the need for training and regulation. Current trends in formwork design and use show promising possibilities for the integration of digital technologies and the development of sustainable and ‘smart’ formwork systems. Continued research within the field has the possibility to explore new formwork materials and technologies, which will contribute to the implementation of more effective and sustainable practices in concrete construction.
Non-Native Marine Macroalgae of the Azores: An Updated Inventory
Authors: Gabriel Daniela , Ferreira Ana Isabel , Micael Joana , Fredericq Suzanne
Published: October 2023

Non-native species (NNS) represent a threat to biodiversity, and their occurrence and distribution should be periodically updated and made easily available to researchers and policymakers. An updated inventory of macroalgal NNS currently present in the Azores was produced based on published reports. Data concerning the first report and the distribution in the archipelago are provided for each species, as well as their respective native ranges and possible vectors of introduction. The resulting list comprises 42 taxa, i.e., 8.05% of the marine flora presently reported in the Azores, with 16 new NNS recorded over the last decade. The most isolated islands of the Western Group presented lower numbers of NNS (4.25% and 6.25%). In contrast, the two islands with the most used marina for transatlantic recreational sailing presented higher numbers (12.90% and 16.87%). Shipping is the main introduction vector (68%), whereas most macroalgal NNS are originally from the Pacific Ocean (31%) and the Indo-Pacific (31%). The presence of 13 species is restricted to single islands, and no species is reported exclusively in the Western group. Asparagopsis armata is the only algal NNS reported from all islands of the Azores. Future work is proposed to support policymaking.
The Impact of Repeating COVID-19 Rapid Antigen Tests on Prevalence Boundary Performance and Missed Diagnoses
Authors: Kost Gerald J.
Published: October 2023

A prevalence boundary (PB) marks the point in prevalence in which the false omission rate, RFO = FN/(TN + FN), exceeds the tolerance limit for missed diagnoses. The objectives were to mathematically analyze rapid antigen test (RAgT) performance, determine why PBs are breeched, and evaluate the merits of testing three times over five days, now required by the US Food and Drug Administration for asymptomatic persons. Equations were derived to compare test performance patterns, calculate PBs, and perform recursive computations. An independent July 2023 FDA–NIH–university–commercial evaluation of RAgTs provided performance data used in theoretical calculations. Tiered sensitivity/specificity comprise the following: tier (1) 90%, 95%; tier (2) 95%, 97.5%; and tier (3) 100%, ≥99%. Repeating a T2 test improves the PB from 44.6% to 95.2% (RFO 5%). In the FDA–NIH-university–commercial evaluation, RAgTs generated a sensitivity of 34.4%, which improved to 55.3% when repeated, and then improved to 68.5% with the third test. With RFO = 5%, PBs are 7.37/10.46/14.22%, respectively. PB analysis suggests that RAgTs should achieve a clinically proven sensitivity of 91.0–91.4%. When prevalence exceeds PBs, missed diagnoses can perpetuate virus transmission. Repeating low-sensitivity RAgTs delays diagnosis. In homes, high-risk settings, and hotspots, PB breaches may prolong contagion, defeat mitigation, facilitate new variants, and transform outbreaks into endemic disease. Molecular diagnostics can help avoid these potential vicious cycles.
Steatosis Quantification on Ultrasound Images by a Deep Learning Algorithm on Patients Undergoing Weight Changes
Authors: Harrison Adam P. , Li Bowen , Hsu Tse-Hwa , Chen Cheng-Jen , Yu Wan-Ting , Tai Jennifer , Lu Le , Tai Dar-In
Published: October 2023

Introduction: A deep learning algorithm to quantify steatosis from ultrasound images may change a subjective diagnosis to objective quantification. We evaluate this algorithm in patients with weight changes. Materials and Methods: Patients (N = 101) who experienced weight changes ≥ 5% were selected for the study, using serial ultrasound studies retrospectively collected from 2013 to 2021. After applying our exclusion criteria, 74 patients from 239 studies were included. We classified images into four scanning views and applied the algorithm. Mean values from 3–5 images in each group were used for the results and correlated against weight changes. Results: Images from the left lobe (G1) in 45 patients, right intercostal view (G2) in 67 patients, and subcostal view (G4) in 46 patients were collected. In a head-to-head comparison, G1 versus G2 or G2 versus G4 views showed identical steatosis scores (R2 > 0.86, p < 0.001). The body weight and steatosis scores were significantly correlated (R2 = 0.62, p < 0.001). Significant differences in steatosis scores between the highest and lowest body weight timepoints were found (p < 0.001). Men showed a higher liver steatosis/BMI ratio than women (p = 0.026). Conclusions: The best scanning conditions are 3–5 images from the right intercostal view. The algorithm objectively quantified liver steatosis, which correlated with body weight changes and gender.
Prognostic Value of Mandard’s Tumor Regression Grade (TRG) in Post Chemo-Radiotherapy Cervical Cancer
Authors: Scaglione Giulia , Arciuolo Damiano , Travaglino Antonio , Santoro Angela , Angelico Giuseppe , Spadola Saveria , Inzani Frediano , D’Alessandris Nicoletta , Raffone Antonio , Fulgione Caterina , Padial Urtueta Belen , Sfregola Stefania , Valente Michele , Addante Francesca , d’Amati Antonio , Cianfrini Federica , Piermattei Alessia , Pedone Anchora Luigi , Scambia Giovanni , Ferrandina Gabriella , Zannoni Gian
Published: October 2023

In locally advanced cervical cancer (LACC), definitive chemo-radiotherapy is the standard treatment, but chemo-radiotherapy followed by surgery could be an alternative choice in selected patients. We enrolled 244 patients affected by LACC and treated with CT-RT followed by surgery in order to assess the prognostic role of the histological response using the Mandard scoring system. Results: A complete pathological response (TRG 0) was observed in 118 patients (48.4%), rare residual cancer cells (TRG2) were found in 49 cases (20.1%), increased number of cancer cells but fibrosis still predominating (TRG3) in 35 cases (14.3%), and 42 (17.2%) were classified as non-responders (TRG4–5). TRG was significantly associated with both OS (p < 0.001) and PFS (p < 0.001). The survival curves highlighted two main prognostic groups: TRG1-TRG2 and TRG3-TRG4–5. Main responders (TRG1–2) showed a 92% 5-year overall survival (5y-OS) and a 75% 5-year disease free survival (5y-DFS). Minor or no responders showed a 48% 5y-OS and a 39% 5y-DFS. The two-tiered TRG was independently associated with both DFS and OS in Cox regression analysis. Conclusion. We showed that Mandard TRG is an independent prognostic factor in post-CT/RT LACC, with potential benefits in defining post-treatment adjuvant therapy.
Efficient Skip Connections-Based Residual Network (ESRNet) for Brain Tumor Classification
Authors: B. Ashwini , Kaur Manjit , Singh Dilbag , Roy Satyabrata , Amoon Mohammed
Published: October 2023

Brain tumors pose a complex and urgent challenge in medical diagnostics, requiring precise and timely classification due to their diverse characteristics and potentially life-threatening consequences. While existing deep learning (DL)-based brain tumor classification (BTC) models have shown significant progress, they encounter limitations like restricted depth, vanishing gradient issues, and difficulties in capturing intricate features. To address these challenges, this paper proposes an efficient skip connections-based residual network (ESRNet). leveraging the residual network (ResNet) with skip connections. ESRNet ensures smooth gradient flow during training, mitigating the vanishing gradient problem. Additionally, the ESRNet architecture includes multiple stages with increasing numbers of residual blocks for improved feature learning and pattern recognition. ESRNet utilizes residual blocks from the ResNet architecture, featuring skip connections that enable identity mapping. Through direct addition of the input tensor to the convolutional layer output within each block, skip connections preserve the gradient flow. This mechanism prevents vanishing gradients, ensuring effective information propagation across network layers during training. Furthermore, ESRNet integrates efficient downsampling techniques and stabilizing batch normalization layers, which collectively contribute to its robust and reliable performance. Extensive experimental results reveal that ESRNet significantly outperforms other approaches in terms of accuracy, sensitivity, specificity, F-score, and Kappa statistics, with median values of 99.62%, 99.68%, 99.89%, 99.47%, and 99.42%, respectively. Moreover, the achieved minimum performance metrics, including accuracy (99.34%), sensitivity (99.47%), specificity (99.79%), F-score (99.04%), and Kappa statistics (99.21%), underscore the exceptional effectiveness of ESRNet for BTC. Therefore, the proposed ESRNet showcases exceptional performance and efficiency in BTC, holding the potential to revolutionize clinical diagnosis and treatment planning.
HDR-EfficientNet: A Classification of Hypertensive and Diabetic Retinopathy Using Optimize EfficientNet Architecture
Authors: Abbas Qaisar , Daadaa Yassine , Rashid Umer , Sajid Muhammad Zaheer , Ibrahim Mostafa E. A.
Published: October 2023

Hypertensive retinopathy (HR) and diabetic retinopathy (DR) are retinal diseases closely associated with high blood pressure. The severity and duration of hypertension directly impact the prevalence of HR. The early identification and assessment of HR are crucial to preventing blindness. Currently, limited computer-aided methods are available for detecting HR and DR. These existing systems rely on traditional machine learning approaches, which require complex image processing techniques and are often limited in their application. To address this challenge, this work introduces a deep learning (DL) method called HDR-EfficientNet, which aims to provide an efficient and accurate approach to identifying various eye-related disorders, including diabetes and hypertensive retinopathy. The proposed method utilizes an EfficientNet-V2 network for end-to-end training focused on disease classification. Additionally, a spatial-channel attention method is incorporated into the approach to enhance its ability to identify specific areas of damage and differentiate between different illnesses. The HDR-EfficientNet model is developed using transfer learning, which helps overcome the challenge of imbalanced sample classes and improves the network’s generalization. Dense layers are added to the model structure to enhance the feature selection capacity. The performance of the implemented system is evaluated using a large dataset of over 36,000 augmented retinal fundus images. The results demonstrate promising accuracy, with an average area under the curve (AUC) of 0.98, a specificity (SP) of 96%, an accuracy (ACC) of 98%, and a sensitivity (SE) of 95%. These findings indicate the effectiveness of the suggested HDR-EfficientNet classifier in diagnosing HR and DR. In summary, the HDR-EfficientNet method presents a DL-based approach that offers improved accuracy and efficiency for the detection and classification of HR and DR, providing valuable support in diagnosing and managing these eye-related conditions.
Entanglement Degradation in Two Interacting Qubits Coupled to Dephasing Environments
Authors: Abdelmagid Rahma , Alshehhi Khadija , Sadiek Gehad
Published: October 2023

One of the main obstacles toward building efficient quantum computing systems is decoherence, where the inevitable interaction between the qubits and the surrounding environment leads to a vanishing entanglement. We consider a system of two interacting asymmetric two-level atoms (qubits) in the presence of pure and correlated dephasing environments. We study the dynamics of entanglement while varying the interaction strength between the two qubits, their relative frequencies, and their coupling strength to the environment starting from different initial states of practical interest. The impact of the asymmetry of the two qubits, reflected in their different frequencies and coupling strengths to the environment, varies significantly depending on the initial state of the system and its degree of anisotropy. For an initial disentangled, or a Werner, state, as the difference between the frequencies increases, the entanglement decay rate increases, with more persistence at the higher degrees of anisotropy in the former state. However, for an initial anti-correlated Bell state, the entanglement decays more rapidly in the symmetric case compared with the asymmetric one. The difference in the coupling strengths of the two qubits to the pure (uncorrelated) dephasing environment leads to higher entanglement decay in the different initial state cases, though the rate varies depending on the degree of anisotropy and the initial state. Interestingly, the correlated dephasing environment, within a certain range, was found to enhance the entanglement dynamics starting from certain initial states, such as the disentangled, anti-correlated Bell, and Werner, whereas it exhibits a decaying effect in other cases such as the initial correlated Bell state.
Land Reform and Its Effect on Farm Household Income Inequality: Evidence from Georgia
Authors: Kimhi Ayal
Published: October 2023

This article examines the importance of landholdings in explaining income inequality among family farms in four districts in Georgia following the land reform of the 1990s. Income inequality is decomposed by sources of income and by determinants of income. The results indicate that farm income is a disequalizing source of income among family farms in these districts. In addition, a uniform increase in landholding is expected to reduce income inequality. Combining the two results, we conclude that the impact of land reform on farm household income inequality depends on the resulting distribution of landholdings. It can reduce inequality if land is distributed relatively equally, but inequality can increase if the wealthier farmers are able to gain control of more (and perhaps better) land resources. A possible implication of this result is that for land reform to be equalizing, distributing land to smallholders should be accompanied by additional policies and regulations supporting small farmers, such as land titling and registration, support for cooperation, and access to credit and other market services.
Development of 180 kW Organic Rankine Cycle (ORC) with a High-Efficiency Two-Stage Axial Turbine
Authors: Sim Jung-Bo , Yook Se-Jin , Kim Young Won
Published: October 2023

The design of turbines used to convert thermal energy into electrical energy in an organic Rankine cycle (ORC) is crucial. A high-speed turbine requires high-performance bearings, which increases turbine manufacturing costs. In this study, a high-efficiency two-stage axial turbine at a low rotational speed was developed, and the ORC performance was presented. We designed a 180-kW axial turbine of 12,000 rpm. To increase turbine efficiency, the number of turbine stages was set to two, and turbine blades were designed to reduce pressure losses. One-dimensional design parameters of blades that minimized the total pressure loss were selected using an in-house code based on a generalized reduced gradient (GRG) nonlinear algorithm. Three-dimensional turbine blade modeling and numerical analysis were performed using commercial software. The total-to-static isentropic efficiency and output of the two-stage axial turbine were predicted to be 85.1% and 176 kW, respectively. ORC performance was assessed using the predicted turbine performance results. Assuming the temperature of the condenser outlet working fluid to be 25 °C, the ORC thermal efficiency and exergy efficiency were found to be 7.40% and 34.49%, respectively. Our findings highlight the applicability of various rotational speeds and number of stages for an axial turbine in an ORC.
LLC Resonant Converters as Isolated Power Factor Corrector Pre-Regulators—Analysis and Performance Evaluation
Authors: Sucameli Matteo , Adragna Claudio
Published: October 2023

The power supply of many applications running off the power line is made up of an isolated dc-dc converter powered by a front-end power factor corrector (PFC) stage. The PFC stage ensures compliance with the electromagnetic compatibility regulations but does not usually provide safety isolation since it is typically implemented with a boost converter. Lately, the increase in multi-output power supplies, especially in lighting and USB Power Delivery applications, has raised the need for an isolated PFC at power levels where currently there is not an industry standard solution. This isolated PFC is intended to power one or more non-isolated post-regulators to enable a substantial simplification of the overall architecture and a cost reduction. The usage of an LLC resonant converter as an isolated PFC has been considered and demonstrated only quite recently, raising the industry’s attention due to the favorable converter’s characteristics that have led to its success as a dc-dc converter. This paper provides two significant contributions. Firstly, it provides a quantitative assessment of the difference in the results obtained by designing an LLC-based PFC converter based on the first harmonic approximation analysis or the time-domain analysis by applying them to the design of the same converter. Secondly, it demonstrates that designing an LLC-based PFC converter to work also in the above-resonance region optimizes its performance by reducing the (magnetizing) reactive current in the resonant tank and, therefore, the rms currents on both the input and the output side and the related power loss.
Development of Methods for an Overhead Cable Health Index Evaluation That Considers Economic Feasibility
Authors: Lee Hyeseon , Lee Byungsung , Han Gyurim , Kim Yuri , Kim Yongha
Published: October 2023

To supply stable and high-quality power according to the advancement of industrial growth, electric power companies have performed maintenance of power facilities using various methods. In the case of domestic power distribution facilities, there are limitations in performing diagnostic management on all facilities owing to the large number of facilities; therefore, old facilities are managed using the health index assessment method. The health index assessment comprises only facility operation data and external environmental data and is managed only for four types of distribution facilities including overhead/underground transformers and switchgears. In the case of high voltage overhead lines, there are a large number of wires such as transformers and switchgears connected to the lines, and the ripple effect of power outages is large. However, in Korea, there is no overhead line health index standard. In overseas cases, a health index for overhead lines was developed, but only the material characteristics and surrounding environment of the overhead lines were considered and economic feasibility was not considered. Therefore, in this paper, we developed a health index evaluation methodology for ultra-high voltage overhead lines that considers economic feasibility. In this paper, unlike the existing health index evaluation method that uses only operational data and external environmental data to determine facility performance evaluation and aging replacement standards, we developed an economic health index evaluation methodology that additionally considers failure probability and risk costs. Using the health index assessment methodology developed in this paper, it is possible to expect a reduction in facility operating costs and investment costs from the perspective of the electric power companies through the replacement of old extra-high voltage overhead cables. In addition, from the perspective of consumers, it is expected to increase power reliability and reduce the ripple effect of failure by preferentially replacing equipment with a high probability of failure.
Analysis of Hydrogen Distribution and Diffusion in Pre-Strained SUS316L through Scanning Kelvin Probe Force Microscopy and Thermal Desorption Spectroscopy
Authors: Chi Shuanghe , Guo Jinxing , Hua Zhengli , Shang Juan , Xing Baihui
Published: October 2023

Austenitic stainless steels (γ-SS) play an important role in the storage of high-pressure hydrogen. However, hydrogen embrittlement (HE) can significantly degrade the mechanical properties of γ-SS. Measuring the distribution of hydrogen in γ-SS is a vital way to learn about HE. In this paper, scanning Kelvin probe force microscopy (SKPFM) and thermal desorption spectroscopy (TDS) have been utilized to analyze the distribution and diffusion of hydrogen in pre-strained SUS316L. Additionally, the McNabb–Foster model is employed to calculate hydrogen in the lattice and phase boundaries along the sample’s thickness direction. The results demonstrate that the combination of SKPFM and TDS is an effective approach for studying hydrogen distribution and diffusion in metals. It was observed that hydrogen segregation occurs at the boundary between the martensitic (α′) and austenite (γ) phases. The inhibitory effect of the oxide film on hydrogen diffusion is more significant at lower temperatures. However, it should be noted that the McNabb–Foster model exhibits relatively high accuracy in predicting hydrogen desorption at higher temperatures while disregarding the influence of the native oxide film.
N2-Fixing Tree Species Help to Alleviate C- and P-Limitation in Both Rhizosphere and Non-Rhizosphere Soils in the Eucalyptus Plantations of Subtropical China
Authors: Li Jiajun , Huang Haimei , You Yeming , Xiang Mingzhu , Li Changhang , Ming Angang , Ma Hailun , Huang Xueman
Published: October 2023

The extracellular enzyme activity (EEA) and enzymatic stoichiometry (EES) of soil are useful indicators of shifts in soil nutrition and microbial resource requirements. Nevertheless, it is uncertain how the limitation of soil microbial nutrients is altered by a Eucalyptus plantation mixed with a N2-fixing tree species. Our study examined the microbial nutrient limitation in two plantations: a pure Eucalyptus plantation (PP) and a mixed plantation (Eucalyptus and Erythrophleum fordii, MP) in rhizosphere and non-rhizosphere soils, beginning with two indicators, soil EEA and EES. In this study, the soil EEA was considerably (p < 0.05) greater in the MP contrasted to the PP, and the enzyme C:N:P ratios of the PP (1.12:1:1.10) and MP (1.07:1:1.08) both diverged from the global average EEA (1:1:1), and the deviation degree of the PP was greater. The results of the vector analysis demonstrated that the vector angle (VA) and vector length (VL) were considerably (p < 0.05) smaller in the MP contrasted to the PP. In comparison to the PP, the MP had a considerably (p < 0.05) poorer carbon quality index (CQI). Additionally, both microbial and soil properties have a considerable impact on soil EEA and EES, according to variance partitioning analysis (VPA) and redundancy analysis (RDA). In summary, our results show that the restriction of microorganisms on C and P in rhizosphere soils is usually weaker than that in non-rhizosphere soils and that the addition of N2-fixing tree species to Eucalyptus plantations can lessen but not completely remove the restriction of soil microorganisms on C and P. Future management practices involving mixed plantations with N2-fixing trees species could help decrease microbial nutrient limitation and promote sustainable plantations.