bluuebunny/crossref_metadata_2025 huggingface dataset:
Stage I epithelial or stromal type Wilms tumors are low risk tumors: An analysis of patients treated on the SIOP‐WT‐2001 protocol in the UK‐CCLG and GPOH studies (2001–2020)
Authors: D’Hooghe Ellen , Furtwängler Rhoikos , Chowdhury Tanzina , Vokuhl Christian , Al‐Saadi Reem , Pritchard‐Jones Kathy , Graf Norbert , Vujanić Gordan M.
Published: March 2023

Background

Patients treated with preoperative chemotherapy with stage I intermediate‐risk Wilms tumor (IR‐WT) represent the largest group of patients with Wilms tumor (WT), and they have excellent outcomes.

Methods

The authors performed a retrospective analysis of patients with stage I epithelial (ET‐WT) or stromal type WT (ST‐WT) treated pre‐ and postoperatively according to the International Society of Paediatric Oncology‐WT‐2001 protocol in the UK Children's Cancer and Leukaemia Group and Gesellschaft für Pädiatrische Onkologie und Hämatologie groups' participation in the relevant WT trials and studies (2001–2020).

Results

There were 880 patients with stage I IR‐WT, including 124 with ET‐WT, 156 with ST‐WT, and 600 with other IR‐WT (oIR‐WT). Patients with stage I ET‐WT or ST‐WT were significantly younger than patients with oIR‐WT, represented a large proportion of stage I WTs in their groups, and tumors showed poor histologic response to preoperative chemotherapy. The 5‐year event‐free survival (EFS) estimates for patients with stage I ET‐WT (96.8% ± 1.8 SE) or ST‐WT (96.8% ± 1.6 SE) were significantly better than for patients with oIR‐WT (90.3% ± 1.3 SE) (p = .014 and p = .009, respectively). A multivariate analysis showed that histologic type (ET‐WT or ST‐WT) remained a significant factor for EFS when adjusted for age and gender (p = .032 and p = .022, respectively). In both groups, relapses occurred in 3.2% of patients, and the overall survival was 99.2%.

Conclusions

The results suggest that stage I ET‐WT or ST‐WT could be regarded as low‐risk WT, for which omission of postoperative chemotherapy should be considered.

Plain Language Summary

Patients with pretreated intermediate‐risk Wilms tumor (WT) represent the largest group of patients with WT.

This study reports the outcomes of patients with stage I epithelial type (ET‐WT) or stromal type WT (ST‐WT).

These patients were significantly younger and had a larger proportion of stage I cases than patients with other intermediate‐risk WT (oIR‐WT).

The event‐free survival for patients with stage I ET‐WT and ST‐WT was significantly better than for patients with oIR‐WT.

Rare relapses were curable resulting in 99.2% overall survival.
An adjoint‐based method for the computation of gradients in coagulation schemes
Authors: Nicoud Franck
Published: March 2023

An adjoint‐based methodology is proposed to compute the gradient of the outcomes of mathematical models for the coagulation cascade. The method is first exposed and validated by considering a simple, analytically tractable case involving only 3 species. Its potential is further illustrated by considering a detailed model for the extrinsic pathway involving 34 chemical species interacting through 45 chemical reactions and for which the gradient of Endogeneous Thrombin Potential, clotting time, maximum rate and peak value of thrombin with respect to the initial concentrations and reactions rates are computed. It is shown that the method produces gradients estimates that are fully consistent with the finite differences approximation used so far in the literature, but at a much lower computational cost.
A state‐of‐the‐art survey of predicting students' performance using artificial neural networks
Authors: Xiao Wen , Hu Juan
Published: March 2023

Predicting students' performance is one of the most important issue in educational data mining. In order to investigate the state‐of‐the‐art research development in predicting students' performance by using artificial neural networks (ANN), we conducted a survey on 39 important studies on this issue from 2016 to 2021. The results show that: (1) objectives of most prediction model is the performance of learners on the program and course; (2) datasets used for training prediction model are collected from logs of the learning management system; (3) the most commonly used ANN is feedforward neural network; (4) researchers use stochastic gradient descent and Adam algorithm to optimizes the parameters in ANN and configure hyper parameters of ANN manually; (5) feature selection is not necessary because ANN can automatically adjust the weights of artificial neurons; and (6) ANN has better performance than the classical classifiers in predicting student performance. The challenges in previous studies were comprehensively analyzed, suggestions for future research were put forward.
Neuropsychiatric profile in average intelligent individuals with coexisting epilepsy and psychogenic non‐epileptic seizures
Authors: Giugno Alessia , Martino Iolanda , Sammarra Ilaria , Fratto Enrico , Fortunato Francesco , Labate Angelo , Gambardella Antonio
Published: March 2023

Global neuropsychological impairments with intellectual disability (ID) seem to play a major role in the occurrence of psychogenic non‐epileptic seizures (PNES) in epilepsy. Conversely, the pathophysiology underlying PNES combined with epilepsy without ID remains elusive. We investigated the neuropsychiatric profile in 26 average intelligent subjects (15 women, mean age: 40.04 ± 13.53 years) with temporal lobe epilepsy (TLE) plus PNES (TLE + PNES), compared with 28 with TLE and 22 with PNES alone, matched for age and sex. All subjects underwent neuropsychiatric assessment, including Beck Depression Inventory‐2 (BDI‐2), State‐Trait Anxiety Inventory (STAI), Dissociative Experiences Scale (DES), Toronto Alexithymia Scale (TAS‐20), Traumatic Experience Checklist (TEC), and cognitive evaluation. TLE + PNES and PNES groups shared a similar psychiatric profile with higher levels of depression (BDI‐2, P < 0.001), anxiety (STAI‐S, P < 0.001; STAI‐T, P < 0.001), dissociation (DES, P < 0.001), and alexithymia (TAS, P = 0.005) scales than the TLE group. Nonetheless, like individuals with TLE, patients with TLE + PNES had a lower rate of a potentially traumatizing event than PNES. The very low rate of potentially traumatizing event in subjects with TLE + PNES leads us to hypothesize that epilepsy itself may be the psychophysiological distress that contributed to PNES. A psychopathological assessment in subjects with epilepsy is crucial to identify those more likely to develop PNES.
Human measure and natural fecundity: Mythos and logos in the past and future of the humanities
Authors: Angus Ian
Published: March 2023

The beginnings of social forms are shrouded in, and justified by, myths which establish both the manifest content of stories and religion. The replacement of myth by logic is never total and the role of logic depends upon the mythic origin that it partially replaces. The form of heritage is constituted in large part by the manner in which intertwining between mythos and logos is structured. Taking the measure of humanitas today means noting, not only the internal articulation of a heritage but those elements of a given heritage which resonate with other heritages. The proximity of Socrates and Protagoras, in Plato's dialogue of the same name, allows us to glimpse a possibility not visible in any other confrontation between Socrates and the sophists: a unity of philosophy and rhetoric in the constitution and heritage of humanism. George Lukács' late, unfinished work, The Ontology of Social Labour, aimed to establish an ontological foundation for the relation between science and religion. In this way, the ontology of labour introduces a new twist into the relation between mythos and logos. One critical comment about Lukács' ontology of labour pertinent to the relation between mythos and logos is that the experience of nature in labour may be more affirmative than the trajectory of classical Marxism allows. The productivity of labour, which increases with social organization and division of labour, is based upon natural fecundity. A human being lives a necessary paradox of seeing human excellence and good in distinction from nature and as part of the nature that surpasses it. The humanities are charged with investigating this paradox in all its forms. Even while inhabiting a given tradition, the mythos/logos complexes of other societies may be approached, listened to, and even understood.
New palaeomagnetic results of Permian tectonic blocks in the western segment of the Yarlung Zangbo Suture Zone and their tectonic implications
Authors: Li Zijian , Li Yalin , Tan Xiaodong , Li Shuai , Ma Xingduo , Huang Song , Xiao Siqi , Cheng Jianbo , Zhang Jiawei
Published: March 2023

The composition and structure of the Yarlung Zangbo Suture Zone (YZSZ) provide important constraints on long‐standing disputes about the evolution of the Neo‐Tethys Ocean and continental collision. The Permian tectonic blocks (mainly composed of limestones and volcanic rocks) are widely distributed in the YZSZ. There are still different understandings about the origin of these blocks and their relationship with the evolution of the Neo‐Tethys Ocean. Here, we report the first reliable palaeomagnetic results of the Permian tectonic blocks in the Gyanyima and Mayum areas, the western segment of the YZSZ. Fossil records and our new zircon U–Pb results provide 254–252 Ma and 249 ± 2 Ma age constraints for the strata in the Gyanyima and Mayum sections, respectively. A total of 109 specimens were subjected to stepwise thermal demagnetizations. Among them, 83 specimens yielded interpretable results. After removing a recent geomagnetic field direction at low to intermediate temperature ranges, characteristic remanent magnetization (ChRM) directions can be isolated from the upper Permian–lower Triassic Gyanyima Formation (Fm). Unblocking temperature spectra of the ChRM indicate magnetite and haematite as the main carriers in the basalt and limestone/andesitic‐basalt samples, respectively. The ChRM passed the fold tests and a reversal test at 95% confidence level, indicating that it is most likely a primary remanence. The tilt‐corrected mean direction for 14 sites is D = 18.0°, I = −14.4°, k = 20.5, and α95 = 9.0°, which corresponds to a palaeolatitude of 7.3°S and a palaeopole at 48.3°N, 233.3°E with A95 = 8.1°. Combining the rock assemblage, palaeomagnetic, palaeontological, and geochronologic data, we conclude that these blocks were most likely seamounts formed in the low‐latitude area of the Neo‐Tethys Ocean. The palaeolatitude and origin of these blocks indicate that the evolution of the Neo‐Tethys Ocean was a complex process interspersed with the development of a series of seamounts and microblocks.
RETRACTED: Evaluating the impact of climate change and geo‐environmental factors on flood hazards in India: An integrated framework
Authors: Chowdhuri Indrajit , Pal Subodh Chandra , Roy Paramita , Chakrabortty Rabin , Saha Asish , Shit Manisa
Published: March 2023

Among several devastating natural hazards, flooding is a common and serious threat to society causing huge loss of lives, properties, and infrastructure throughout the world. The intensity and frequency of this extreme weather event are expected to increase due to significant changes in the present‐day climate and land use and land cover (LULC) pattern. India has a very systematic and organized structural program and policies but lacks proper implementations, and adverse effect of climate change and the extreme event goes on in society. This paper is an analysis of floods in India and hazards due to climate change and LULC change patterns. Three models, namely “Eco‐biogeography‐based optimization (EBO), Random forest (RF), and Support vector machine (SVM)” were used to obtain the final output to prepare a “Flood susceptibility map”. The result was validated through the “Receiver operating characteristics (ROC)” with “Area under curve (AUC)” values. The future rainfall scenario has been estimated by considering the “General circulation models” through different “shared socioeconomic pathways (SSPs)”. The values of AUC are 0.915 (EBO), 0.887 (RF), and 0.869 (SVM), respectively. After consideration of different SSPs, the result shows that there is an increasing tendency of flood hazards in the projected period. Among all the employed modelling approaches, the EBO model has notable potential in delineating the possible flood‐prone regions for effective flood planning and management. Decision‐makers can benefit from country‐specific information and regional planner to implement sustainable and long‐term measures to overcome this type of hazardous situation.
Oral rehabilitation with dental implants in patients with systemic sclerosis: A systematic review
Authors: Mosaddad Seyed Ali , Abdollahi Namanloo Reza , Ghodsi Raziye , Salimi Yasaman , Taghva Masumeh , Naeimi Darestani Meshkat
Published: March 2023

Objective

To assess the influence of systemic sclerosis (SSc) on the survival rate of dental implants in SSc patients receiving implant‐supported treatments.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) Statement and the Cochrane Collaboration's guiding principles were followed during the study's execution. The data from three databases, PubMed, Google Scholar, and Scopus, available until January 2023, were used to compile the material for our research. Only English‐language publications were submitted for this research and evaluated based on their titles, abstracts, and full texts. For performing a quality assessment, quality scores were calculated.

Results

The total number of patients and implants studied were 37 and 153, respectively, all having had scleroderma. The patients’ ages ranged from 28 to 77 years old, with a mean (SD) age of 58.16 (12.88). All the patients in the case reports and most in the case series study were female. The range of follow‐up duration was from 1 to 10 years. In case report studies, the survival rate was 100%; in case series, it was 89.2%.

Conclusion

The SSc status had no discernible impact on the implant survival rate. Implant‐based treatments in SSc patients should not worsen the overall morbidity and should not conflict with systemic treatments. Before starting implant therapy, a thorough risk assessment is essential, though.
Lupus Recipe inhibits cGVHD‐induced lupus nephritis in mice and promote renal LC3‐associated autophagy
Authors: Liu Ruihua , Huang Xuan , Ye Hongjian , Wu Haishan , Guo Jing , Peng Yuan , Wu Meiju , Fan Jinjin , Yang Xiao
Published: March 2023

Lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE). The chronic graft versus host disease (cGVHD) mouse model is a well‐established model of SLE. LC3‐associated autophagy plays a critical role in extracellular particle clearance, including pathogens and apoptotic cells. Lupus Recipe (LR) is a Chinese herbal compound that has been proven to be effective in treating SLE. In the study, we investigated the protective effects of LR or LR combined with prednisone on cGVHD mouse model and LC3‐associated autophagy in the kidney. The mice were subjected to six groups. The LR treatment group received LR at the dosage of 1.15 and 2.3 g/kg/day, respectively. The corticosteroid treatment group received prednisone at a dosage of 5 mg/kg/day. The combination treatment group received LR at a dosage of 2.3 g/kg/day, and prednisone at 2.5 mg/kg/day. LR treatment reduced proteinuria and serum triglyceride levels, as well as spleen weight. LR also alleviated pathologic damage and immunoglobulin G deposition in the kidney. LR combined with a low dose of prednisone significantly improved kidney function and decreased serum triglyceride, total cholesterol, and spleen weight. In addition, combination treatment relieved kidney injury more effectively than LR alone. Western blot revealed that LR treatment or LR combined with prednisone increased the LC3‐associated autophagy protein of Rubicon and Nox2, as well as LC3I levels in the kidney tissues. In conclusion, LR inhibited the manifestation of cGVHD‐induced LN, which may attribute to the increased levels of LC3‐associated autophagy.
CA‐UNet: Convolution and attention fusion for lung nodule segmentation
Authors: Wang Tong , Wu Fubin , Lu Haoran , Xu Shengzhou
Published: March 2023

Lung cancer is one of the deadliest cancers in the world and is a serious threat to human life. Lung nodules are an early manifestation of lung cancer, early detection and treatment of which can improve the survival rate of patients. In order to accurately segment the lung nodule regions in lung CT images, CA‐UNet, an encoding and decoding structure based on convolution and attention fusion, is proposed based on the U‐Net network. It has improved on two points: First, at the skip connection, the global feature information is extracted using the Swin Transformer block and then fused with the pre‐extraction features and subsequently fed into the corresponding layer of the decoder; second, each channel information is reweighted in the decoder by the channel attention module so that the network focuses on more important channels. Experimental results on the LIDC‐IDRI public database of lung nodules showed that the intersection of union, dice similarity coefficient, precision, and recall of the algorithm were 82.42%, 89.86%, 89.07%, and 92.44%, respectively. The algorithm has better segmentation performance compared to other segmentation methods.
Self‐selective memristor‐enabled in‐memory search for highly efficient data mining
Authors: Yang Ling , Huang Xiaodi , Li Yi , Zhou Houji , Yu Yingjie , Bao Han , Li Jiancong , Ren Shengguang , Wang Feng , Ye Lei , He Yuhui , Chen Jia , Pu Guiyou , Li Xiang , Miao Xiangshui
Published: March 2023

Similarity search, that is, finding similar items in massive data, is a fundamental computing problem in many fields such as data mining and information retrieval. However, for large‐scale and high‐dimension data, it suffers from high computational complexity, requiring tremendous computation resources. Here, based on the low‐power self‐selective memristors, for the first time, we propose an in‐memory search (IMS) system with two innovative designs. First, by exploiting the natural distribution law of the devices resistance, a hardware locality sensitive hashing encoder has been designed to transform the real‐valued vectors into more efficient binary codes. Second, a compact memristive ternary content addressable memory is developed to calculate the Hamming distances between the binary codes in parallel. Our IMS system demonstrated a 168× energy efficiency improvement over all‐transistors counterparts in clustering and classification tasks, while achieving a software‐comparable accuracy, thus providing a low‐complexity and low‐power solution for in‐memory data mining applications.

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Facilitating factors and barriers for use of medications to treat opioid use disorder (MOUD) among justice‐involved individuals in rural Appalachia
Authors: Staton Michele , Pike Erika , Tillson Martha , Lofwall Michelle R.
Published: March 2023

The purpose of this qualitative study is to assess facilitating factors and barriers for medications to treat opioid use disorder (MOUD) initiation among justice‐involved individuals in one rural Appalachian community, as well as how those factors may differ across the three types of Food and Drug Administration (FDA) approved medications. Qualitative interviews were conducted with rural justice‐involved individuals (N = 10) with a history of opioid use in the target community. Overall, participants demonstrated knowledge of the different types of MOUD and their pharmacological properties, but limited overall health literacy around opioid use disorder and MOUD treatment. Treatment access was hampered by transportation, time burdens, and costs. Findings call for research into improving health literacy education, training, and resources to decrease stigma and increase access to MOUD, particularly in light of the ongoing opioid crisis. State policies also need to increase access to all FDA medications among justice‐involved individuals, as well as supporting a care continuum from facility entry, release, and community re‐entry.
Engineer identity and degree completion intentions in doctoral study
Authors: Bahnson Matthew , Satterfield Derrick , Perkins Heather , Parker Mackenzie , Tsugawa Marissa , Cass Cheryl , Kirn Adam
Published: March 2023

Background

Degree completion rates for doctoral engineering students remain stagnant at levels lower than necessary to meet national and global workforce needs. Increasing degree completion can improve opportunities for individuals and provide the human resources needed to address engineering challenges.

Purpose/Hypothesis

In this work, we measure the association of engineering identity variables with degree completion intentions for students who have persisted in doctoral study. We add to existing literature that suggests the importance of advisor and peer relationships, and the number of years in the doctoral program.

Design/Method

We use data collected via a national cross‐sectional survey of doctoral engineering students, which included measures of social and professional identities, graduate school experiences, and demographics. Surveys were collected from 1754 participants at 98 US universities between late 2017 and early 2018. The analyses reported here use multiple regression to measure associations with engineering doctoral degree completion intentions.

Results

Research interest and scientist performance/competence are individually associated with degree completion intentions in students who are persisting in doctoral study. Overall, graduate engineering identity explains significant portions of variation in degree completion intentions (9.5%) beyond advisor and peer relationship variables and the number of years in graduate programs.

Conclusions

Researcher interest and scientist performance/competence may be key opportunities to engage doctoral student engineering identity to improve degree completion rates. Accordingly, institutions can foster students' interest in research and build their confidence in their scientific competence to support students as they complete the doctoral degree.
Deep Learning‐Based Segmentation of Locally Advanced Breast Cancer on MRI in Relation to Residual Cancer Burden: A Multi‐Institutional Cohort Study
Authors: Janse Markus H. A. , Janssen Liselore M. , van der Velden Bas H. M. , Moman Maaike R. , Wolters‐van der Ben Elian J. M. , Kock Marc C. J. M. , Viergever Max A. , van Diest Paul J. , Gilhuijs Kenneth G. A.
Published: March 2023

Background

While several methods have been proposed for automated assessment of breast‐cancer response to neoadjuvant chemotherapy on breast MRI, limited information is available about their performance across multiple institutions.

Purpose

To assess the value and robustness of deep learning‐derived volumes of locally advanced breast cancer (LABC) on MRI to infer the presence of residual disease after neoadjuvant chemotherapy.

Study Type

Retrospective.

Subjects

Training cohort: 102 consecutive female patients with LABC scheduled for neoadjuvant chemotherapy (NAC) from a single institution (age: 25–73 years). Independent testing cohort: 55 consecutive female patients with LABC from four institutions (age: 25–72 years).

Field Strength/Sequence

Training cohort: single vendor 1.5 T or 3.0 T. Testing cohort: multivendor 3.0 T. Gradient echo dynamic contrast‐enhanced sequences.

Assessment

A convolutional neural network (nnU‐Net) was trained to segment LABC. Based on resulting tumor volumes, an extremely randomized tree model was trained to assess residual cancer burden (RCB)‐0/I vs. RCB‐II/III. An independent model was developed using functional tumor volume (FTV). Models were tested on an independent testing cohort and response assessment performance and robustness across multiple institutions were assessed.

Statistical Tests

The receiver operating characteristic (ROC) was used to calculate the area under the ROC curve (AUC). DeLong's method was used to compare AUCs. Correlations were calculated using Pearson's method. P values <0.05 were considered significant.

Results

Automated segmentation resulted in a median (interquartile range [IQR]) Dice score of 0.87 (0.62–0.93), with similar volumetric measurements (R = 0.95, P < 0.05). Automated volumetric measurements were significantly correlated with FTV (R = 0.80). Tumor volume‐derived from deep learning of DCE‐MRI was associated with RCB, yielding an AUC of 0.76 to discriminate between RCB‐0/I and RCB‐II/III, performing similar to the FTV‐based model (AUC = 0.77, P = 0.66). Performance was comparable across institutions (IQR AUC: 0.71–0.84).

Data Conclusion

Deep learning‐based segmentation estimates changes in tumor load on DCE‐MRI that are associated with RCB after NAC and is robust against variations between institutions.

Evidence Level

2.

Technical Efficacy

Stage 4.
Torque‐teno virus for the prediction of graft rejection and infection disease after kidney transplantation: A systematic review and meta‐analysis
Authors: Zeng Jun , Tang Yangming , Lin Tao , Song Turun
Published: March 2023

Torque teno virus (TTV) is a promising novel marker for quantifying the immune function in solid organ recipients, whose diagnostic accuracy of acute rejection (AR) and infection after kidney transplantation (KT) has not been evaluated. We performed a systematic review and meta‐analysis to evaluate the diagnostic accuracy of TTV for discriminating AR and infection after KT. Eleven studies were included in the meta‐analysis. Seven studies focused on the diagnostic accuracy of TTV for AR, and the pooled analysis indicated patients who developed AR had a significant lower TTV viral DNA load (log10 copies/mL, MD: −0.74, p < 0.01). The pooled sensitivity, specificity, and area under the receiver operating characteristics curve for TTV in AR differentiation were 0.61 (0.36−0.82), 0.81 (0.64−0.91), and 0.79 (0.75−0.82), respectively. The overall diagnostic odds ratio (DOR) was 6.74 (2.60−17.50), positive likelihood ratio (PLR) was 3.22 (1.75−5.95), and negative likelihood ratio (NLR) was 0.48 (0.27−0.84), respectively. Similarly, seven studies investigated the infection discrimination and found that patients who subsequently developed posttransplant infection had higher plasma TTV DNA loads (log10 copies/mL, MD: 0.65; p < 0.01) than those remaiing infection‐free. Pooled sensitivity, specificity, and area under the receiver operating characteristics curve for TTV in infection differentiation were 0.72 (0.39−0.91), 0.57 (0.30−0.80), and 0.68 (0.64−0.72), respectively. The overall DOR was 3.28 (95% confidence interval [CI]: 2.08−5.17), the pooled PLR and NLR were 1.65 (95% CI: 1.25−2.18) and 0.50 (95% CI: 0.29−0.86), respectively. TTV might be a modest indicator for risk stratification of AR after KT, but it is a poor to discriminate posttransplant infection.
Ultra‐performance liquid chromatography‐Quadrupole time‐of‐flight tandem mass spectrometry‐based metabolite profiling, quality evaluation, and marker analysis of Trachyspermum ammi (L.) Sprague by high‐performance thin‐layer chromatography
Authors: Gupta Barun Das , Kar Amit , Narayan Shyam , Thakur Chandreshwar Prasad , Mukherjee Pulok Kumar , Haldar Pallab Kanti
Published: March 2023

Trachyspermum ammi (L.) Sprague (Apiaceae), commonly known as “Ajwain” is distributed throughout India. Ajwain fruits contain fiber, carbohydrates, phenolic acids, flavonoids, and tannins. The fruits also yield a small amount of essential oil, with Thymol as the principal constituent. Ajwain has various pharmacological activities like anti‐leishmanial, antimicrobial, cytotoxic, antispasmodic, nematocidal, and anthelmintic. The fruits are of high therapeutic value; thus, it becomes quite essential to evaluate the quality of Trachyspermum ammi (L.) Sprague to authenticate and ensure its therapeutic and nutritional properties. The ethyl acetate fraction of Trachyspermum ammi (L.) Sprague fruits exhibited the highest total phenolic and flavonoid content values of 149.55 ± 1.19 mg rutin equivalent and 682.85 ± 3.68 mg gallic acid equivalent, respectively. Metabolite profiling of the ethyl acetate fraction using ultra‐performance liquid chromatography‐quadrupole time‐of‐flight tandem mass spectrometry analysis resulted in identifying 19 phytomolecules. A validated high‐performance thin‐layer chromatography method was developed to quantify standard phytomolecules in the ethyl acetate fraction. The highest and lowest percentages of phytomarker were found to be caffeic acid (5.51% ± 0.16% w/w) and gallic acid (1.29% ± 0.09% w/w), respectively. This validated rapid, accurate, and precise method for standardization of Trachyspermum ammi (L.) Sprague will be beneficial for its quality evaluation as well as the derived products.
Outcomes of Cesarean Scar Pregnancies in Early Gestation According to the New Delphi Consensus Criteria
Authors: Pekar‐Zlotin Marina , Zur‐Naaman Hili , Maymon Ron , Tsviban Anna , Melcer Yaakov
Published: March 2023

Objectives

Clinical evaluation of the new Delphi consensus definition of cesarean scar pregnancy (CSP) in early gestation.

Methods

A retrospective cohort of 36 women diagnosed with CSP and treated with combined local and systemic methotrexate (MTX) between 2008 and 2021. The CSPs were classified according to the new Delphi consensus criteria into three subgroups based on the depth of the gestational sac herniation in the sagittal plane. Subgroup A included 8 (22.2%) cases in which the largest part of the gestational sac protruded toward the uterine cavity. Subgroup B included 22 (61.1%) cases in which the largest part of the gestational sac was embedded in the myometrium, and subgroup C included 6 (16.7%) cases in which the gestational was partially located outside the outer contour of the cervix or uterus.

Results

The β‐HCG level upon admission was significantly lower in subgroup A than in subgroups B or C (11,075 ± 7109, 18,787 ± 16,585, and 58,273 ± 55,267 mIU/mL, respectively, P = .01). All subgroup C patients had repeated courses of MTX and surgical interventions (laparotomy, uterine artery embolization, and operative hysteroscopy) at double the rate of subgroups A or B (100, 50, and 40.9%, respectively, P = .036). The duration of hospitalization was significantly shorter in subgroup A than in subgroups B or C (1.9 ± 1.5, 2.1 ± 1.1, and 5.4 ± 4.9 days, P = .01).

Conclusions

The outcome according to Delphi consensus criteria for defining CSP in early gestation has implications for clinical decision‐making, patient care, and the follow‐up of CSP.
Patulous Eustachian Tube Dysfunction Symptoms Following Balloon Dilation
Authors: Hubbell Richard D. , Toivonen Joonas , Kawai Kosuke , Kim H. Jeffrey , Nieman Carrie L. , Ward Bryan K. , Poe Dennis S.
Published: March 2023

Objective

Clinicians increasingly perform balloon dilation of the Eustachian tube (BDET) to treat obstructive Eustachian tube dysfunction (OETD) refractory to medical management. Reported complications have been limited and include patulous Eustachian tube dysfunction (PETD). This multicenter study investigates the incidence of PETD and associated factors.

Methods

Consecutive patients at three academic centers undergoing BDET (January 2014–November 2019) for OETD refractory to medical therapy were included. PETD was diagnosed by patient‐reported symptoms of autophony of voice and/or breathing. Associated factors studied include age, sex, comorbidities, balloon size, duration of inflation, repeat BDET, and adjunctive procedures.

Results

BDET procedures (n = 295 Eustachian tubes) were performed on 182 patients. Mean age was 38.4 years (SD 21.0; range 7–78) and 41.2% were female. Twenty cases of PETD (6.8% of procedures; 9.3% of patients) occurred following BDET. Risk of PETD did not vary by institution, comorbidities, or adjunctive procedure. Age ≤18 years (adjusted risk ratio [RR] = 3.26; 95% confidence interval [CI]: 1.24, 8.54; p = 0.02), repeat BDET (RR = 3.26; 95% CI: 2.15, 4.96; p < 0.001), and severe preoperative Eustachian tube inflammation (RR = 2.83; 95% CI: 1.10, 7.28; p = 0.03) were associated with increased risk of developing PETD in the multivariable model. Most symptoms were reported as mild or intermittent.

Conclusion

BDET caused PETD symptoms in approximately 7% of dilated Eustachian tubes in this study with increased risk for younger patients and those with severe inflammation or undergoing repeat dilations. Although most cases were self‐limited, symptoms can persist. Awareness of risk factors may aid clinicians in limiting this complication.

Level of Evidence

4 Laryngoscope, 133:3152–3157, 2023
Lubrication performance of GQDs@PNIPAM microgels for titanium alloys
Authors: Fu Kang , Sun Kequn , Zheng Quan , Yao Lulu , Song Ruhong , Xu Yufu
Published: March 2023

The tribological behaviour of YG8‐cemented carbide/Ti6Al4V (YG8/TC4) contacts under aqueous lubrication was investigated in this work. Three types of nano‐additives including poly (N‐isopropylacrylamide) (PNIPAM), graphene quantum dots (GQDs), and GQDs@PNIPAM microgels were prepared for use as water lubricant additives. Tribological tests were conducted at different concentrations of nano‐additives using a ball‐on‐disk reciprocating tribometer. The experimental results show that GQDs@PNIPAM has the optimum lubricating performance, the average friction coefficient decreases by 28.7% and the average cutting wear volume of the TC4 disk increases by 29.5% when the concentration is 1.5 wt.%. This provides a new strategy for the cutting of titanium alloy materials, which not only reduces the friction coefficient, but also increases the cutting wear volume of the TC4 disk, thereby improving the machining efficiency.
Synthesis, Characterization, and Properties of Sulfonated CNT‐Doped Poly(aniline‐co‐carbazole)‐PVA Conductive Films
Authors: Lakouraj Moslem M. , Norouzian Rafieh‐sadat , Tavakoli Malihe
Published: March 2023

Conductive flexible films are successfully synthesized from polyvinyl alcohol matrix and poly(aniline‐co‐carbazole) charge carrier. To improve the mechanical properties of polyvinyl alcohol and promote charge transition in the conductive copolymer, dual purpose sulfonated multiwall carbon nanotube is added. Conductivity is enhanced via sulfonic acid protonic dopant and mechanical property is increased by its hexagonal nanorods. Nanocomposites are prepared by adding 0.025, 0.050, and 0.075 g of carbon nanotube which is added at 1%, 3%, and 5% loads to the polymer matrix. Films are characterized by infrared, UV–vis, X‐ray diffraction, scanning electron microscopy, and thermogravimetric analysis. Conductivity is measured by the four‐probe technique and mechanical property is assessed through tensile tests and dynamic mechanic thermal analysis. A 5 × 10−6 S cm−1 conductivity and 116 MPa tensile strength are recorded for the conductive film with optimum dopant/nanocomposite loads. The electrochemical property and corrosion resistance are studied by cyclic voltammetry and Tafel curves, respectively. The conductive films show an increase in corrosion potential and a decrease in corrosion current referring to a reliable corrosion protection film. The water uptake and contact angle of the films are measured to be 157% and 80.1° respectively to confirm its required hydrophilic property.
BORIS variant SF2(C2/A4) promotes the malignant development of liver cancer by activating epithelial‐mesenchymal transition and hepatic stellate cells
Authors: Wei Ling , Liu Zhongjian , Qin Lu , Xian Longjun , Chen Kefei , Zhou Siqi , Hu Lei , Xiong Yimei , Li Bo , Qin Yang
Published: March 2023

The underlying mechanisms of metastasis and recurrence of liver cancer remain largely unknown. Here, we found that Brother of the Regulator of Imprinted Sites (BORIS) variant SF2(C2/A4) was highly expressed in high metastatic potential hepatocellular carcinoma (HCC) cells and clinical tumor samples, related to the formation of satellite nodules. Its over expression promoted self‐renewal, the expression of tumor stem cell markers, chemoresistance, wound healing rate, invasion and metastasis of HepG2 and Hep3B cells; reinforced epithelial‐mesenchymal transition (EMT), decreased the expression of E‐cadherin and increased N‐cadherin and Vimentin. Subcellular localization experiment showed that BORIS SF2(C2/A4) was localized in nucleus and cytoplasm. Further double luciferase reporter gene experiment confirmed that it bound to TWIST1 gene promoter and significantly increased latter expression. BORIS SF2(C2/A4) knock down induced apoptosis of HCCLM3 and PLC/PRF/5 cells, and increased the protein content of cleaved caspase 3. Additionally, BORIS SF2(C2/A4) over expression increased the expression of fibroblast growth factor 2 (FGF2) in HepG2 and Hep3B cells. FGF2 expressed higher in HCC tumor tissues than in paired peri‐tumor tissues, and its expression was positively correlated with BORIS SF2(C2/A4). Interestingly, high expression of FGF2 is also associated with the formation of satellite nodules. Moreover, using the medium from BORIS SF2(C2/A4) overexpressed cell lines to coculture hepatic stellate cell (HSCs) line LX‐2, the latter could be activated and increased the expression of CD90 and PIGF, which is consistent with the effect of adding bFGF alone. These results indicate that BORIS SF2(C2/A4) plays a role in deterioration of liver cancer by regulating TWIST1 to induce EMT, and by FGF2 to activate HSCs.
Effect of coronary artery dynamics on the wall shear stress vector field topological skeleton in fluid–structure interaction analyses
Authors: Carpenter Harry J. , Ghayesh Mergen H. , Zander Anthony C. , Psaltis Peter J.
Published: March 2023

In this paper, we investigate the impact of coronary artery dynamics on the wall shear stress (WSS) vector field topology by comparing fluid–structure interaction (FSI) and computational fluid dynamics (CFD) techniques. As one of the most common causes of death globally, coronary artery disease (CAD) is a significant economic burden; however, novel approaches are still needed to improve our ability to predict its progression. FSI can include the unique dynamical factors present in the coronary vasculature. To investigate the impact of these dynamical factors, we study an idealized artery model with sequential stenosis. The transient simulations made use of the hyperelastic artery and lipid constitutive equations, non‐Newtonian blood viscosity, and the characteristic out‐of‐phase pressure and velocity distribution of the left anterior descending coronary artery. We compare changes to established metrics of time‐averaged WSS (TAWSS) and the oscillatory shear index (OSI) to changes in the emerging WSS divergence, calculated here in a modified version to handle the deforming mesh of FSI simulations. Results suggest that the motion of the artery can impact downstream patterns in both divergence and OSI. WSS magnitude is also decreased by up to 57% due to motion in some regions. WSS divergence patterns varied most significantly between simulations over the systolic period, the time of the largest displacements. This investigation highlights that coronary dynamics could impact markers of potential CAD progression and warrants further detailed investigations in more diverse geometries and patient cases.
Aridity drives clinal patterns in leaf traits and responsiveness to precipitation in a broadly distributed Australian tree species
Authors: Aspinwall Michael J. , Blackman Chris J. , Maier Chelsea , Tjoelker Mark G. , Rymer Paul D. , Creek Danielle , Chieppa Jeff , Griffin‐Nolan Robert J. , Tissue David T.
Published: March 2023

Aridity shapes species distributions and plant growth and function worldwide. Yet, plant traits often show complex relationships with aridity, challenging our understanding of aridity as a driver of evolutionary adaptation. We grew nine genotypes of Eucalyptus camaldulensis subsp. camaldulensis sourced from an aridity gradient together in the field for ~650 days under low and high precipitation treatments. Eucalyptus camaldulesis is considered a phreatophyte (deep‐rooted species that utilizes groundwater), so we hypothesized that genotypes from more arid environments would show lower aboveground productivity, higher leaf gas‐exchange rates, and greater tolerance/avoidance of dry surface soils (indicated by lower responsiveness) than genotypes from less arid environments. Aridity predicted genotype responses to precipitation, with more arid genotypes showing lower responsiveness to reduced precipitation and dry surface conditions than less arid genotypes. Under low precipitation, genotype net photosynthesis and stomatal conductance increased with home‐climate aridity. Across treatments, genotype intrinsic water‐use efficiency and osmotic potential declined with increasing aridity while photosynthetic capacity (Rubisco carboxylation and RuBP regeneration) increased with aridity. The observed clinal patterns indicate that E. camaldulensis genotypes from extremely arid environments possess a unique strategy defined by lower responsiveness to dry surface soils, low water‐use efficiency, and high photosynthetic capacity. This strategy could be underpinned by deep rooting and could be adaptive under arid conditions where heat avoidance is critical and water demand is high.
Hydroxyurea treatment for sickle cell anemia during pregnancy and lactation: Current evidence and knowledge gaps
Authors: Dong Min , Ware Russell E. , Dallmann André , Vinks Alexander A.
Published: March 2023

Sickle cell anemia (SCA) is a life‐threatening genetic condition contributing to high‐risk pregnancies affecting both the mother and fetus. With improved management of children with SCA, this life‐threatening hematological disorder has evolved into a chronic disease of adults, and consequently parenthood has now become a possible and important life goal for many patients. Providing continuous management with healthy red blood cell function and avoiding SCA‐associated complications, such as pain crises, acute chest syndrome, and stroke, are crucial for a healthy pregnancy. Despite its excellent safety profile in non‐pregnant adults and children, and based on theoretical concerns derived from data using animal models and supraphysiological dosing, hydroxyurea is currently contraindicated for pregnant and lactating women with SCA. Clinical experience of hydroxyurea use during pregnancy is increasingly reported, however, and has shown inconsistent results of fetal or infant adverse effects. How the hydroxyurea exposure level may correlate with pregnancy outcomes is still unclear. Accordingly, efforts should be made to systemically evaluate exposure and safety of hydroxyurea treatment during pregnancy and lactation. Novel approaches such as physiologically based pharmacokinetic (PBPK) modeling, coupled with the ex vivo human placental cotyledon perfusion assay, provide opportunities to understand hydroxyurea exposure not only in pregnant women but also in the developing fetus. Combined with animal data, research using these approaches might be able to define safe and effective hydroxyurea dosing regimens for pregnant and lactating women with SCA, when the benefits of continuing hydroxyurea treatment likely outweigh the risks of non‐treatment, by avoiding substantial morbidity and even mortality for both mothers and infants.
“You just want someone to help”: Outcomes that matter to parents when their child is treated for chronic pain
Authors: Joslin Rhiannon , Donovan‐Hall Maggie , Roberts Lisa
Published: March 2023

In children's chronic pain services, healthcare decisions involve a three‐way interaction between the child, their parent or guardian, and the health professional. Parents have unique needs, and it is unknown how they visualize their child's recovery and which outcomes they perceive to be an indication of their child's progress. This qualitative study explored the outcomes parents considered important, when their child was undergoing treatment for chronic pain. A purposive sample of twenty‐one parents of children receiving treatment for chronic musculoskeletal pain, completed a one‐off semi‐structured interview that involved drawing a timeline of their child's treatment. The interview and timeline content were analyzed using thematic analysis. Four themes are evident at different points of the child's treatment course. The “perfect storm” that described their child's pain starting, “fighting in the dark” was a stage when parents focused on finding a service or health professional that could solve their child's pain. The third stage, “drawing a line under it,” changed the outcomes parents considered important, parents changed how they approached their child's pain and worked alongside professionals, focusing on their child's happiness and engagement with life. They watched their child make positive change and moved toward the final theme “free.” The outcomes parents considered important changed over their child's treatment course. The shift described by parents during treatment appeared pivotal to the recovery of young people, demonstrating the importance of the role of parents within chronic pain treatment.
Gas‐phase polymerization of ultra‐high molecular weight polyethylene with decreased entanglement density
Authors: do Rosario Roberta Lopes , Christakopoulos Fotis , Tervoort Theo A. , Brunel Fabrice , McKenna Timothy F. L.
Published: March 2023

It is well known that ultra‐high molecular weight polyethylene (UHMWPE) is a polymer with long chains and very high molecular weight that poses difficulties in terms of processability due to the presence of chain entanglements. In many cases is thus necessary to treat the material in different ways after the polymerization to minimize the amount of entanglements and improve the processability. Based on observations that the use of inert condensing agents (ICA) had a noticeable impact on molecular weight and crystallinity, it was decided to develop a gas‐phase polymerization process with addition of ICA for UHMWPE with a high fraction of disentangled chains. For the optimization of this process, the comparison with slurry is important for the understanding the improvement. Thus, a clear difference between slurry and gas phase is observed in terms of crystallinity and the lamellar thickness of the crystals, molecular weight and entanglements. Characterization techniques are developed to measure the properties of the reactor powder and understand the impact of the alkanes in situ. Using solid‐state drawability, the entanglement degree of the reactor powder is analyzed. From the small‐angle x‐ray scattering and wide‐angle x‐ray scattering techniques, it is possible to find a correlation of entanglements and lamellar thickness. Moreover, crystallization kinetics measurements of the polymer in presence of ICA constitutes a powerful method to explain the phenomena of entanglement and crystal formation.
The impact of elexacaftor/tezacaftor/ivacaftor on body composition in a small cohort of youth with cystic fibrosis
Authors: Granados Andrea , Chan Christine L. , Moheet Amir , Vigers Timothy , Arbeláez Ana María , Larson Ode Katie
Published: March 2023

Background

The effects of elexacaftor‐tezacaftor‐ivacaftor (ETI) on body composition in people with CF (pwCF) are unknown.

Methods

Dual‐energy X‐ray absorptiometry fat‐free mass and fat mass adjusted for height (FMI) as well as oral glucose tolerance test derived measures of insulin secretion and sensitivity were compared before and after ETI initiation in eight pwCF.

Results

Patients median age: 22 years interquartile range (IQR: 16–28), 87.5% male, median time on ETI:11 months. Weight z‐score increased from −0.52 to 0.18 (p = 0.014); FMI increased from 4.12 to 6.29 (p = 0.014). Insulin secretion (C pep iAUC/Gluc iAUC) increased from 8.71 to 14.21 (p = 0.021), insulin resistance (HOMA2 IR) increased from 0.73 to 1.25 (p = 0.014) and insulin sensitivity decreased (Matsuda) 8.88 to 5.58 (p = 0.036).

Conclusions

ETI resulted in increased weight and fat mass. BMI and muscle mass did not change. Both insulin secretion and insulin resistance increased. Longer‐term metabolic consequences of ETI need further investigation.