bluuebunny/crossref_metadata_2025 huggingface dataset:
Tacrolimus-induced posterior reversible encephalopathy syndrome presenting as left upper limb monoplegia, convulsions, and sudden blindness: case report
Authors: Mogawer Mohamad-Sherif , EL-Shazly Mostafa , Salah Ayman , Abdel-Maqsod Amany , Abdelaziz Omar , Abdel-Ghani Ahmed , Essam Mahmoud , Abdellatif Abeer Awad
Published: November 2020

Background

To report a case of sudden onset left upper limb monoplegia, convulsions, and bilateral blindness in a patient receiving tacrolimus for immunosuppression following living donor liver transplantation (LDLT) consistent with posterior reversible encephalopathy syndrome (PRES).

Case presentation

We report a case of a 64-year-old male patient on tacrolimus treatment following LDLT. On day 11, during his post-operative routine follow-up. The patient developed sudden onset of left upper limb monoplegia associated with attacks of convulsions and sudden bilateral blindness. MRI revealed multiple, bilateral cortical, and subcortical areas of high T2 and FLAIR signal intensity that did not show restricted diffusion. Findings were suggestive of posterior reversible encephalopathy syndrome (PRES). After the cessation of tacrolimus, vision was completely regained and all other neurologic symptoms were resolved, and follow-up MRI was normal. This case represents an uncommon presentation of tacrolimus toxicity.

Conclusion

Tacrolimus toxicity may present with PRES. Neurological deficits may be fully reversible with discontinuation of the drug; therefore, the early recognition and prompt management of this condition are of utmost importance.
Vacuum-ultraviolet photodetectors
Authors: Jia Lemin , Zheng Wei , Huang Feng
Published: November 2020

High-performance vacuum-ultraviolet (VUV) photodetectors are of great significance to space science, radiation monitoring, electronic industry and basic science. Due to the absolute advantages in VUV selective response and radiation resistance, ultra-wide bandgap semiconductors such as diamond, BN and AlN attract wide interest from researchers, and thus the researches on VUV photodetectors based on these emerging semiconductor materials have made considerable progress in the past 20 years. This paper takes ultra-wide bandgap semiconductor filterless VUV photodetectors with different working mechanisms as the object and gives a systematic review in the aspects of figures of merit, performance evaluation methods and research progress. These miniaturized and easily-integrated photodetectors with low power consumption are expected to achieve efficient VUV dynamic imaging and single photon detection in the future.
Reimagining T Staging Through Artificial Intelligence and Machine Learning Image Processing Approaches in Digital Pathology
Authors: Bera Kaustav , Katz Ian , Madabhushi Anant
Published: November 2020

Tumor stage and grade, visually assessed by pathologists from evaluation of pathology images in conjunction with radiographic imaging techniques, have been linked to outcome, progression, and survival for a number of cancers. The gold standard of staging in oncology has been the TNM (tumor-node-metastasis) staging system. Though histopathological grading has shown prognostic significance, it is subjective and limited by interobserver variability even among experienced surgical pathologists. Recently, artificial intelligence (AI) approaches have been applied to pathology images toward diagnostic-, prognostic-, and treatment prediction–related tasks in cancer. AI approaches have the potential to overcome the limitations of conventional TNM staging and tumor grading approaches, providing a direct prognostic prediction of disease outcome independent of tumor stage and grade. Broadly speaking, these AI approaches involve extracting patterns from images that are then compared against previously defined disease signatures. These patterns are typically categorized as either (1) handcrafted, which involve domain-inspired attributes, such as nuclear shape, or (2) deep learning (DL)–based representations, which tend to be more abstract. DL approaches have particularly gained considerable popularity because of the minimal domain knowledge needed for training, mostly only requiring annotated examples corresponding to the categories of interest. In this article, we discuss AI approaches for digital pathology, especially as they relate to disease prognosis, prediction of genomic and molecular alterations in the tumor, and prediction of treatment response in oncology. We also discuss some of the potential challenges with validation, interpretability, and reimbursement that must be addressed before widespread clinical deployment. The article concludes with a brief discussion of potential future opportunities in the field of AI for digital pathology and oncology.
Significance of Discordant Results Between Confirmatory Tests in Diagnosis of Primary Aldosteronism
Authors: Fukumoto Tazuru , Umakoshi Hironobu , Ogata Masatoshi , Yokomoto-Umakoshi Maki , Matsuda Yayoi , Motoya Misato , Nagata Hiromi , Nakano Yui , Iwahashi Norifusa , Kaneko Hiroki , Wada Norio , Miyazawa Takashi , Sakamoto Ryuichi , Ogawa Yoshihiro
Published: November 2020

Context

Current clinical guidelines recommend confirmation of a positive result in at least one confirmatory test in the diagnosis of primary aldosteronism (PA). Clinical implication of multiple confirmatory tests has not been established, especially when patients show discordant results.

Objective

The aim of the present study was to explore the role of 2 confirmatory tests in subtype diagnosis of PA.

Design and Setting

A retrospective cross-sectional study was conducted at two referral centers.

Participants and Methods

We identified 360 hypertensive patients who underwent both a captopril challenge test (CCT) and a saline infusion test (SIT) and exhibited at least one positive result. Among them, we studied 193 patients with PA whose data were available for subtype diagnosis based on adrenal vein sampling (AVS).

Main Outcome Measure

The prevalence of bilateral subtype on AVS according to the results of the confirmatory tests was measured.

Results

Of patients studied, 127 were positive for both CCT and SIT (double-positive), whereas 66 were positive for either CCT or SIT (single-positive) (n = 34 and n = 32, respectively). Altogether, 135 were diagnosed with bilateral subtype on AVS. The single-positive patients had milder clinical features of PA than the double-positive patients. The prevalence of bilateral subtype on AVS was significantly higher in the single-positive patients than in the double-positive patients. (63/66 [95.5%] vs 72/127 [56.7%], P < .01). Several clinical parameters were different between CCT single-positive and SIT single-positive patients.

Conclusion

Patients with discordant results between CCT and SIT have a high probability of bilateral subtype of PA on AVS.
COVID-19 Hospitalization in Adults with Type 1 Diabetes: Results from the T1D Exchange Multicenter Surveillance Study
Authors: O’Malley Grenye , Ebekozien Osagie , Desimone Marisa , Pinnaro Catherina T , Roberts Alissa , Polsky Sarit , Noor Nudrat , Aleppo Grazia , Basina Marina , Tansey Michael , Steenkamp Devin , Vendrame Francesco , Lorincz Ilona , Mathias Priyanka , Agarwal Shivani , Golden Lauren , Hirsch Irl B , Levy Carol J
Published: November 2020

Context

Diabetes mellitus is associated with increased COVID-19 morbidity and mortality, but there are few data focusing on outcomes in people with type 1 diabetes.

Objective

The objective of this study was to analyze characteristics of adults with type 1 diabetes for associations with COVID-19 hospitalization.

Design

An observational multisite cross-sectional study was performed. Diabetes care providers answered a 33-item questionnaire regarding demographics, symptoms, and diabetes- and COVID-19-related care and outcomes. Descriptive statistics were used to describe the study population, and multivariate logistic regression models were used to analyze the relationship between glycated hemoglobin (HbA1c), age, and comorbidities and hospitalization.

Setting

Cases were submitted from 52 US sites between March and August 2020.

Patients or Other Participants

Adults over the age of 19 with type 1 diabetes and confirmed COVID-19 infection were included.

Interventions

None.

Main Outcome Measures

Hospitalization for COVID-19 infection.

Results

A total of 113 cases were analyzed. Fifty-eight patients were hospitalized, and 5 patients died. Patients who were hospitalized were more likely to be older, to identify as non-Hispanic Black, to use public insurance, or to have hypertension, and less likely to use continuous glucose monitoring or insulin pumps. Median HbA1c was 8.6% (70 mmol/mol) and was positively associated with hospitalization (odds ratio 1.42, 95% confidence interval 1.18-1.76), which persisted after adjustment for age, sex, race, and obesity.

Conclusions

Baseline glycemic control and access to care are important modifiable risk factors which need to be addressed to optimize care of people with type 1 diabetes during the worldwide COVID-19 pandemic.
Conserved LBL1-ta-siRNA and miR165/166-RLD1/2 modules regulate root development in maize
Authors: Gautam Vibhav , Singh Archita , Yadav Sandeep , Singh Sharmila , Kumar Pramod , Sarkar Das Shabari , Sarkar Ananda K.
Published: November 2020

Root system architecture and anatomy of monocotyledonous maize is significantly different from dicotyledonous model Arabidopsis. The molecular role of non-coding RNA (ncRNA) is poorly understood in maize root development. Here we address the role of LEAFBLADELESS1 (LBL1), a component of maize trans-acting short-interfering RNA (ta-siRNA), in maize root development. We report that the root growth, anatomical patterning, number of lateral roots (LRs) and monocot-specific crown roots (CRs) and seminal roots (SRs) are significantly affected in lbl1-rgd1 mutant, which is defective in production of ta-siRNA, including tasiR-ARF that targets AUXIN RESPONSE FACTOR3 (ARF3) in maize. Altered accumulation and distribution of auxin, due to differential expression of auxin biosynthesis and transporter genes, created an imbalance in auxin signaling. Altered expression of microRNA165/166 (miR165/166) and its targets ROLLED1/2 (RLD1/2) contributed to the changes in lbl1-rgd1 root growth and vascular patterning, as was evident by altered root phenotype of Rld1-O semi-dominant mutant. Thus, LBL1/ta-siRNA module regulates root development, possibly by affecting auxin distribution and signaling, in crosstalk with miR165/166-RLD1/2 module. We further showed that ZmLBL1 and its Arabidopsis homolog AtSGS3 proteins are functionally conserved.
Structure and function of the nervous system in nectophores of the siphonophore Nanomia bijuga
Authors: Norekian Tigran P. , Meech Robert W.
Published: November 2020

i) Although Nanomia’s bell-shaped nectophores are specialized for locomotion, their cellular elements and complex nerve structures suggest they have multiple subsidiary functions.

ii) The main nerve complex is a nerve ring at the base of the bell, an adjacent columnar-shaped matrix plus two associated nerve projections. An upper nerve tract may provide a sensory input while a lower nerve tract connects with the rest of the colony apparently via a cluster of nerve cells at the stem.

iii) The structure of the extensively innervated “flask cells” located around the bell margin suggests a secretory function.

iv) The numerous nematocytes present on exposed ridges of the nectophore appear to have an entangling rather than a penetrating role.

v) Movements of the velum, produced by contraction of the Claus’ muscle system during backwards swimming, can be elicited by electrical stimulation of the surface epithelium even when the major nerve tracts serving the nerve ring have been destroyed (confirming Mackie, 1964).

vi) Epithelial impulses generated by electrical stimulation elicit slow potentials and action potentials in the velum musculature. The slow potentials arise at different sites around the velum and give rise to action potentials in contracting Claus’ muscle fibres.

vii) A synaptic rather than an electrotonic model can more readily account for the time course of the slow potentials.

viii) During backward swimming radial muscle fibres in the endoderm contract isometrically providing the Claus’ fibres with a firm foundation.
Diagnostic Accuracy of Nipple Aspirate Fluid Cytology in Asymptomatic Patients: A Meta-analysis and Systematic Review of the Literature
Authors: Jiwa Natasha , Gandhewar Rishikesh , Chauhan Hemali , Ashrafian Hutan , Kumar Swathica , Wright Corrina , Takats Zoltan , Leff Daniel Richard
Published: November 2020

Purpose

To calculate the diagnostic accuracy of nipple aspirate fluid (NAF) cytology.

Background

Evaluation of NAF cytology in asymptomatic patients conceptually offers a non-invasive method for either screening for breast cancer or else predicting or stratifying future cancer risk.

Methods

Studies were identified by performing electronic searches up to August 2019. A meta-analysis was conducted to attain an overall pooled sensitivity and specificity of NAF for breast cancer detection.

Results

A search through 938 studies yielded a total of 19 studies. Overall, 9308 patients were examined, with cytology results from 10,147 breasts [age (years), mean ± SD = 49.73 ± 4.09 years]. Diagnostic accuracy meta-analysis of NAF revealed a pooled specificity of 0.97 (95% CI 0.97–0.98), and sensitivity of 0.64 (95% CI 0.62–0.66).

Conclusions

The diagnostic accuracy of nipple smear cytology is limited by poor sensitivity. If nipple fluid assessment is to be used for diagnosis, then emerging technologies for fluid biomarker analysis must supersede the current diagnostic accuracy of NAF cytology.
Longitudinal trajectories of brain age in young individuals at familial risk of mood disorder from the Scottish Bipolar Family Study
Authors: de Nooij Laura , Harris Mathew A. , Hawkins Emma L. , Clarke Toni-Kim , Shen Xueyi , Chan Stella W. Y. , Ziermans Tim B. , McIntosh Andrew M. , Whalley Heather C.
Published: November 2020

Background:Within young individuals, mood disorder onset may be related to changes in trajectory of brain structure development. To date, however, longitudinal prospective studies remain scarce and show partly contradictory findings, with a lack of emphasis on changes at the level of global brain patterns. Cross-sectional adult studies have applied such methods and show that mood disorders are associated with accelerated brain aging. Currently, it remains unclear whether young individuals show differential brain structure aging trajectories associated with onset of mood disorder and/or presence of familial risk.

Methods:Participants included young individuals (15-30 years, 53%F) from the prospective longitudinal Scottish Bipolar Family Study with and without close family history of mood disorder. All were well at time of recruitment. Implementing a structural MRI-based brain age prediction model, we globally assessed individual trajectories of age-related structural change using the difference between predicted brain age and chronological age (brain-predicted age difference (brain-PAD)) at baseline and at 2-year follow-up. Based on follow-up clinical assessment, individuals were categorised into three groups: (i) controls who remained well (C-well,n= 93), (ii) high familial risk who remained well (HR-well,n= 74) and (iii) high familial risk who developed a mood disorder (HR-MD,n= 35).

Results:At baseline, brain-PAD was comparable between groups. Results showed statistically significant negative trajectories of brain-PAD between baseline and follow-up for HR-MD versus C-well (β= -0.60,pcorrected< 0.001) and HR-well (β= -0.36,pcorrected= 0.02), with a potential intermediate trajectory for HR-well (β= -0.24 years,pcorrected= 0.06).  

Conclusions:These preliminary findings suggest that within young individuals, onset of mood disorder and familial risk may be associated with a deceleration in brain structure aging trajectories. Extended longitudinal research will need to corroborate findings of emerging maturational lags in relation to mood disorder risk and onset.
Created Co-creator, a Theory of Human Becoming in an Era of Science and Technology
Authors: Kwakye Ahenkora Siaw
Published: November 2020

Scientific discoveries and the emergence of cosmological theories such as the Big Bang Theory and evolution have challenged the Christian doctrine of creation and its reliability on many fronts, because the discoveries appear to contradict the Christian account as to how creation unfolded. Hefner sees the situation as an additional interpretative task to theologians. He, however, posits that scientific discoveries are an opportunity to communicate the Christian message through social and scientific experience to bring meaning to broader society. He expresses the notion that religion will remain relevant only if it measures up to science, because we are in a science and technology era. Hefner, therefore, introduced the concept of created co-creator as a metaphor and analytical tool to explain the meaning and purpose of humans within the biosphere. The concept is characterized by the ability to communicate religion through science and to relate with available models of origin. This work expounds on the concept of created co-creator’s ability to explain human technological trajectory in theology. There is also an effort to establish a relationship between Hefner’s concept and Haraway’s cyborg with an emphasis on the concept’s ability to communicate the Christian doctrine of creation through scientific knowledge and why such an enterprise is useful.
Machine or Melody? Joseph Ratzinger on Divine Causality in Evolutionary Creation
Authors: Ramage Matthew J.
Published: November 2020

In a document penned under the direction of its then-president Cardinal Joseph Ratzinger, the Vatican’s International Theological Commission observed that many neo-Darwinian materialists and their Christian critics share a misunderstanding of the nature of divine causality. This article explores the thought of Joseph Ratzinger in view of proposing the features of a path that seeks to eschew these faulty understandings of how God causes evolutionary change within our world, thus providing an alternative to the Intelligent Design movement’s approach to creation. . Ratzinger has a deep respect for the integrity of nature, rejecting the notion that God is a “craftsman” who “tinkers” with the world. According to Ratzinger, evolutionary change occurs “precisely in the processes of a living being” even as human beings are “not the mere product of development.” Finally, the emeritus pontiff insists that creation is an ever-present act that unfolds “in the manner in which thought is creative,” a dynamic that he describes variously as a story, drama, melody, and symphony. Wedding these and other key insights, this article submits that Ratzinger’s thought on evolution should lead us to conceive of creation less along the lines of an intelligently designed machine and more as a masterpiece story that is continually being told as its plot unfolds naturally over the course of time.
The Theory of Evolution in the Writings of Joseph Ratzinger
Authors: Novo Francisco J.
Published: November 2020

In this article I analyse the texts in which Joseph Ratzinger deals with the topic of evolution, particularly in the context of the compatibility between faith in creation and acceptance of the theory of evolution. I have grouped his writings into three periods that reflect the changes in his ideas on this topic. His early writings, until 1979, contain the most elaborate and deepest theological insights, with a defence of the compatibility between faith in creation and the theory of evolution when each one is kept within the boundaries of its own explanatory framework. There is a clear change of attitude at the beginning of the 1980s, when he becomes aware of the attempts by some atheist scientists to portray evolution as a “first philosophy”. This triggers a critical response against some technical aspects of the theory of evolution, a position that was reinforced by his contacts with anti-evolution German intellectuals during this period. The conflict reached its climax in the 1999 lecture at the Sorbonne University and the 2006 meeting of the Schulerkreis in Castel Gandolfo. After 2006 his references to this topic were few, and he seemed to return to the original ideas expressed in his early writings, stressing the intrinsic rationality and inner logic of the cosmos.
Review of Creative Nature (part 3)
Authors: Woollard Geoffrey
Published: November 2020

The short monograph Creative Nature (Francisco Javier Novo, Rubén Pereda, and Javier Sánchez-Cañizares. 2018. Naturaleza Creativa. Madrid: Rialp. ISBN: 978-84-321-4916-0. 196 pp. Paperback, €14.25) is a welcome contribution to the philosophy of nature that arose from interdisciplinary conversations between authors who are both up-to-date in the scientific literature and deeply grounded in the Western intellectual tradition. In this third and final part of the review essay, I take Creative Nature as a point of departure and develop a theological synthesis of our relationship with the natural world. My approach to making sense of natural evil draws on the Aristotelian-Thomistic metaphysical tradition. I emphasize the wisdom of viewing nature as a whole and avoiding anthropomorphisms, in order to both come to peace with our common home and feel like we belong in a welcoming world. I draw from St. Paul’s teaching on cosmic redemption in his letters to the Colossians and Ephesians to shine the light of supernatural faith on our relationship with the natural world. This approach illustrates how a sound philosophy of nature and biblical interpretation are pivotal for faith–science dialogue.The short monograph Creative Nature (Francisco Javier Novo, Rubén Pereda, and Javier Sánchez-Cañizares. 2018. Naturaleza Creativa. Madrid: Rialp. ISBN: 978-84-321-4916-0. 196 pp. Paperback, €14.25) is a welcome contribution to the philosophy of nature that arose from interdisciplinary conversations between authors who are both up-to-date in the scientific literature and deeply grounded in the Western intellectual tradition. In this third and final part of the review essay, I take Creative Nature as a point of departure and develop a theological synthesis of our relationship with the natural world. My approach to making sense of natural evil draws on the Aristotelian-Thomistic metaphysical tradition. I emphasize the wisdom of viewing nature as a whole and avoiding anthropomorphisms, in order to both come to peace with our common home and feel like we belong in a welcoming world. I draw from St. Paul’s teaching on cosmic redemption in his letters to the Colossians and Ephesians to shine the light of supernatural faith on our relationship with the natural world. This approach illustrates how a sound philosophy of nature and biblical interpretation are pivotal for faith–science dialogue.
La participación ciudadana en el futuro de Europa: instrumentos y oportunidades para promover un espacio público europeo
Authors: Pérez de las Heras Beatriz
Published: November 2020

Como organización internacional de integración y proyecto de unión
política, la Unión Europea (UE) ha introducido en la última década diversos
mecanismos de participación ciudadana con el fin de reforzar su legitimidad
democrática y apoyo popular. A pesar de su relevancia, estos instrumentos no han
tenido un efecto transformador visible en las políticas y normativas europeas. La
Conferencia sobre el Futuro de Europa, como nuevo foro participativo, aspira a
dar ese salto cualitativo en el modelo de gobernanza, canalizando las propuestas
colectivas resultantes de este proceso a través del ciclo institucional normativo.
Esta nueva dinámica de innovación política requerirá cambios sistémicos en la
representación y participación ciudadana. Sólo así podrá configurarse un espacio
público genuinamente europeo, en el que los ciudadanos se identifiquen como
demos de una comunidad política supranacional.
The Enlargement of Competences of the European Union between State Sovereignty and the so-called European “Sovereignty”: Focus on the Limits of Applicability of the Charter of Fundamental Rights of the European Union
Authors: Di Stasi1 Angela
Published: November 2020

Starting from an overview on the current crisis in the European integration
process, caused inter alia by the emergence of forms of “souverainisms”, the
following paper focuses on the peculiarity of the European Union phenomenon
and on the effects of the gradual enlargement of the European competences with
respect to the classical concept of sovereignty. In this view, some observations
will be made around the subtle limit which separates the EU competence from the
one of its member States. For this purpose, the Charter of fundamental rights of the EU and the issue of the field of its application towards the member States is
adopted as a privileged observation point.
China en los intersticios de la crisis del multilateralismo y la globalización neoliberal: La Franja y la Ruta en Europa y el caso italiano
Authors: Vadell Javier , Staiano Maria Francesca
Published: November 2020

El artículo tiene como objetivo analizar la presencia de China en Europa
a través de la Iniciativa de la Franja y la Ruta (IFR) en un contexto de crisis
de la globalización neoliberal y del multilateralismo. Las preguntas iniciales son
¿de qué manera la IFR está contribuyendo a reconfigurar la globalización y el
regionalismo en la Unión Europea (UE) y cuáles son los impactos en la UE de este
tipo de acuerdos? El artículo enfoca en el caso de Italia como análisis descriptivo
y exploratorio, que si bien no es el único país de la UE que firmó un Memorándum
de Entendimiento de la IFR, fue el único del G7 que lo hizo. Finalmente, el
artículo destaca cómo la pandemia del COVID19 tornó más compleja la relación
China-Europa, provocando reacciones diferenciadas entre la UE e Italia
La influencia del campo social pro-bicicleta en el proceso de promoción del ciclismo urbano en Sevilla
Authors: Malpica Pedro
Published: November 2020

In the successful process of planning, design and implementation of cycling infrastructures in Seville, the intervention and participation of certain actors proved to be decisive. In order to identify and characterize the evolution, milestones, components, interests and other relevant aspects of this process of cultural production, various qualitative and ethnographic techniques have been used, especially the interview, the participant observation and the analysis of sources, using Bourdieu’s concept of field as a methodological axis according to Martín’s proposal. Through the historical analysis of this local social field of urban cycling —formed by technicians, politicians, institutions, firms and academics around a pre-existing core of activist kind— it can be stated that the specific knowledge held by its members, as well as their positions in different fields of influence, turned out to be decisive for such a proposal from municipal institutions to be well valued and embodied by broad social segments.
Mejora participativa del hábitat en contextos de desigualdad en ciudades intermedias
Authors: Boldrini Paula , Malizia Matilde
Published: November 2020

The conditions that are vulnerable urban varied qualitatively in the last ten years. To the already known prevailing inequality conditions are added the increase and consolidation of drug production, sale and consumption circuits, mainly paco, which generate and deepen various problems, structurally transforming regional, local and neighborhood socio-spatial dynamics. Given this situation, other modes of social organization arise, which bring with them new coping strategies, technical support (public, academic and non-governmental institutions, among others), design and implementation of public policies that seek to influence specific transformations in the territory. However, this scenario finds technicians mostly de-instrumented to intervene in the territory with the old strategies —already rudimentary and now also outdated— that require rigorous transformations to reach an appropriate social approach. That is why it is proposed as a main objective to identify those appropriate strategies for the integral improvement of the popular habitat through community participation and strengthening processes. For its development it is based on concrete experiences of technical support carried out in five vulnerable neighborhoods of the Gran San Miguel de Tucumán agglomerate, located in northwestern Argentina, since 2015.
Challenges of SARS-CoV-2 and conflicting PPE guidelines
Authors: Master Shamima , Gerrard Mark
Published: November 2020

During the coronavirus disease 2019 (COVID-19) pandemic, personal protective equipment (PPE) has become a contentious issue in healthcare settings, no more so than in the prehospital environment. The current severe acute respiratory syndrome 2 virus (SARS-CoV-2) has pathogenic and transmission similarities to previous coronaviruses, severe acute respiratory syndrome (SARS-CoV) and Middle Eastern respiratory syndrome (MERS-CoV). There are differences in global and domestic PPE guidelines concerning SARS-CoV-2.
Automatic Measurement of Subregional Vertebral Bone Mineral Density via Deep Learning of Quantitative Computed Tomography Images
Authors: Li Chentian , Ma Chi , Zhuo Xianglong , Wang Wei , Li Li , Ip Wing-Yuk , Li Bing , Li Tao , Li Songjian , Zhu Feng , Lu William W.
Published: November 2020

Background: Measurement of subregional Bone Mineral Density (BMD) of the vertebral body has been shown to hold a critical role in osteoporotic fracture risk analysis. The reproducibility and precision of the measurement rely highly on the vertebral body region of interest segmentation accuracy, which requires expert-level experience in medical image preprocessing and is time-consuming work. The establishment of a reliable automatic method could enhance the efficiency and precision of these measurements in clinical practice.
Purpose: To develop and validate a deep learning-based segmentation approach for subregional vertebral BMD measurement with quantitative CT scans.
Materials and Methods: Quantitative CT images from 115 subjects (62 women and 53 men with a mean age of 66.4 ± 13.4 years) were retrospectively collected. A deep learning-based segmentation pipeline was trained on a total of 403 manual segmented lumbar vertebral bodies. The performance was evaluated by its accuracy, Dice Score, and Intersection over Union (IoU) score. A scan-rescan test was performed to evaluate the subregional BMD measurement reliability and reproducibility by analyzing the intraclass correlation coefficient and Bland-Altman analysis.
Results: This automatic approach achieved high segmentation performance for the entire vertebral body segmentation (accuracy 0.98 ± 0.02, dice coefficient 0.92 ± 0.06, and IoU 0.87 ± 0.09), cortical bone segmentation (accuracy 0.95 ± 0.02, dice coefficient 0.92 ± 0.03, and IoU 0.85 ± 0.05), and endplate segmentation (accuracy 0.89 ± 0.05 and Dice coefficient 0.75 ± 0.09, IoU 0.61 ± 0.12). The scan-rescan test further showed the automatic measurement is highly reproducible (r = 0.96, limit of agreement [LoA] = -20.4~17.9 mg/cm3 for entire region; r = 0.95, LoA = -39.5~33.3 mg/cm3 for cortical region; r = 0.89, LoA = -23.4~20.9 mg/cm3 for cancellous region; r = 0.82, LoA = -44.9~58.9 mg/cm3 for superior endplate; r = 0.63, LoA = -81.6~106.5 mg/cm3, respectively).
Conclusion: The deep learning-based approach is feasible for vertebral body subregions segmentation, which ensures the precision and reproducibility of BMD measurement. The cortical and cancellous BMD can be separately measured by the deep learning-based approach, providing an automatic and reliable framework for the investigation of subregional osteoporosis changes with Quantitative Computed Tomography (QCT) spine scans.
Mid-term results after in situ pinning and hip arthroscopy for mild slipped capital femoral epiphysis: A minimum five-year follow-up
Authors: Rahm Stefan , Jud Lukas , Jungwirth-Weinberger Anna , Tondelli Timo , Falkowski Anna L. , Sutter Reto , Zingg Patrick O.
Published: November 2020

Purpose

In situ pinning of mild slipped capital femoral epiphysis (SCFE) results in an aspherical head–neck junction and arthroscopic osteochondroplasty can successfully correct the head–neck junction. However, whether the correction stays stable over at least five years remains unknown.

Methods

In a retrospective and consecutive series, 11 patients with a mean age of 12 years (range, 10 years to 15 years) were included. All patients were treated for mild SCFE with in situ pinning and staged hip arthroscopy correcting the head–neck junction. All patients were assessed clinically and radiographically (radiograph and magnetic resonance imaging (MRI)) pre-operatively, 12 weeks and at least five years’ post-operatively.

Results

The mean range of motion (ROM) for flexion and internal rotation was stable over time with 100° (sd 4) and 21° (sd 6), respectively at the last follow-up. The mean alpha angle decreased from pre-operative 64° (range 61° to 68°) to 12 weeks post-operative 49° (range 46° to 52°; p = 0.001) and stayed stable over time. New superficial cartilage damage on either the acetabular or femoral side was seen in each three patients. Progressive labral degeneration was present in two patients.

Conclusion

In situ pinning and staged hip arthroscopy for the correction of mild SCFE is safe, restores normal alpha angles and reveals stable morphological correction at mid-term follow-up. Furthermore, the clinical results were excellent with almost normalized internal hip rotation at mid-term follow-up in patients who had reached adulthood. However, there was some joint deterioration, but without negative impact on subjective and clinical outcome after at least five years.

Level of evidence

IV
Field Evaluation of Targeted Shake-and-Catch Harvesting Technologies for Fresh Market Apple
Authors: Zhang Xin , He Long , Karkee Manoj , Whiting Matthew David , Zhang Qin
Published: November 2020

Highlights

Three shaking methods and vibratory harvesting systems were evaluated and compared.

Multi-year field evaluations were performed with up to six cultivars trained to formal architectures.

The updated semi-automated system achieved the highest fruit removal efficiency and the best fruit quality.

Abstract. Apple is the most economically important agricultural crop in Washington State. In 2018, Washington State produced ~3.3 billion kg of apple, accounting for approximately 63% of U.S. production. Fresh-market apple is currently harvested manually, requiring large numbers seasonal semi-skilled workers for a small harvest window. To overcome the increasing challenges of uncertain labor availability and raising labor costs, a promising mechanical harvesting system, using a targeted shake-and-catch approach, is under development at Washington State University. This study evaluated the system by analyzing its fruit harvest efficiency and fruit quality with three shaking methods, i.e., continuous non-linear, continuous linear, and intermittent linear shaking, on up to six apple cultivars trained to formal tree architectures. Results showed that intermittent linear shaking achieved 90% fruit removal efficiency for ‘Scifresh’ cultivar, while continuous linear shaking achieved only 63% removal efficiency for ‘Gala’. This study also compared three vibratory systems: a hand-held system, a hydraulically driven system, and a semi-automated hydraulic system. The semi-automated system achieved the highest fruit removal efficiency (90%), followed by the hand-held (87%) and hydraulic (84%) systems, mainly due to the different shaking methods employed. However, the differences were statistically insignificant. Fruit catching efficiency varied among the harvesting systems, with the hand-held system achieving the highest efficiency (97%), followed by the hydraulic (91%) and semi-automated (88%) systems. Among the three tested technologies, the prototype semi-automated system achieved the highest level of mechanization, as well as high fruit removal efficiency and the best fruit quality. Because the semi-automated system did not include an auto-positioning function, positioning its shaker head took about eight times longer (~103 s) than the actual shaking time (~13 s), which suggests that a fully automated system is desirable to further increase productivity. This study showed that the shake-and-catch approach has great potential for practical adoption in harvesting of fresh-market apple and therefore can have a positive economic impact on the U.S. apple industry. Keywords: Automation in apple production, Bulk mechanical harvest, Semi-automated system, Shaking method, Time efficiency.
Non-Destructive Identification of Internal Watercore in Apples Based on Online Vis/NIR Spectroscopy
Authors: Chang Han , Wu Qifang , Tian Hao , Yan Jinshan , Luo Xuan , Xu Huirong
Published: November 2020

Highlights

A custom-designed online Vis/NIR spectroscopy system was used for real-time detection of watercore in apples.

Watercore severity index (WSI) was applied for watercore severity assessment.

Higher than 95.0% accuracy was obtained for total samples in classifying sound apples from watercore groups using kNN, BPNN, SVM, and 1D CNN at a detection speed of 3 apples s-1.

Linear kernel SVM achieved the best classification accuracy of 96% for samples in the prediction set.

Abstract. Watercore, an internal physiological disorder affecting apples, can be characterized by water-soaked, glassy regions near the fruit core. It is used as an indicator of full ripeness, storage suitability, and price of apples in many countries. Therefore, fast and non-destructive detection of watercore plays an important role in improving the commercial value of apples and reducing postharvest costs. In this study, an online visible/near-infrared (Vis/NIR) spectroscopy system was proposed for real-time detection of watercore in ‘Fuji’ apples (Malus pumila Mill.). A total of 318 samples harvested during harvest season in the same orchard were analyzed for both watercore severity index (WSI) and soluble solids content (SSC). According to the USDA watercore classification standard, all samples were classified into one of four classes (sound, slight, moderate, or severe) based on the affected area of watercore. Results showed that, although there was a positive correlation between spectral intensity and affected area of watercore, no significant relationship between affected area size and SSC could be obtained by Pearson test (correlation coefficient ~0.094). Generally, >95.0% accuracy was obtained for total samples at a detection speed of 3 apples s-1 in classifying sound from watercore groups using k-nearest neighbors (kNN) algorithm, back-propagation neural network (BPNN), support vector machine (SVM) classification, and one-dimensional convolutional neural network (1D-CNN). The best classification result was achieved by linear kernel SVM, with an accuracy of 96% for total samples. These classification algorithms showed preliminary feasibility for online screening of apples with watercore using Vis/NIR spectroscopy in industrial applications. Keywords: Apple watercore, Machine learning, Online detection, Vis/NIR spectroscopy, Watercore severity index.
Improving thermal stability of a resonant fiber optical gyroscope using triple closed loops
Authors: Liu Lu , Tu Junyu , Ye Sen , Ma Huilian
Published: November 2020

A closed-loop resonant fiber optic gyroscope (RFOG) configuration with three resonance frequency servo loops is proposed. By using one laser-servo loop and two symmetrical phase modulator (PM) servo loops, the effect of the reset due to the limited tracking range of the laser-servo loop is solved. Further long-term stability for 48 h and thermal stability at moderate rate measurements show that the output of the triple closed-loop RFOG is insensitive to environmental temperature variations. When the temperature increased from 17.5°C to 40.7°C in 1800 s and the maximum temperature rate was about 0.025°C/s during heating, the laser-servo loop was reset a total of 413 times. However, the output of the triple closed-loop RFOG is not affected by those frequent resets in the laser-servo loop because the two PM-servo loops are free of glitch pulses under this new scheme. Compared to the traditional double closed-loop RFOG, the thermal bias stability of the triple closed-loop RFOG is improved by a factor of 15 times from 29.8°/h to 1.88°/h.
Efficient simulation of surface scattering in symmetry-free optical systems
Authors: Lu Xiang , Gross Herbert
Published: November 2020

Simulation of scattering from optical surfaces is usually based on Monte Carlo methods in which the bidirectional scattering distribution function (BSDF) of the optical surfaces are sampled randomly by many rays, resulting in long calculation times. In order to accelerate the simulation, a quasi-analytical phase space model is proposed. In this model, few rays are traced from the object and image space to the target surface to determine the illumination and acceptance areas in phase space, where these areas can be conveniently coupled simultaneously in the spatial and angular domain. Since no random sampling is involved in the phase space model, no statistical noise perturbs the result and the surface scattering simulation can be greatly accelerated. Additionally, due to the use of real raytracing, the phase space model removes the limitation of paraxial approximation, which usually limits the accuracy of deterministic stray light analysis models. Meanwhile, by the discretization of the optical surfaces into subareas, this new approach is able to model freeform surfaces with arbitrary geometries, and space-variant BRDFs can be applied for different subareas of the optical surface.
Unraveling the origin of frequency modulated combs using active cavity mean-field theory
Authors: Burghoff David
Published: November 2020

In many laser systems, frequency combs whose output is frequency-modulated (FM) can form, producing light whose frequency sweeps linearly. While this intriguing result has been replicated experimentally and numerically, a compact description of the core physics has remained elusive. By creating a mean-field theory for active cavities analogous to the Lugiato–Lefever equation, we show that these lasers are described by a nonlinear Schrödinger equation with a potential proportional to the phase of the electric field. This equation can be solved analytically and produces a field with quasi-constant intensity and piecewise quadratic phase. We refer to these nondispersive waves as extendons, and they describe both fundamental FM combs and harmonic states. Our results apply to many lasers, explaining the ubiquity of this phenomenon, and our new theory unifies many experimental observations.
Angular displacement estimation enhanced by squeezing and parametric amplification
Authors: Jiao Gao-Feng , Wang Qiang , Chen L. Q. , Zhang Weiping , Yuan Chun-Hua
Published: November 2020

We theoretically study angular displacement estimation based on a modified Mach-Zehnder interferometer (MZI), in which two optical parametric amplifiers (PAs) are introduced into two arms of the standard MZI, respectively. The employment of PAs can both squeeze the shot noise and amplify the photon number inside the interferometer. When the unknown angular displacements are introduced to both arms, we derive the multiparameter quantum Cramér-Rao bound (QCRB) using the quantum Fisher information matrix approach, and the bound of angular displacement difference between the two arms is compared with the sensitivity of angular displacement using the intensity detection. On the other hand, in the case where the unknown angular displacement is in only one arm, we give the sensitivity of angular displacement using the method of homodyne detection. It can surpass the standard quantum limit (SQL) and approach the single parameter QCRB. Finally, the effect of photon losses on sensitivity is discussed.
Conflicting findings between the Mitra-Fr and the Coapt trials: Implications regarding the cost-effectiveness of percutaneous repair for heart failure patients with severe secondary mitral regurgitation
Authors: Armoiry Xavier , Obadia Jean-François , Auguste Peter , Connock Martin
Published: November 2020

Purpose

Two randomized controlled trials (RCTs), Mitra-Fr and Coapt, evaluating the benefit of percutaneous repair (PR) for heart failure (HF) patients with severe mitral regurgitation, have led to conflicting results. We aimed to evaluate the impact of these trial results on the cost-effectiveness of PR using effectiveness inputs from the two RCTs.

Methods

We developed a time varying Markov type model with three mutually exclusive health states: alive without HF hospitalisation, alive with HF hospitalisation, and dead. Clinically plausible extrapolations beyond observed data were obtained by developing parametric modelling for overall survival and HF hospitalisations using published data from each trial. We adopted the perspective of the French Health System and used a 30-year time horizon. Results were expressed as € / quality-adjusted life year (QALY) gained using utility inputs from literature.

Findings

Results are presented using treatment efficacy measures from Mitra-F and Coapt trials respectively. With the Mitra-Fr data, after annual discounting, the base case model generated an incremental 0.00387 QALY at a cost of €25,010, yielding an incremental cost effectiveness ratio (ICER) of €6,467,032 / QALY. The model was sensitive to changes made to model inputs. There was no potential of PR being cost-effective.

With the Coapt data, the model generated 1.19 QALY gain at a cost of €26,130 yielding an ICER of €21,918 / QALY and at a threshold of >€50,000/QALY PR had a probability of 1 of being cost-effective.

Implications

Cost effectiveness results were conflicting; reconciling differences between trials is a priority and could promote optimal cost effectiveness analyses and resource allocation.
A multivariate, quantitative assay that disentangles key kinetic parameters of primary human T cell function in vitro
Authors: Huang Grace L. , Nampe Daniel P. , Yi Jason , Gabrelow Grant B. , Negri Kathleen R. , Kamb Alexander , Xu Han
Published: November 2020

Cell therapy is poised to play a larger role in medicine, most notably for immuno-oncology. Despite the recent success of CAR-T therapeutics in the treatment of blood tumors and the rapid progress toward improved versions of both CAR- and TCR-Ts, important analytical aspects of preclinical development and manufacturing of engineered T cells remain immature. One limiting factor is the absence of robust multivariate assays to disentangle key parameters related to function of engineered effector cells, especially in the peptide-MHC (pMHC) target realm, the natural ligand for TCRs. Here we describe an imaging-based primary T cell assay that addresses several of these limitations. To our knowledge, this assay is the first quantitative, high-content assay that separates the key functional parameters of time- and antigen-dependent T cell proliferation from cytotoxicity. We show that the assay sheds light on relevant biology of CAR- and TCR-T cells, including response kinetics and the influence of effector:target ratio.