bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of normal stress‐induced three‐dimensional rough fracture aperture heterogeneity on nonlinear seepage‐heat transfer coupling processes
Authors: Zhang Ze , Wang Shuhong , Han Bowen , Dong Furui , Hou Qinkuan
Published: December 2023

A clear understanding of the dependence of the heat transfer process on the flow field in three‐dimensional (3D) rough fractures is crucial for many underground projects. In this study, 3D rough rock fractures with heterogeneous apertures and mechanical effects are established. Navier‐Stokes flow and local heat balance theory are used to simulate the seepage‐heat transfer coupling process. Five normal stresses and five flow velocities are set to quantify the influence of aperture variability on the flow field and heat transfer behavior of the fractures. The results show that the change in fracture aperture caused by normal stress is the direct cause of the nonlinear distribution of the flow field and temperature fluctuation. A quantitative parameter of temperature fluctuation degree in the fracture is proposed, which decreases exponentially with increasing fracture aperture and increases with greater flow velocity. An empirical model is established to describe the relationship between the heat transfer coefficient and the ratio of hydraulic aperture to mechanical aperture. The correctness of the model is verified by published seepage‐heat transfer coupling test results. The model is extended to establish the relationship between the heat transfer coefficient and the volume fraction of eddy. It is confirmed that the heat transfer coefficient increases with the augmentation of nonlinear flow, and the reason why the results of evaluating the heat transfer coefficient by roughness alone in related experiments are inconsistent is revealed. The results enhance the understanding of convective heat transfer characteristics in 3D rough rock fractures.
Autologous platelet rich plasma (A‐PRP) combined with pelvic floor muscle training for the treatment of female stress urinary incontinence (SUI): A randomized control clinical trial
Authors: Saraluck Apisith , Chinthakanan Orawee , Kijmanawat Athasit , Aimjirakul Komkrit , Wattanayingcharoenchai Rujira , Manonai Jittima
Published: December 2023

Importance

Autologous platelet‐rich plasma (A‐PRP) injection is a novel intervention for stress urinary incontinence (SUI) in women. However, no Phase II clinical trial has compared the outcomes of A‐PRP injection combined with pelvic floor muscle training (PFMT) with those of PFMT alone in these women.

Objective

The primary aim was to compare the efficacy of A‐PRP + PFMT versus PFMT alone in women with SUI. The secondary aim was to determine any adverse effects of A‐PRP injection.

Design

Randomized clinical trial, single‐blind assessment.

Setting

Urogynecology clinic at a tertiary medical center.

Participants

Women with previously untreated SUI. Women in whom there was any suspicion of urgency, those with an Overactive Bladder Symptoms Score of ≥1, and those with obesity, pelvic organ prolapse, thrombocytopenia, or coagulopathy were excluded.

Interventions

Two injections of A‐PRP were administered with a 1‐month interval between injections in the A‐PRP injection + PFMT group. Both groups received PFMT.

Main Outcomes and Measures

The primary outcome was determined using the 1‐h pad weight test (PWT). Secondary outcomes were measured using the Incontinence Quality of Life Questionnaire, item 11 on the International Consultation on Incontinence Questionnaire‐Female Lower Urinary Tract Symptoms questionnaire, Patient Global Impression of Improvement, and the percentage subjective improvement score.

Results

Data for 60 study participants were available for analysis (A‐PRP + PFMT group, n = 31; PFMT group, n = 29). The 1‐h PWT decreased significantly in the A‐PRP + PFMT group but only slightly in the PFMT group at the 5‐month follow‐up. There was a statistically significant between‐group difference in the 1‐h pad weight of about 8 g in favor of the A‐PRP + PFMT group. A statistically significant difference in symptoms of SUI measured by the questionnaires was found between the A‐PRP + PFMT group and the PFMT group at the 2‐ and 5‐month follow‐up assessments. There were no reports of adverse events following injection of A‐PRP.

Conclusions and Relevance

A‐PRP + PFMT could be a treatment option for women with SUI. Large Phase III randomized controlled trials are required to confirm our findings.
The correlation between sadomasochists' experience and their sadomasochistic behaviors and fantasies: A qualitative analysis of interviews
Authors: Liang Wanying , Zhang Yuqing
Published: December 2023

Lacking a comprehensive understanding of sadomasochism makes difficulties in judicial dispositions, clinical interventions, and mental health services. This study explores the correlation between sadomasochists' growth experience and their sadomasochistic behaviors and fantasies. We interviewed 51 sadomasochists from a Chinese subcultural website, coded and analyzed the interview records, conducted correlation and cluster analyses on the reference points of the nodes of impressive experience and sadomasochistic behaviors and fantasies, and constructed the model of Experience—Behaviors and Fantasies. We found that sadomasochists' typical impressive experiences are family parenting and sexual experience; sadomasochistic behaviors and fantasies can be classified into five categories: spirit, punishment, sex, canine, and excretion; and sadomasochistic behaviors and fantasies are partially correlated with sadomasochists' impressive experiences, indicating psychoanalytic theory is the leading theory for the driving processes of sadomasochism, while behaviorist and Gestalt theories also contribute.
Pulmonary embolism induces pneumonia‐like lung injury beyond pulmonary infarction
Authors: Wang Yue , Liu Bo , Zhou Chuming , Wang Yuan , Miao Jianing , Zhao Li
Published: December 2023

Patients with pulmonary embolism (PE) commonly manifest concomitant “pneumonia,” which is generally believed to be either a cause (infection) or a consequence (infarction) of PE. This study aimed to clarify the relationship between PE and “pneumonia‐like” lesions beyond pulmonary infection and infarction. Chest computed tomography (CT) images of patients with PE and deep vein thrombosis (DVT) were retrospectively analyzed to compare the incidence of pneumonia lesions. The pathological damage and wet/dry ratio of lung tissues were observed in PE rats and PE plasma‐injected rats. In total, 793 and 914 inpatients were enrolled in the PE and DVT groups, respectively. Pneumonia lesions were observed in 36.9% and 26.3% of patients in the PE and DVT groups, respectively (p < 0.0001). Among PE rats, 33.3% exhibited focal severe lung injury, which closely resembled the pathological damage of community‐acquired pneumonia. The wet/dry ratio was significantly higher in the PE group than in the PE‐control group (4.98 ± 0.08 vs. 4.39 ± 0.06, p < 0.0001). Among PE plasma‐injected rats, individuals with focal proven lung injury were found at all experimental points, with an incidence of 27.6%. The lung wet/dry ratio was significantly higher in the PE plasma group than in the PE‐control plasma group at 1 and 2 h postinjection (5.02 ± 0.12 vs. 4.61 ± 0.06 and 4.76 ± 0.16 vs. 4.34 ± 0.09, respectively; p < 0.05). In conclusion, the manifestation of pneumonia lesions in chest CT images was higher among PE patients than among DVT patients. Plasma of PE rats could induce focal pneumonia‐like lung injury in healthy rats.
Tackling the activity and selectivity challenges of electrocatalysts toward the CO2RR via biatom catalysts on the 2D extended phthalocyanines
Authors: Wang Junyou , Wu Manhong , Zhao Bin , Wan Rui , Li Zhongyao
Published: December 2023

The development of efficient CO2 electrocatalytic reduction catalysts has become increasingly important. However, addressing issues related to activity and selectivity remains challenging due to the lack of robust design criteria. Organometallic sheets, characterized by their high surface area and well‐dispersed metal sites, offer a unique platform for catalysis. In this study, we employed large‐scale density functional theory calculations to investigate the transition metal dimers doped two‐dimensional extended phthalocyanines (TM2‐Pcs) as the biatom catalysts for the electrocatalysis of the CO2 reduction reaction (CO2RR). After systematical studies, the four catalysts of Mo2‐Pc, W2‐Pc, Ti2‐Pc, and Re2‐Pc were determined from 26 different TM2‐Pcs. Among them, Mo2‐Pc, Ti2‐Pc, and W2‐Pc have not only high faradaic efficiency (FE) but also small limiting potentials of reducing CO2 to CH4. Besides, the limiting potentials for the reduction of CO2 to CH2CH2 on Mo2‐Pc and Re2‐Pc fall within the range of −1.4 to −.8 V versus reversible hydrogen electrode. They demonstrate higher FE than the experimental results obtained on Cu(111). This work not only expands the possibilities for discovering more effective CO2 reduction catalysts but also provides a feasible strategy for the rational design of electrocatalysts CO2RR.
Initial stability of cementless acetabular cups using robotic‐assisted total hip arthroplasty compared with the conventional manual technique: An in vitro biomechanical study
Authors: Hidaka Ryo , Matsuda Kenta , Mochizuki Hidetaka , Kawano Hirotaka
Published: December 2023

Background

The aim of this study is to determine whether the initial stability of a cementless cup with the Mako system is superior to that of a conventional manual technique using bone models.

Methods

The bone models were prepared using a polyurethane foam block. Two hemispherical cementless cups (highly porous titanium cup [Trident II Tritanium, Stryker] and hydroxyapatite‐coated titanium cup [Trident HA, Stryker]) were implanted using the Mako system. The torque of the cups was measured by rotational and lever‐out torque testing and compared with that of a conventional manual technique.

Results

The two types of cups that were implanted using the Mako system demonstrated significantly higher mean rotational torque than that of the manual technique (p < 0.01, p = 0.01, respectively).

Conclusions

This study provides the advantage of the initial stability of a cementless hemispherical cup implanted by the Mako system compared with that of the conventional manual technique.
Asynchronous event‐triggered adaptive robust switching filtering for nonlinear industrial cyber physical systems under data injection attacks
Authors: Qin Yanfei , Sun Ziwen
Published: December 2023

By fully taking the effects of data injection attacks and nonlinear disturbances into consideration, based on dynamic asynchronous event‐triggered approach, an adaptive robust H‐Infinity switching filtering (ARSF) method is proposed for the stability of industrial cyber physical systems. An adaptive feedback controller utilizing anticipated states and error‐dependent parameters can proficiently counteract the deleterious impacts of data injection attacks originating from the measurement channel. Furthermore, a filter, which includes the value of the measurement signal, is designed to monitor the system's state changes in real‐time and ensure the stable operation of the system under attacks. Based on the design of an adaptive feedback controller and a filter eliminating the effects of data injection attacks originating from the measurement channel, a switching scheme is further proposed for compensating the effect of data injection attacks in the control channel. Finally, simulation tests are conducted by using MATLAB to control the robustness of a practical quadrotor UAV system's angles by adopting ARSF, whose results verify that the correctness and effectiveness of the proposed ARSF.
Dixon's asymptotic without the classification of finite simple groups
Authors: Eberhard Sean
Published: December 2023

Without using the classification of finite simple groups (CFSG), we show that the probability that two random elements of generate a primitive group smaller than is at most . As a corollary we get Dixon's asymptotic expansion
for the probability that two random elements of (or ) generate a subgroup containing .
Ultrasensitive Biochemical Sensing Platform Enabled by Directly Grown Graphene on Insulator
Authors: Jing Qiushi , Liu Junjiang , Wang Huanming , Wang Yanli , Xue Honglei , Ren Shan , Wang Wenjing , Zhang Xiaoyan , Xu Zhi , Fu Wangyang
Published: December 2023

To fabricate label‐free and rapid‐resulting semiconducting biosensor devices incorporating graphene, it is pertinent to directly grow uniform graphene films on technologically important dielectric and semiconducting substrates. However, it has long been intuitively believed that the nonideal disordered structures formed during direct growth, and the resulted inferior electrical properties will inevitably lead to deteriorated sensing performance. Here, graphene biosensor chips are constructed based on direct plasma‐enhanced chemical vapor deposition (PECVD) grown graphene on a 4‐inch silicon wafer with excellent film uniformity and high yield. To surprise, optimal operations of graphene biosensors permit ultrasensitive detection of SARS‐CoV‐2 virus nucleocapsid protein with dilutions down to sub‐femtomolar concentrations. Such impressive limit of detection (LOD) is comparable to or even outperforms that of the state‐of‐the‐art biosensor devices based on high‐quality graphene. Further noise spectral characterizations and analysis confirms that the LOD is limited by molecular diffusion and/or known interference signals such as drift and instability of the sensors, rather than the electrical merits of the graphene devices along. Hence, result sheds light on processing directly grown PECVD graphene into high‐performance sensor devices with important economic benefits and social significance.
Electrochemistry at the Edge of a van der Waals Heterostructure
Authors: Plačkić Aleksandra , Neubert Tilmann J. , Patel Kishan , Kuhl Michel , Watanabe Kenji , Taniguchi Takashi , Zurutuza Amaia , Sordan Roman , Balasubramanian Kannan
Published: December 2023

Artificial van der Waals heterostructures, obtained by stacking two‐dimensional (2D) materials, represent a novel platform for investigating physicochemical phenomena and applications. Here, the electrochemistry at the one‐dimensional (1D) edge of a graphene sheet, sandwiched between two hexagonal boron nitride (hBN) flakes, is reported. When such an hBN/graphene/hBN heterostructure is immersed in a solution, the basal plane of graphene is encapsulated by hBN, and the graphene edge is exclusively available in the solution. This forms an electrochemical nanoelectrode, enabling the investigation of electron transfer using several redox probes, e.g., ferrocene(di)methanol, hexaammineruthenium, methylene blue, dopamine and ferrocyanide. The low capacitance of the van der Waals edge electrode facilitates cyclic voltammetry at very high scan rates (up to 1000 V s−1), allowing voltammetric detection of redox species down to micromolar concentrations with sub‐second time resolution. The nanoband nature of the edge electrode allows operation in water without added electrolyte. Finally, two adjacent edge electrodes are realized in a redox‐cycling format. All the above‐mentioned phenomena can be investigated at the edge, demonstrating that nanoscale electrochemistry is a new application avenue for van der Waals heterostructures. Such an edge electrode will be useful for studying electron transfer mechanisms and the detection of analyte species in ultralow sample volumes.
Photo‐Thermal Mediated Li‐ion Transport for Solid‐State Lithium Metal Batteries
Authors: Wang Qin , Sun Qi , Pu Yulai , Sun Wenbo , Lin Chengjiang , Duan Xiaozheng , Ren Xiaoyan , Lu Lehui
Published: December 2023

The development of lithium‐based solid‐state batteries (SSBs) has to date been hindered by the limited ionic conductivity of solid polymer electrolytes (SPEs), where nonsolvated Li‐ions are difficult to migrate in a polymer framework at room temperature. Despite the improved cationic migration by traditional heating systems, they are far from practical applications of SSBs. Here, an innovative strategy of light‐mediated energy conversion is reported to build photothermal‐based SPEs (PT‐SPEs). The results suggest that the nanostructured photothermal materials acting as a powerful light‐to‐heat converter enable heating within a submicron space, leading to a decreased Li+ migration barrier and a stronger solid electrolyte interface. Via in situ X‐ray diffraction analysis and molecular dynamics simulation, it is shown that the generated heating effectively triggers the structural transition of SPEs from a highly crystalline to an amorphous state, that helps mediate lithium‐ion transport. Using the assembled SSBs for exemplification, PT‐SPEs function as efficient ion‐transport media, providing outstanding capacity retention (96% after 150 cycles) and a stable charge/discharge capacity (140 mA g−1 at 1.0 C). Overall, the work provides a comprehensive picture of the Li‐ion transport in solid polymer electrolytes and suggests that free volume may be critical to achieving high‐performance solid‐state batteries.
Spacer Engineering Enables Fine‐Tuned Thin Film Microstructure and Efficient Charge Transport for Ultrasensitive 2D Perovskite‐Based Heterojunction Phototransistors and Optoelectronic Synapses
Authors: Lai Jing , Shi Keli , Qiu Beibei , Liang Jufang , Liu Haicui , Zhang Weifeng , Yu Gui
Published: December 2023

2D Ruddlesden–Popper phase layered perovskites (RPLPs) hold great promise for optoelectronic applications. In this study, a series of high‐performance heterojunction phototransistors (HPTs) based on RPLPs with different organic spacer cations (namely butylammonium (BA+), cyclohexylammonium (CyHA+), phenethylammonium (PEA+), p‐fluorophenylethylammonium (p‐F‐PEA+), and 2‐thiophenethylammonium (2‐ThEA+)) are fabricated successfully, in which high‐mobility organic semiconductor 2,7‐dioctyl[1]benzothieno[3,2‐b]benzothiophene is adopted to form type II heterojunction channels with RPLPs. The 2‐ThEA+‐RPLP‐based HPTs show the highest photosensitivity of 3.18 × 107 and the best detectivity of 9.00 × 1018 Jones, while the p‐F‐PEA+‐RPLP‐based ones exhibit the highest photoresponsivity of 5.51 × 106 A W−1 and external quantum efficiency of 1.32 × 109%, all of which are among the highest reported values to date. These heterojunction systems also mimicked several optically controllable fundamental characteristics of biological synapses, including excitatory postsynaptic current, paired‐pulse facilitation, and the transition from short‐term memory to long‐term memory states. The device based on 2‐ThEA+‐RPLP film shows an ultra‐high PPF index of 234%. Moreover, spacer engineering brought fine‐tuned thin film microstructures and efficient charge transport/transfer, which contributes to the superior photodetection performance and synaptic functions of these RPLP‐based HPTs. In‐depth structure‐property correlations between the organic spacer cations/RPLPs and thin film microstructure/device performance are systematically investigated.
Dual‐Plasmonic Ti3C2Tx/CuSe 2D/2D Solar Absorber and a Hydrophilic Device for Efficient Solar‐Driven Water Collection
Authors: Liu Yang , Xiong Yu‐Tong , Qu Shu‐Zhou , Liao Yu‐Xin , Kang Hao‐Sen , Ma Liang , Zou Jing‐Wen , Du Tao‐Yuan , Yang Hui‐Hui , Ding Si‐Jing
Published: December 2023

Solar water evaporation is an emerging technology for drinkable water generation, while it remains a challenge to develop materials and device for efficient water evaporation and collection. Herein, dual‐plasmonic Ti3C2Tx/CuSe two‐dimensional (2D)/2D hybrids are prepared for high‐efficiency solar water evaporation and a hydrophilic device is designed for efficient water collection. The Ti3C2Tx/CuSe hybrids, which monocrystalline CuSe ultrathin nanosheets are chemically bonded with Ti3C2Tx nanosheets, show efficient photothermal conversion owing to the plasmon‐coupling‐induced strong light absorption and fast charge transfer in the 2D/2D interface. By transferring the hybrids on a cotton piece, the Ti3C2Tx/CuSe membrane displays over 95% of solar light absorption, a stable evaporation rate of 1.893 kg m−2 h−1, and solar‐to‐vapor efficiency of 99.13% under one‐sun irradiation. The membrane can also treat water with more than 20 wt% salinity due to the rich microchannel for ion diffusion. Furthermore, a water evaporation device, which the cambered roof is painted with hydrophilic SiO2, is designed for efficient water collection. The treated roof can efficiently reduce the optical loss and transfer the vapor condensation, leading to a high average freshwater generation of 16.4 kg m−2 in a daily (10 h) natural light irradiation, much higher than other reported devices.
Effect of High‐Pressure Microfluidization on the Microstructure, Physicochemical Properties, and Digestibility of the Different Particle Sizes of Potato Starch
Authors: Xie Xinhua , Chen Jianyang , Zhang Bobo , Zhu Hongshuai , Cheng Lilin , Sun Wenhong
Published: December 2023

Potato starch (PS) is widely used in the food industry, but its uncontrolled paste consistency and poor film properties greatly limit its utilization. To expand its application, PS is separated into small‐ (PS‐S), medium‐ (PS‐M), and large‐ (PS‐L) fractions and modified by “high‐pressure microfluidization” (HPM). The effect of HPM on the microstructure, physicochemical properties, and digestibility of fractionated PS is investigated. Results show that the mechanical forces produced by HPM(50–150 MPa) can break PS molecules and enhance digestion rate with increasing pressure. Meanwhile, the relative crystallinity (RC) of HPM(150 MPa)‐modified PS‐L, PS‐M, and PS‐S decreases by about 29.23%, 15.40%, and 9.33%, respectively, relative to the RC of native fractionated PS. The changes in 1047/1022 and ΔH values in the three fractions show similar trends. Thus, the changes in microstructure of HPM‐modified PS‐L show more considerable than that of PS‐S. Compared with the native ones, the final viscosity of HPM(150 MPa)‐modified PS‐L, PS‐M, and PS‐S decreases by about 61.86%, 41.61%, and 35.70%, respectively, and the setback value increases to 379.67, 479.67, and 493.00 cp, respectively. These results indicate that HPM‐modified PS‐S has a higher tendency to form edible films than PS‐L. Therefore, HPM‐modification may expand the industrial application of fractionated PS.
Predictors of 1‐year mortality after gastrectomy for gastric cancer
Authors: Sekimoto Akihiro , Miyake Hideo , Nagai Hidemasa , Yoshioka Yuichiro , Yuasa Norihiro
Published: December 2023

Purpose

One‐year mortality is important for referrals to specialist palliative care or advance care planning (ACP). This helps optimize comfort for those who cannot be cured or have a lower life expectancy. Few studies have investigated the risk factors for 1‐year mortality after gastrectomy for gastric cancer (GC).

Methods

A total of 1415 patients with gastric cancer (stages I–IV) who underwent gastrectomy between 2005 and 2020 were included. The patients were randomly assigned to the investigation group (n = 850) and validation group (n = 565) in a 3:2 ratio. In the investigation group, significant independent prognostic factors for predicting 1‐year survival were identified. A scoring system for predicting 1‐year mortality was developed which was validated in the validation group.

Results

Multivariate analysis revealed that the following seven variables were significant independent factors for 1‐year survival: age ≧78, preoperative comorbidity, total gastrectomy, postoperative complication (Clavien–Dindo classification CD ≧ 3a), stage III and IV, and R2 resection. While developing a 1‐year mortality score (OMS), an age ≧78 was scored 2, preoperative comorbidity, total gastrectomy, and postoperative complication (CD ≧ 3a) were scored 1, and stage III, IV, and R2‐resection were scored 2, 3, and 3, respectively. OMS 3 had a sensitivity of 91% and a specificity of 66% for predicting death within 1 year. In the validation group, OMS 5 had a sensitivity of 55% and a specificity of 93% for predicting death within 1 year.

Conclusions

OMS may provide important information and help surgeons select the timing of ACP in patients with GC.
The politicizing clinic: insights on ‘the social’ for mental health policy and practice
Authors: Béhague Dominique P. , Gonçalves Helen , da Cruz Suélen Henriques , de Cruz Larissa , Horta Bernardo L. , Lima Natália P.
Published: December 2023

Purpose

In this paper, we explore how Brazilian socially sensitive therapy can respond to care-users’ desire to change the social and political forces shaping their lives. We use this case to demonstrate the limits of the “social determinants of health” agenda which, when operationalized, tends to leave questions of lasting structural change aside.

Methods

We report on mixed methods ethnographic and epidemiological results from the 1982 Pelotas (Brazil) birth cohort study, a prospective study of 5914 children. Ethnographic analysis explored the cyclical relationship between schooling, mental health care, conceptualizations of mental distress, social and political engagement, and experiences with diverse forms of discrimination. Epidemiological bivariate and multivariate analyses examined differences in socio-political participation and the reporting of discrimination at different time-points for participants who used therapy with those who did not. Effect modification analysis tested the hypothesis that the socially empowering effects of therapy were greater for marginalized and minoritized youth.

Results

Most young people living in situations of precarity experienced therapy, particularly when based in schools, to be a blame-inducing process. A more fulfilling and impactful therapeutic experience took shape when young people were able to shift the focus away from symptom reduction and behavioral management toward narrative life analyses, social debate, and political agency. Use of socially sensitive therapy was statistically associated with increased political participation and reporting of discrimination after controlling for confounders. The empowering effects of therapy were greater for those with less formal education and family income, but not for young people who identified as black, brown, or non-white.

Conclusion

The findings underscore the importance of considering agency, sociality, and politics when theorizing “the social” in clinical practice, and health and social policy.
A super-localized generalized finite element method
Authors: Freese Philip , Hauck Moritz , Keil Tim , Peterseim Daniel
Published: December 2023

This paper presents a novel multi-scale method for elliptic partial differential equations with arbitrarily rough coefficients. In the spirit of numerical homogenization, the method constructs problem-adapted ansatz spaces with uniform algebraic approximation rates. Localized basis functions with the same super-exponential localization properties as the recently proposed Super-Localized Orthogonal Decomposition enable an efficient implementation. The method’s basis stability is enforced using a partition of unity approach. A natural extension to higher order is presented, resulting in higher approximation rates and enhanced localization properties. We perform a rigorous a priori and a posteriori error analysis and confirm our theoretical findings in a series of numerical experiments. In particular, we demonstrate the method’s applicability for challenging high-contrast channeled coefficients.
Automatic estimation of brain parenchymal fraction in patients with multple sclerosis: a comparison between synthetic MRI and an established automated brain segmentation software based on FSL
Authors: Yazici Ilyas , Krieger Britta , Bellenberg Barbara , Ladopoulos Theodoros , Gold Ralf , Schneider Ruth , Lukas Carsten
Published: December 2023

Purpose

We aimed to validate the estimation of the brain parenchymal fraction (BPF) in patients with multiple sclerosis (MS) using synthetic magnetic resonance imaging (SyMRI) by comparison with software tools of the FMRIB Software Library (FSL). In addition to a cross-sectional method comparison, longitudinal volume changes were assessed to further elucidate the suitability of SyMRI for quantification of disease-specific changes.

Methods

MRI data from 216 patients with MS and 28 control participants were included for volume estimation by SyMRI and FSL-SIENAX. Moreover, longitudinal data from 35 patients with MS were used to compare registration-based percentage brain volume changes estimated using FSL-SIENA to difference-based calculations of volume changes using SyMRI.

Results

We observed strong correlations of estimated brain volumes between the two methods. While SyMRI overestimated grey matter and BPF compared to FSL-SIENAX, indicating a systematic bias, there was excellent agreement according to intra-class correlation coefficients for grey matter and good agreement for BPF and white matter. Bland–Altman plots suggested that the inter-method differences in BPF were smaller in patients with brain atrophy compared to those without atrophy. Longitudinal analyses revealed a tendency for higher atrophy rates for SyMRI than for SIENA, but SyMRI had a robust correlation and a good agreement with SIENA.

Conclusion

In summary, BPF based on data from SyMRI and FSL-SIENAX is not directly transferable because an overestimation and higher variability of SyMRI values were observed. However, the consistency and correlations between the two methods were satisfactory, and SyMRI was suitable to quantify disease-specific atrophy in MS.
Responsivität
Authors: Caspar Franz
Published: December 2023

Responsivität, die Berücksichtigung von individuellen Voraussetzungen bei Patient:innen durch die Therapeut:innen, ist in der Diskussion um optimale Psychotherapieangebote ein hochaktuelles Thema. Alle Therapieansätze bemühen sich darum, wobei sich Definition und Praxis recht stark unterscheiden. Dazu wird ein Überblick gegeben, und der eigene Ansatz der Motivorientierten Beziehungsgestaltung („motive-oriented therapeutic relationship“, MOTR) wird, einschließlich eines praxisnahen Forschungsansatzes, exemplarisch ausführlicher dargestellt. Kurze Fallbeispiele sind zur Illustration eingefügt. Am Schluss steht ein Resümee mit Hinweisen auf Konsequenzen für die Praxis.
Fully dynamic reorder policies with deep reinforcement learning for multi-echelon inventory management
Authors: Hammler Patric , Riesterer Nicolas , Braun Torsten
Published: December 2023

The operation of inventory systems plays an important role in the success of manufacturing companies, making it a highly relevant domain for optimization. In particular, the domain lends itself to being approached via Deep Reinforcement Learning (DRL) models due to it requiring sequential reorder decisions based on uncertainty to minimize cost. In this paper, we evaluate state-of-the-art optimization approaches to determine whether Deep Reinforcement Learning can be applied to the multi-echelon inventory optimization (MEIO) framework in a practically feasible manner to generate fully dynamic reorder policies. We investigate how it performs in comparison to an optimized static reorder policy, how robust it is when it comes to structural changes in the environment, and whether the use of DRL is safe in terms of risk in real-world applications. Our results show promising performance for DRL with potential for improvement in terms of minimizing risky behavior.
Gadolinium-enhanced intracranial aneurysm wall imaging and risk of aneurysm growth and rupture: a multicentre longitudinal cohort study
Authors: van der Kamp Laura T. , Edjlali Myriam , Naggara Olivier , Matsushige Toshinori , Bulters Diederik O. , Digpal Ronneil , Zhu Chengcheng , Saloner David , Hu Peng , Zhai Xiaodong , Mossa-Basha Mahmud , Tian Bing , Sakamoto Shigeyuki , Fu Qichang , Ruigrok Ynte M. , Zhao Huilin , Chen Huijun , Rinkel Gabriel J. E. , van der Schaaf Irene C. , Vergouwen Mervyn D. I.
Published: December 2023

Objectives

In patients with an unruptured intracranial aneurysm, gadolinium enhancement of the aneurysm wall is associated with growth and rupture. However, most previous studies did not have a longitudinal design and did not adjust for aneurysm size, which is the main predictor of aneurysm instability and the most important determinant of wall enhancement. We investigated whether aneurysm wall enhancement predicts aneurysm growth and rupture during follow-up and whether the predictive value was independent of aneurysm size.

Materials and methods

In this multicentre longitudinal cohort study, individual patient data were obtained from twelve international cohorts. Inclusion criteria were as follows: 18 years or older with ≥ 1 untreated unruptured intracranial aneurysm < 15 mm; gadolinium-enhanced aneurysm wall imaging and MRA at baseline; and MRA or rupture during follow-up. Patients were included between November 2012 and November 2019. We calculated crude hazard ratios with 95%CI of aneurysm wall enhancement for growth (≥ 1 mm increase) or rupture and adjusted for aneurysm size.

Results

In 455 patients (mean age (SD), 60 (13) years; 323 (71%) women) with 559 aneurysms, growth or rupture occurred in 13/194 (6.7%) aneurysms with wall enhancement and in 9/365 (2.5%) aneurysms without enhancement (crude hazard ratio 3.1 [95%CI: 1.3–7.4], adjusted hazard ratio 1.4 [95%CI: 0.5–3.7]) with a median follow-up duration of 1.2 years.

Conclusions

Gadolinium enhancement of the aneurysm wall predicts aneurysm growth or rupture during short-term follow-up, but not independent of aneurysm size.

Clinical relevance statement

Gadolinium-enhanced aneurysm wall imaging is not recommended for short-term prediction of growth and rupture, since it appears to have no additional value to conventional predictors.

Graphical abstract

Key Points

• Although aneurysm wall enhancement is associated with aneurysm instability in cross-sectional studies, it remains unknown whether it predicts risk of aneurysm growth or rupture in longitudinal studies.

• Gadolinium enhancement of the aneurysm wall predicts aneurysm growth or rupture during short-term follow-up, but not when adjusting for aneurysm size.

• While gadolinium-enhanced aneurysm wall imaging is not recommended for short-term prediction of growth and rupture, it may hold potential for aneurysms smaller than 7 mm.
Age standardization and time-of-day performance for the Oldenburg Sentence Test (OLSA): results from the population-based Gutenberg Health Study
Authors: O’Brien Karoline , Hackenberg Berit , Döge Julia , Bohnert Andrea , Rader Tobias , Lackner Karl J. , Beutel Manfred E. , Münzel Thomas , Wild Philipp S. , Chalabi Julian , Schuster Alexander K. , Schmidtmann Irene , Matthias Christoph , Bahr-Hamm Katharina
Published: December 2023

Purpose

The Oldenburg Sentence Test (OLSA) is a German matrix test designed to determine speech recognition thresholds (SRT). It is widely used for hearing-aids and cochlear implant fitting, but an age-adjusted standard is still lacking. In addition, knowing that the ability to concentrate is an important factor in OLSA performance, we hypothesized that OLSA performance would depend on the time of day it was administered. The aim of this study was to propose an age standardization for the OLSA and to determine its diurnal performance.

Methods

The Gutenberg Health Study is an ongoing population-based study and designed as a single-centre observational, prospective cohort study. Participants were interviewed about common otologic symptoms and tested with pure-tone audiometry and OLSA. Two groups—subjects with and without hearing loss—were established. The OLSA was performed in two runs. The SRT was evaluated for each participant. Results were characterized by age in 5-year cohorts, gender and speech recognition threshold (SRT). A time stamp with an hourly interval was also implemented.

Results

The mean OLSA SRT was − 6.9 ± 1.0 dB (group 1 male) and − 7.1 ± 0.8 dB (group 1 female) showing an inverse relationship with age in the whole cohort, whereas a linear increase was observed in those without hearing loss. OLSA-SRT values increased more in males than in females with increasing age. No statistical significance was found for the diurnal performance.

Conclusions

A study with 2900 evaluable Oldenburg Sentence Tests is a novelty and representative for the population of Mainz and its surroundings. We postulate an age- and gender-standardized scale for the evaluation of the OLSA. In fact, with an intergroup standard deviation (of about 1.5 dB) compared to the age dependence of 0.7 dB/10 years, this age normalization should be considered as clinically relevant.
Impact of atorvastatin and mesenchymal stem cells combined with ivermectin on murine trichinellosis
Authors: Hassan Zeinab R. , El-Sayed Samar , Zekry Kareman M. , Ahmed Samah Gouda , Abd-Elhamid Asmaa Hassan , Salama Doaa E. A. , Taha Azza Kamal , Mahmoud Nihal A. , Mohammed Shaymaa Fathy , Amin Mona M. , Mohamed Rasha Elsayed , Eraque Ayat M. S. , Mohamed Shimaa A. , Abdelgalil Ranya M. , Atta Shimaa Attia , Fahmy Nermeen Talaat , Badr Mohamed S.
Published: December 2023

Trichinellosis is one of the global food-borne parasitic diseases that can cause severe tissue damage. The traditionally used drugs for the treatment of trichinellosis have limited efficacy against the encysted larvae in the muscular phase of the disease. Therefore, this study aimed to evaluate the role of atorvastatin and mesenchymal stem cells combined with ivermectin against different phases of Trichinella in experimentally infected mice. A total of 120 male Swiss albino mice were divided into two major groups (n = 60 of each), intestinal and muscular phases. Then, each group was subdivided into 10 subgroups (n = 6); non-infected control, infected non-treated control, infected ivermectin treated, infected atorvastatin treated, infected mesenchymal stem cells treated, infected combined ivermectin and atorvastatin treated, infected combined mesenchymal stem cells and ivermectin treated, infected combined mesenchymal stem cells and atorvastatin treated, infected combined mesenchymal stem cells and a full dose of (ivermectin and atorvastatin) treated, and infected combined mesenchymal stem cells and half dose of (ivermectin and atorvastatin) treated. Mice were sacrificed at days 5 and 35 post-infection for the intestinal and muscular phases, respectively. The assessment was performed through many parameters, including counting the adult intestinal worms and muscular encysted larvae, besides histopathological examination of the underlying tissues. Moreover, a biochemical assay for the inflammatory and oxidative stress marker levels was conducted. In addition, levels of immunohistochemical CD31 and VEGF gene expression as markers of angiogenesis during the muscular phase were investigated. The combined mesenchymal stem cells and atorvastatin added to ivermectin showed the highest significant reduction in adult worms and encysted larvae counts, the most noticeable improvement of the histopathological changes, the most potent anti-inflammatory (lowest level of IL-17) and anti-angiogenic (lowest expression of CD31 and VEGF) activities, and also revealed the highly effective one to relieve the oxidative stress (lowest level of SOD, GSH, and lipid peroxidase enzymes). These observed outcomes indicate that adding mesenchymal stem cells and atorvastatin to ivermectin synergistically potentiates its therapeutic efficacy and provides a promising candidate against trichinellosis.
Profitieren Schmerztherapiepatienten von ihren Mitpatienten?
Authors: Lindenberg Nicole , Bundscherer Anika , Wiese Christoph , Lassen Christoph
Published: December 2023

Hintergrund

Interdisziplinäre multimodale Schmerztherapie (IMST) wird meist im Gruppensetting durchgeführt, um den Erfahrungsaustausch zwischen Patienten anzuregen und so die Veränderung schmerzbezogener Einstellungen und Verhaltensweisen zu erleichtern. Wie aus der Psychotherapieforschung bekannt ist, haben die Mitpatienten einer Therapiegruppe einen relevanten Einfluss auf den Therapieerfolg der einzelnen Patienten.

Ziel der Arbeit

Wir untersuchten, inwieweit der Therapieerfolg in einer IMST-Gruppe von einzelnen Mitpatientencharakteristika wie dem mittleren Stadium kognitiv-verhaltensorientierter Schmerzbewältigung der Mitpatienten, der Differenz zum eigenen Schmerzbewältigungsstadium und dem Anteil an therapiewiederholenden Mitpatienten beeinflusst wird.

Methodik

In einer retrospektiv geplanten Untersuchung der psychometrischen Testungen aller Patienten in einer stationären IMST zwischen Januar 2013 und Februar 2020 wurde mittels binärer logistischer Regressionsanalysen der Einfluss der Mitpatientencharakteristika auf klinisch relevante Veränderungen hinsichtlich verschiedener Parameter zur Ausprägung der chronischen Schmerzerkrankung analysiert.

Ergebnisse

Untersucht wurden 540 Erstaufenthalte von 636 Behandlungsfällen. Pro Behandlungstag waren durchschnittlich 5 Mitpatienten, davon 15 % Therapiewiederholer, anwesend. Es zeigte sich, dass die Wahrscheinlichkeit, einen Erfolg in mindestens einem der untersuchten Parameter zu erreichen, zum einen vom Schmerzbewältigungsstadium der Mitpatienten (p < 0,001; OR = 2,885) und zum anderen vom Anteil an therapiewiederholenden Mitpatienten (p < 0,001; OR = 1,032) signifikant erhöht wird. Ein Einfluss auf den Therapieerfolg in einem spezifischen Parameter konnte nicht nachgewiesen werden.

Fazit

Trotz methodischer Limitationen legen unsere Ergebnisse nahe, in Patientengruppen einer IMST therapieerfahrene Patienten und solche in einem fortgeschrittenen Schmerzbewältigungsstadium mit Neulingen und Patienten, die noch am Anfang der Bewältigung der Schmerzerkrankung stehen, zu kombinieren.

Graphic abstract
Masitinib as a neuroprotective agent: a scoping review of preclinical and clinical evidence
Authors: Hamad Abdullah Ashraf , Amer Basma Ehab , Hawas Yousef , Mabrouk Manar Alaa , Meshref Mostafa
Published: December 2023

Objectives

Masitinib, originally developed as a tyrosine kinase inhibitor for cancer treatment, has shown potential neuroprotective effects in various neurological disorders by modulating key pathways implicated in neurodegeneration. This scoping review aimed to summarize the current evidence of masitinib’s neuroprotective activities from preclinical to clinical studies.

Methods

This scoping review was conducted following the guidelines described by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria covered all original studies reporting on the neuroprotective effects of masitinib, including clinical studies, animal studies, and in vitro studies.

Results

A total of 16 studies met the inclusion criteria and were included in the review. These comprised five randomized controlled trials (RCTs), one post-hoc analysis study, one case report, and nine animal studies. The RCTs focused on Alzheimer’s disease (two studies), multiple sclerosis (two studies), and amyotrophic lateral sclerosis (one study). Across all included studies, masitinib consistently demonstrated neuroprotective properties. However, the majority of RCTs reported concerns regarding the safety profile of masitinib. Preclinical studies revealed the neuroprotective mechanisms of masitinib, which include inhibition of certain kinases interfering with cell proliferation and survival, reduction of neuroinflammation, and exhibition of antioxidant activity.

Conclusion

The current evidence suggests a promising therapeutic benefit of masitinib in neurodegenerative diseases. However, further research is necessary to validate and expand upon these findings, particularly regarding the precise mechanisms through which masitinib exerts its therapeutic effects. Future studies should also focus on addressing the safety concerns associated with masitinib use.
Cognitive function in amyotrophic lateral sclerosis: a cross-sectional and prospective pragmatic clinical study with review of the literature
Authors: Katerelos Adamantios , Alexopoulos Panagiotis , Economou Polychronis , Polychronopoulos Panagiotis , Chroni Elisabeth
Published: December 2023

Background

Amyotrophic lateral sclerosis (ALS) can present with either bulbar or spinal symptoms, and in some cases, both types of symptoms may be present. In addition, cognitive impairment has been observed in ALS. The study aimed to evaluate the frontal and general cognitive performance in ALS not only cross-sectionally but also longitudinally.

Methods and materials

The Frontal Assessment Battery (FAB) and the Montreal Cognitive Assessment (MoCA) were employed to assess cognitive function in 52 adults with ALS and 52 cognitively healthy individuals. The statistical analyses encompassed the Pearson Chi square test, the Skillings-Mack test, the Spearman’s rank correlation coefficient, and the Proportional Odds Logistic Regression Model (POLR).

Results

Cross-sectionally, lower cognitive performance was associated with ALS diagnosis, older age, and motor functional decline. The cognitive impairment of individuals with bulbar and spinal-bulbar symptoms showed faster deterioration compared to those with spinal symptoms. The spinal subgroup consistently performed worst in delayed recall and attention, while the spinal-bulbar and bulbar subgroups exhibited inferior scores in delayed recall, attention, visuospatial skills, orientation, and verbal fluency.

Conclusion

The incorporation of cognitive screening in the diagnostic workup of ALS may be beneficial, as early detection can enhance symptom management and improve the quality of life for both individuals with ALS and their care partners.
The Effects of Introducing a Harm Threshold for Medical Treatment Decisions for Children in the Courts of England & Wales: An (Inter)National Case Law Analysis
Authors: Neefjes Veronica M. E.
Published: December 2023

The case of Charlie Gard sparked an ongoing public and academic debate whether in court decisions about medical treatment for children in England & Wales the best interests test should be replaced by a harm threshold. However, the literature has scantly considered (1) what the impact of such a replacement would be on future litigation and (2) how a harm threshold should be introduced: for triage or as standard for decision-making. This article directly addresses these gaps, by first analysing reported cases in England & Wales about medical treatment in the context of a S31 order, thus using a harm threshold for triage and second comparing court decisions about medical treatment for children in England & Wales based on the best interest test with Dutch and German case law using a harm threshold. The investigation found that whilst no substantial increase of parental discretion can be expected an introduction of a harm threshold for triage would change litigation. In particular, cases in which harm is limited, currently only heard when there are concerns about parental decision-making, may be denied a court hearing as might cases in which the child has lost their capacity to suffer. Applying a harm threshold for triage in decisions about withholding or withdrawing life-sustaining treatment might lead to a continuation of medical treatment that could be considered futile.