bluuebunny/crossref_metadata_2025 huggingface dataset:
Aktuelle Entwicklungen in der Behandlung neuroendokriner Tumoren
Authors: Kiesewetter-Wiederkehr Barbara , Melhorn Philipp , Scheuba Christian , Raderer Markus
Published: April 2024

Hintergrund

Gut differenzierte neuroendokrine Tumoren (NET) sind seltene Malignome, die klinisch sehr heterogen sind. Entsprechend ist auch ihre Behandlung komplex und von diversen Faktoren abhängig. Mit den heute verfügbaren Therapien ist die Prognose oft günstig.

Ziel der Arbeit

Dieser Artikel soll einen Überblick über die aktuellen Therapiestrategien bei NET geben und dabei auf die wichtigsten NET-Lokalisationen eingehen.

Methoden

Zu diesem Zweck wurden die aktuellen europäischen Leitlinien und die einschlägige Literatur zur Behandlung von NET zusammengefasst.

Ergebnisse

Das Therapiespektrum ist ausgesprochen breit: Bei den NET des Magens/Duodenums, der Appendix und des Rektums ist oft die endoskopische respektive chirurgische Entfernung ausreichend, und metastasierte Tumoren sind selten. NET des Pankreas, des Dünndarms und der Lunge sollen in frühen Stadien auch einer potenziell kurativen Resektion zugeführt werden. Im metastasierten Stadium haben lokale Therapiemaßnahmen wie Chirurgie und Leber-Tumorembolisation ebenfalls einen Stellenwert. Zuletzt gab es viele Fortschritte hinsichtlich der medikamentösen Therapie, wobei insbesondere Somatostatin-Analoga (Octreotid und Lanreotid), ein mTOR-Inhibitor (Everolimus) und ein Tyrosinkinase-Inhibitor (Sunitinib) eingesetzt werden. Ferner stellt die Peptidrezeptor-Radionuklid-Therapie (PRRT) ein wichtiges Verfahren dar. Auch die klassische Chemotherapie ist in einigen Fällen indiziert.

Diskussion

Inzwischen gibt es viele effektive Therapien für NET. Es ist wichtig, im interdisziplinären Management für jeden Patienten und jede Patientin die richtige Therapie zum richtigen Zeitpunkt auszuwählen.
Study on magnetohydrodynamic internal cooling mechanism within an aluminium oxide cutting tool
Authors: O’Hara John , Fang Fengzhou
Published: April 2024

One of the challenges in the transfer of heat during the mechanical machining process is the coolant substance used in the internal cooling method which is generally liquid water or a water-based coolant. This limits the heat transfer capacity insofar as the thermal conductivity of liquid water is concerned. The other difficulty is the requirement for an external mechanical system to pump the coolant around the internal channel, providing efficient transfer of the accumulated thermal energy. This study proposes a novel method to address this issue by using liquid gallium which provides the means to transfer the excess heat generated during the cutting process by integrating the design into an aluminium oxide insert. Combining this with a magnetohydrodynamic drive, the coolant system operates without the need for mechanical input. Liquid gallium is nontoxic and has a much higher thermal conductivity over liquid water. Investigations of the novel cooling system is performance compared against liquid water through numerical modelling, followed by an experimental machining test to ascertain the difference in heat transfer effectiveness, tool wear rates and workpiece surface finish when compared to dry machining and external cooling conditions on stainless steel 316L. Without cooling, experimental machining tests employing a cutting speed of Vc = 250 m min−1 resulted in a corner wear VBc rate of 75 μm, and with the magnetohydrodynamic-based coolant on, produced a VBc rate of 48 μm, indicating a difference of 36% in relative tool wear under the same cutting conditions. Increasing the cutting speed Vc to 900 m min−1, produced a corner wear VBc rate of 357 μm without the active coolant and a VBc rate of 246 μm with the magnetohydrodynamic-based coolant on, representing a decrease of 31% in relative tool wear. Further tests comparing external liquid water cooling against the liquid gallium coolant showed at Vc = 250 m min−1, a difference of 29% in relative tool wear rate reduction was obtained with the internal liquid gallium coolant. Increasing the cutting speed to Vc = 900 m min−1, the data indicated a difference of 16% relative tool wear reduction with the internal liquid gallium. The results support the feasibility of using liquid gallium as an internal coolant in cutting inserts to effectively remove thermal energy.
Medullabeteiligung bei einer Schraubenosteosynthese einer Densfraktur Typ II nach Anderson und D’Alonzo – eine forensisch-funktionelle Frakturanalyse
Authors: Saternus K.-S. , Hoffmann E. , Kernbach-Wighton G.
Published: April 2024

Dargestellt werden in einem ersten Teil Klinik und postmortale Untersuchungen einer tödlich verlaufenden direkten Verletzung der Medulla bei einer ventralen Zugschraubenosteosynthese einer Typ-II-Densfraktur. Offensichtlich war es dabei zu einem Einbruch des knöchernen Widerlagers für die Schraube gekommen. Die präparative Darstellung ergab eine intraoperative Teilresektion des Corpus axis, einschließlich des primären Widerlagers, mit tiefer Verlagerung der Schraube in das Corpus dentis. Klinische Angaben fehlen dazu. Somit galt es, für eine forensische Verletzungsrekonstruktion nach Wegen einer indirekten Beurteilung der Knochenqualität des Widerlagers zu suchen. Dazu wurde ein biomechanischer Ansatz mit einer detailreichen Darstellung der knöchernen Dichteverteilung im Axis und der Spannungsmaxima unter hoher Zugbeanspruchung gewählt, Teilabschnitt 2.

Unabhängig von der altersbedingten Osteoporose erwies sich der Umfang von Mikrofrakturen in der Spongiosa als maßgebliche Größe zur Beurteilung der Knochenqualität des Widerlagers. Im konkreten Fall der 72-jährigen Frau hatte eine rotatorische Krafteinleitung bei einem häuslichen Sturz zu einer asymmetrischen Densfraktur mit Ausriss einer breiten Spongiosamanschette geführt. Aufgrund der damit verbundenen umfangreichen Mikrofrakturen musste das knöcherne Widerlager für eine Schraubenosteosynthese als posttraumatisch instabil angesehen werden. Damit lag vom morphologischen Befund her eine Kontraindikation für eine operative Versorgung der Densfraktur vor.
Finite regular semigroups with permutations that map elements to inverses
Authors: Higgins Peter M.
Published: April 2024

We give an account on what is known on the subject of permutation matchings, which are bijections of a finite regular semigroup that map each element to one of its inverses. This includes partial solutions to some open questions, including a related novel combinatorial problem.
Clinical implications of primary “occult” vesicoureteral reflux in male children
Authors: Guarino Stefano , Di Sessa Anna , Rivetti Giulio , Capasso Giusy , Schiano di Cola Roberta , Rimoli Antonietta , Miraglia del Giudice Emanuele , Polito Cesare , La Manna Angela , Marzuillo Pierluigi
Published: April 2024

Objectives

To compare characteristics and outcomes of vesicoureteral reflux (VUR) detected solely on isotopic cystography (IC) (“occult” VUR) with voiding cystourethrography (VCUG)-detected VUR.

Materials and methods

Between 2015 and 2020, we retrospectively enrolled all male children first undergoing VCUG and, if negative, IC in the same session. Kidney injury (KI) was defined by abnormal estimated glomerular filtration rate and/or blood pressure and/or proteinuria.

Results

We enrolled 421 males with a median age of 3 months and a follow-up of 5.3 years. None exhibited KI initially, but 10% of those with VUR developed KI during follow-up. Two hundred and twenty-two patients (52.7%) did not show VUR, 152 (36.1%) had VCUG-diagnosed VUR, and 47 (11.2%) had occult VUR. Therefore, 47/199 patients (23.6%) with VUR had occult VUR. Among these, 34/47 (72.3%) had dilated VUR, and 22/47 (46.8%) exhibited split renal function < 45% and/or scar (scintigraphic damage). Compared to patients with occult VUR, those with VCUG-diagnosed VUR showed a similar prevalence of febrile urinary tract infection (fUTI) before and after VUR diagnostics and KI at the last follow-up but a higher prevalence of dilated VUR, of scintigraphic damage, and underwent surgery more frequently. At multiple logistic regression analysis, patients with VCUG-diagnosed VUR presented an increased risk of fUTI either before or after VUR diagnosis and of KI, while patients with occult VUR presented an increased risk of fUTI before (and among patients with dilated VUR also after) VUR diagnosis and of KI.

Conclusion

Occult VUR affects 23.6% of male children with VUR with a non-negligible risk of VUR-associated KI and fUTI. IC could select, among males with recurrent fUTIs and negative VCUG, those requiring surgery for a possible dilated occult VUR.

Clinical relevance statement

Vesicoureteral reflux may be overlooked in 25% of boys during VCUG, yet they are at risk of fUTIs and KI. In case of recurrent infections post-negative cystourethrography, IC could detect occult reflux, guiding surgical intervention.
Evaluation of multidisciplinary high-risk pregnancy clinic for myelomeningocele
Authors: Anderson Luke , Hopson Betsy , Caudill Caroline , Rocque Brandon G. , Blount Jeffrey , Arynchyna-Smith Anastasia , Thrower Jessica , Johnston James , Rozzelle Curtis
Published: April 2024

Introduction

A cross-sectional study retrospectively evaluating the perceived usefulness of attending a multi-disciplinary, roundtable, educational prenatal clinic for mothers expecting children with myelomeningocele is presented.

Methods

Mothers who currently have children with SB completed a survey which evaluated their overall preparedness, spina bifida education, delivery plans, surgical expectations, and expectations in terms of quality of life and development. Open comments were also collected. Statistical analysis was performed to identify differences between those who attended prenatal counseling and those who did not.

Results

Approximately half of these mothers received some form of prenatal SB counseling. Mothers who attended prenatal counseling reported that they felt more informed and prepared throughout their pregnancy, during the delivery of their child and during their initial hospital stay than mothers who did not. They reported that the roundtable discussions were beneficial, and the education they received was useful in helping them form accurate expectations and feel more at ease.

Conclusion

This suggests that prenatal counseling and the High-Risk Pregnancy Clinic (HRPC) provides perceived utility to families and mothers and that the HRPC is an effective method of providing prenatal counseling to mothers whose unborn children have been diagnosed with myelomeningocele.
Preparation and characterization of a novel amphiphilic nanocarrier based on enzymatic polymerization-derived α-1,3-glucan for efficient quercetin encapsulation
Authors: Su Zhengyu , Takeda Yoichi , Matsui Daisuke , Toyotake Yosuke , Wakayama Mamoru
Published: April 2024

Biodegradable nanocarriers based on polysaccharide-derived amphiphilic copolymers are promising candidates to enhance drug solubility and stability. This study aimed to design a novel amphiphilic carrier based on enzymatic polymerization-derived exopolysaccharides, α-1,3-glucan. Glycosyltransferase I from Streptococcus mutans was used to synthesize α-1,3-glucan, and the amphiphilic α-1,3-glucan-graft-poly(ε-caprolactone) (Glucan-g-PCL) copolymer was synthesized via a homogeneous ring-opening polymerization (ROP) in ionic liquid, 1-butyl-3-methylimidazolium chloride. The chemical structures and physical properties of Glucan-g-PCL copolymer were characterized by FT-IR, 1H NMR, XRD, and TGA. The self-assembly behavior of the amphiphilic α-1,3-glucan derivative was investigated by fluorescence probe. The results showed that Glucan-g-PCL exhibited a low critical aggregation concentration (CAC) and formed core-shell structured nanostructure via self-assembly. Quercetin (Qu), a hydrophobic active component, was successfully encapsulated within the Glucan-g-PCL micelle-like nanostructure, showing efficient encapsulation and dispersion in water. Qu/Glucan-g-PCL micelle-like nanostructure (Qu/M) was characterized by DLS, TEM, FT-IR, and XRD. FT-IR and XRD analyses showed that Qu was present in an amorphous state in the formulation and without any chemical reactions during the sample preparation procedures. In addition, the antioxidant properties of the Qu/M were investigated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method, and significantly improved antioxidant activity was observed for Qu/M compared to Qu/water. The utilization of Glucan-g-PCL nanostructure encapsulation opens up new possibilities for enhancing and expanding the practical applications of quercetin and α-1,3-glucan.

Graphic Abstract
Geochemistry and volatile contents of olivine-hosted melt inclusions from Mt. Etna tholeiitic and alkaline magmatism
Authors: Giacomoni P. P. , Masotta M. , Delpech G. , Lanzafame G. , Ferlito C. , Villeneuve J. , Coltorti M.
Published: April 2024

The analysis of olivine-hosted melt inclusions (MIs) from the whole sub-alkaline and alkaline magmatic suites of Mt. Etna provides fundamental information about the composition of undifferentiated magmas and their pristine volatile content. Olivine crystals (Fo88-66) were selected for Secondary Ion Mass Spectrometry (SIMS) analysis of volatile species (H2O, CO2, F, Cl and S) contained in their host MIs, after preliminary high-pressure/high-temperature re-homogenization, which allowed to reduce the developing of cracks in the host olivine and diffusion-driven outgassing of volatiles from the melt inclusions. This permitted to explore the compositional variability of volatiles of undifferentiated melts and the degassing behavior through the feeding system. The studied MIs show significant major elements compositional heterogeneities (44.57–52.37 wt% SiO2; 3.60–7.51 wt% Na2O + K2O). Fractionation modelling was performed with Rhyolite-MELTs under variable fO2 regimes (∆FMQ + 1.5 to + 3), starting from the less evolved MIs compositions and ultimately reproducing most of the observed compositional trends. Mantle melting modelling was used to replicate the observed MIs composition, starting from a spinel-lherzolitic source, accounting for the alkalinity and Fe content of reproduced melts by varying the eutectic contribution of Amph/Phlog and Opx/Cpx respectively. Although most of the studied MIs were degassed in an open-conduit regime, the observed range of volatile concentration in MIs (2.42–6.14 wt% H2O; 308–8474 ppm CO2; 132–697 ppm F; 221–1766 ppm Cl and 16–1992 ppm S) is correlated with a slight decrease in the molar H2O/(H2O + CO2) ratio from early tholeiites to the recent 2015 alkaline products. This observation allows to estimate a minimum 12,250 ppm CO2 and a maximum of 6.14 wt% H2O in primary melts of the current activity.
ENSEMBLE PLUS: final results of shorter ocrelizumab infusion from a randomized controlled trial
Authors: Hartung Hans-Peter , Berger Thomas , Bermel Robert A. , Brochet Bruno , Carroll William M. , Holmøy Trygve , Karabudak Rana , Killestein Joep , Nos Carlos , Patti Francesco , Perrin Ross Amy , Vanopdenbosch Ludo , Vollmer Timothy , Buffels Regine , Garas Monika , Kadner Karen , Manfrini Marianna , Wang Qing , Freedman Mark S.
Published: April 2024

Introduction

Ocrelizumab is an approved intravenously administered anti-CD20 antibody for multiple sclerosis (MS). The safety profile and patient preference for conventional versus shorter ocrelizumab infusions were investigated in the ENSEMBLE PLUS study.

Methods

ENSEMBLE PLUS was a randomized, double-blind substudy to the single-arm ENSEMBLE study (NCT03085810), comparing outcomes in patients with early-stage relapsing–remitting MS receiving ocrelizumab 600 mg over the approved 3.5-h (conventional) versus 2-h (shorter) infusion. The primary endpoint was the proportion of patients with infusion-related reactions (IRRs) following the first randomized dose (RD); the secondary endpoint included IRR frequency at subsequent RDs.

Results

At first RD, the number of patients with an IRR in the conventional (101/373; 27.1%) versus shorter (107/372; 28.8%) infusion group was similar (difference, stratified estimates [95% CI]: 1.9% [− 4.4, 8.2]). Most IRRs (conventional: 99.4%; shorter: 97.7%) were mild/moderate. IRR frequency decreased over the course of RDs; three patients discontinued from the shorter infusion arm but continued with conventional infusion. Overall, > 98% of IRRs resolved without sequelae in both groups. Pre-randomization throat irritation was predictive of future throat irritation as an IRR symptom. Adverse events (AEs) and serious AEs were consistent with the known ocrelizumab safety profile. On completion of ENSEMBLE PLUS, most patients chose to remain on (95%) or switch to (80%) shorter infusion.

Conclusion

ENSEMBLE PLUS demonstrates the safety and tolerability of shorter ocrelizumab infusions. Most patients remained on/switched to shorter infusion after unblinding; IRRs did not strongly influence patient decisions.

Clinical Trials Registration: Substudy of ENSEMBLE (NCT03085810). Registration: March 21, 2017.
Promising anticancer activity of cromolyn in colon cancer: in vitro and in vivo analysis
Authors: Aliabadi Amin , Haghshenas Mohammad Reza , Kiani Razie , Panjehshahin Mohammad Reza , Erfani Nasrollah
Published: April 2024

Purpose

Colon cancer is a prevalent cancer globally, representing approximately 10% of all cancer cases and accounting for 10% of all cancer-related deaths. Therefore, finding new therapeutic methods with high efficiency will be very valuable. Cromolyn (C), a common anti-allergic and mast cell membrane stabilizing drug, has recently shown valuable anti-cancer effects in several studies. This study was designed to investigate the anti-cancer activity of cromolyn on colon cancer in vitro and in vivo and to determine values such as selectivity index and survival effect.

Methods

HT-29 (colon cancer) and MCF-10 (normal epithelial) cell lines were treated with C and Doxorubicin (DOX; Positive control). IC50 values and the effects of C and DOX on apoptosis were explored using methyl thiazole diphenyl-tetrazolium bromide (MTT) assay and Annexin V/PI Apoptosis Assay Kit. To investigate in an animal study, colon cancer was subcutaneously induced by CT26 cells (mouse colon cancer) in bulb/c mice. Mice were treated with 0.05 LD50 intraperitoneal every other day for 35 days. After the death of mice, tumor volume, tumor weight, and survival rate were evaluated.

Results

C selectively and significantly suppressed the proliferation of cancer cells in a dose-dependent manner. The IC50 values for the MCF-10 and HT29 cell lines were 7.33 ± 0.78 μM and 2.33 ± 0.6 μM, respectively. Notably, the selective index (SI) highlighted that C displayed greater selectivity in inhibiting cancer cell growth compared to DOX, with SI values of 3.15 and 2.60, respectively. C exhibited higher effectiveness and selectivity in inducing apoptosis in cancer cells compared to DOX, with a significant p-value (61% vs. 52%, P-value ≤ 0.0001). Also, in mice bearing colon cancer, C reduced the tumor volume (6317 ± 1685mm3) and tumor weight (9.8 ± 1.6 g) compared to the negative control group (weight 12.45 ± 0.9 g; volume 7346 ± 1077) but these values were not statistically significant (P ≤ 0.05).

Conclusion

Our study showed that cromolyn is a selective and strong drug in inhibiting the proliferation of colon cancer cells. Based on our results, the efficacy of C in vitro analysis (MTT assays and apoptosis), as well as animal studies is competitive with the FDA-approved drug doxorubicin. C is very promising as a low-complication and good-efficacy drug for cancer drug repositioning. This requires clinical research study designs to comprehensively evaluate its anti-cancer effects.
Microfilaruria of Dirofilaria immitis in a dog from Italy
Authors: Perles Livia , Gernone Floriana , Menga Giuseppe , Taurino Riccardo , Fornelli Stefania , Covino Marianna , Russo Umberto , Ionascu Iuliana , Otranto Domenico
Published: April 2024

Dirofilaria immitis is a mosquito-borne nematode-causing canine heartworm disease, with adult worms localized in the pulmonary arteries and right heart. In rare cases, ectopic migration might occur, and adults and blood circulating microfilariae can be found in unusual organs or fluids (e.g., eyes, abdominal cavity, bone marrow, and urine). A 17-year-old mixed-breed female dog was presented in a private veterinary clinic in Italy for hematuria and dysuria. Physical examination showed cardiac mitral murmur with marked respiratory distress and cyanotic mucous membranes after handling. Abdominal ultrasounds revealed a non-specific chronic cystopathy, while the echocardiography showed enlargement of the right heart associated with tricuspid insufficiency and mitral regurgitation, with the presence of an adult filariae in the right ventricular chamber. Circulating microfilariae were observed in the blood smear and molecularly identified as D. immitis. Unusual microfilaruria was detected in the urine sediment. Data presented raise awareness about the occurrence of microfilariae in unusual locations, such as the bladder, suggesting the need of a thorough clinical and laboratory assessment where D. immitis is endemic.
A qualitative evaluation of the oncologists’, neurologists’, and pain specialists’ views on the management and care of chemotherapy-induced peripheral neuropathy in The Netherlands
Authors: van Haren F. G. A. M. , Steegers M. A. H. , Vissers K. C. P. , van den Heuvel S. A. S.
Published: April 2024

Purpose

In treating cancer, different chemotherapy regimens cause chemotherapy-induced peripheral neuropathy (CIPN). Despite recent international guidelines, a gold standard for diagnosis, treatment, and care is lacking. To identify the current clinical practice and the physicians’ point of view and ideas for improvement, we evaluated CIPN care by interviewing different specialists involved.

Methods

We performed semi-structured, audio-recorded, transcribed, and coded interviews with a purposive sample of oncologists, pain specialists, and neurologists involved in CIPN patients’ care. Data is analyzed by a constant comparative method for content analysis, using ATLAS.ti software. Codes, categories, and themes are extracted, generating common denominators and conclusions.

Results

With oncologists, pain specialists, and neurologists, nine, nine, and eight interviews were taken respectively (including three, two, and two interviews after thematic saturation occurred). While useful preventive measures and predictors are lacking, patient education (e.g., on symptoms and timely reporting) is deemed pivotal, as is low-threshold screening (e.g., anamnesis and questionnaires). Diagnosis focusses on a temporal relationship to chemotherapy, with adjuvant testing (e.g., EMG) used in severe or atypical cases. Symptomatic antineuropathic and topical medication are often prescribed, but personalized and multidimensional care based on individual symptoms and preferences is highly valued. The limited efficacy of existing treatments, and the lack of standardized protocols, interdisciplinary coordination, and awareness among healthcare providers pose significant challenges.

Conclusion

Besides the obvious need for better therapeutic options, and multidisciplinary exploration of patients’ perspectives, a structured and collaborative approach towards diagnosis, treatment, referral, and follow-up, nurtured by improving knowledge and use of existing CIPN guidelines, could enhance care.
E-waste circular economy decision-making: a comprehensive approach for sustainable operation management in the UK
Authors: Yazdi Mohammad , Moradi Rosita , Nedjati Arman , Ghasemi Pirbalouti Reza , Li He
Published: April 2024

E-waste generation has broadly increased worldwide and is called intense pressure on sustainable practice implementation firms by recycling and redesigning the products. Thus, e-waste operation management in developed countries like the UK has become the top priority and is subjected to multiple sustainable circular economies (CE) contributing factors, including social, technical, environmental, and governmental policies. The authorized decision-makers can benefit from a well-established systematic decision-making tool to assess and evaluate the e-waste operation management considering the potential CE contributing factors. An extensive literature overview is expanded to identify the most relevant and influential contributing factors to e-waste CE. The city of London Metropolitan has been selected as the case location. In this regard, it is necessary to utilize an advanced multi-criteria decision-making tool to explore the interdependency and causality of CE-relevant factors. The present study proposed an innovative decision-making approach to address the multiple contributing factors of causality, interdependency, data, and model uncertainty in practice. It uses the step-wise weighted influence nonlinear gauge system method integrated with Fermatean fuzzy linguistic sets. This study conducted a sensitivity analysis to evaluate the effectiveness of the proposed decision-making approach in e-waste operation management. The results are promising, clearly demonstrating the framework’s competence. The CE index, crucial in designing e-waste operation management strategies, was calculated to be 2.8036. Among the various factors analyzed, “Environmental Management Systems” emerged as the most significant driving factor. This underscores the critical need to improve environmental management systems within e-waste operations.
A hybrid connectionist/LCS for hidden-state problems
Authors: Mitchell Matthew
Published: April 2024

This paper describes and evaluates the performance of a learning classifier system (lcs) inspired algorithm called Temporal Reinforcement And Classification Architecture (traca) on maze navigation tasks which contain hidden state. The evaluation of traca includes comparisons with other learning algorithms on selected difficult maze navigation tasks. Not all lcss are capable of learning all types of hidden-state mazes so traca is specifically compared against selected other lcs-based approaches that are most capable on these tasks, including xcsmh, AgentP (G), and AgentP (SA). Each algorithm is evaluated using a maze navigation task that has been identified as among the most difficult due to recurring aliased regions. The comparisons between algorithms include training time, test performance, and the size of the learned rule sets. The results indicate that each algorithm has its own advantages and drawbacks. For example, on the most difficult maze traca’s average steps to the goal are 10.1 while AgentP (G) are 7.87; however, traca requires an average of only 354 training trials compared with 537 for AgentP (G). Following the maze tasks, traca is also tested on two variations in a truck driving task where it must learn to navigate four lanes of slower vehicles while avoiding collisions. The results show that traca can achieve a low number of collisions with relatively few trials (as low as 24 collisions over 5000 time steps after 10,000 training time steps) but may require multiple network construction attempts to achieve high performance.
Effective Elastic Properties and Micro-mechanical Damage Evolution of Composite Granular Rocks: Insights from Particulate Discrete Element Modelling
Authors: Pothana Prasad , Garcia Fernando E. , Ling Kegang
Published: April 2024

The mechanical behavior of composite granular rocks is a multifaceted phenomenon with broad relevance in various geomechanical applications. Traditional homogenization models and continuum mechanics-based numerical methods often fall short of accurately capturing the intricacies of granular materials. Granular materials exhibit heterogeneity and arching mechanisms governing the force networks that ensure system stability. Unlike continuum-based approaches, discrete element methods (DEM) have an advantage in assessing effective material properties by considering material heterogeneity and grain-level physical interactions. This study evaluates effective elastic properties using DEM with flat-joint contact law for composite binary mixtures with a stiff inclusion embedded within a matrix material. We examine variations in the elastic properties across different structural and laminated geometrical distributions of inclusion materials. Our findings closely adhere to the Voigt-Reuss and Hashin–Strikman bounds within their specific conditions, demonstrating the promising application of DEM in the analysis of composite materials. In addition, our research provides an in-depth analysis of the distinctive stress-evolution and damage-evolution characteristics exhibited by various geometrical configurations of inclusions under unconfined compressive loading. These results offer invaluable insights into the mechanical behavior of composite granular rocks and underscore the potential applications of DEM in addressing rock physics modeling problems encountered in petroleum engineering.
Trends in incidence and treatments of spontaneous subarachnoid hemorrhage- a 10 year hospital based study
Authors: Ronne-Engström Elisabeth , Borota Ljubisa , Lenell Samuel , Lewén Anders , Mahmoud Ehab , Nyberg Christoffer , Velle Fartein , Enblad Per
Published: April 2024

Background

Improved endovascular methods make it possible to treat complex ruptured aneurysms, but surgery is still needed in certain cases. We evaluated the effects on the clinical results of the changes in aneurysm treatment.

Methods

The study cohort was 837 patients with spontaneous subarachnoid hemorrhage (SAH) and one or multiple aneurysms, admitted to Dept of Neurosurgery, Uppsala University Hospital from 2012 to 2021. Demography, location and treatment of aneurysms, neurologic condition at admission and discharge, mortality and last tier treatment of high intracranial pressure (ICP) was evaluated. Functional outcome was measured using the Extended Glasgow Outcome Scale (GOSE) Data concerning national incidences of stroke diseases was collected from open Swedish databases.

Results

Endovascular methods were used in 666 cases (79.6%). In 111 (13.3%) with stents. Surgery was performed in 115 cases (13.7%) and 56 patients (6.7%) had no aneurysm treatment. The indications for surgery were a hematoma (51 cases, 44.3%), endovascular treatment not considered safe (47 cases, 40.9%), or had been attempted without success (13 cases, 11.3%). Treatment with stent devices increased, and with surgery decreased over time. There was a trend in decrease in hemicraniectomias over time. Both the patient group admitted awake (n = 681) and unconscious (n = 156) improved significantly in consciousness between admission and discharge. Favorable outcome (GOSE 5–8) was seen in 69% for patients admitted in Hunt & Hess I-II and 25% for Hunt & Hess III-V. Mortality at one year was 10.9% and 42.7% for those admitted awake and unconscious, respectively.The number of cases decreased during the study period, which was in line with Swedish national data.

Conclusions

The incidence of patients with SAH gradually decreased in our material, in line with national data. The treatment policy in our unit has been shifting to more use of endovascular methods. During the study period the use of hemicraniectomies decreased.
Rising incidence of severe maxillofacial space infections in Germany
Authors: Meisgeier Axel , Pienkohs Simon , Dürrschnabel Florian , Neff Andreas , Halling Frank
Published: April 2024

Objectives

Severe maxillofacial space infection (MSI) as an end stage of dentoalveolar diseases or complication of sialadenitis is a potentially life-threatening disease accompanied by complications including airway obstruction, jugular vein thrombosis, descending mediastinitis, sepsis and acute respiratory distress syndrome. The aim of this study was to analyze the incidence and time trends of severe MSI and potentially influencing factors in the German healthcare system over time.

Materials and methods

Nationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system was received from the German Federal Statistical Office. A retrospective analysis of incidence and time trends of MSI-associated procedures classified with the Operation and Procedure Classification System (OPS), were statistically evaluated using Poisson regression analysis between 2005 and 2022 and were associated with different epidemiological factors.

Results

The total standardized incidence rate of MSI-associated procedures in the observational period 2005—2022 was 9.8 (♀8.2; ♂11.4) per 100,000 person years. For all age groups a significant increase of 46.1% in severe MSI – related surgical interventions was registered within the observational period. The largest increase (120.5%) was found in elderly patients over 80 years. There were significant differences of the incidences of MSI-associated surgeries between the different federal states in Germany.

Conclusions

Severe MSI are a growing challenge in German health care especially among elderly patients over 80 years.

Clinical relevance

Severe MSI is a promising target for prevention. There should be more focus in primary dental and medical care especially in groups depending on social support.
Block-wise imputation EM algorithm in multi-source scenario: ADNI case
Authors: Campos Sergio , Zamora Juan , Allende Héctor ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: April 2024

Alzheimer’s disease is the most common form of dementia and the early detection is essential to prevent its proliferation. Real data available has been of paramount importance in order to achieve progress in the automatic detection despite presenting two major challenges: Multi-source observations containing Magnetic resonance (MRI), Positron emission tomography (PET) and Cerebrospinal fluid data (CSF); and also missing values within all these sources. Most machine learning techniques perform this predictive task by using a single data modality. Nevertheless, the integration of all these sources of evidence could possibly bring a higher performance at different stages of disease progression. The Expectation Maximization (EM) algorithm has been successfully employed to handle missing values, but it is not designed for typical Machine Learning scenarios where an imputation model is created over training data and subsequently applied on a testing set. In this work, we propose EMreg-KNN, a novel supervised and multi-source imputation algorithm. Based on the EM algorithm, EMreg-KNN builds a regression ensemble model for the imputation of future data thus allowing the further utilization of any vector-based Machine Learning method to automatically assess the Alzheimer’s disease diagnosis. Using the ADNI database, the proposed method achieves significant improvements on F1, AUC and Accuracy measures over classical imputation methods for this database using four classification algorithms. Considering these classifiers in four different classification scenarios, our algorithm is experimentally superior in terms of the F measure, in nearly 82% of the cases under evaluation.
“This community will grow” — little concern for future wildfires in a dry and increasingly hotter Swedish rural community
Authors: Eriksson Kerstin , Sjöström Johan , Vermina Plathner Frida
Published: April 2024

Increased risk of wildfires is often highlighted in media coverage of climate change in the Nordic countries. How an increased risk is reflected in the concerns and adaptive measures within the most likely affected communities is nevertheless not known. This study investigates concerns and adaptation to wildfires in a rural community in south-eastern Sweden. The comparatively dry study area has a history of frequent but often low-consequence wildfires and is projected to experience Sweden’s largest increase in severe fire weather towards 2100. Through narratives, this study elucidates potential wildfire concerns in this area and motivations behind adaptation measures. The narratives are compared to a physical causal network extracted from the literature on fires and their consequences in the region. Residents foresee an increased wildfire risk but do not consider it a threat to the future well-being of the community. Forest owners and homeowners express low commitment in preventive or adaptive measures. Instead, contrasting the reality of the twentieth century, the fire service is currently considered to be responsible for both preventing and suppressing fires. This attitude is attributed to the lack of severe implications from the generally well-managed fires in the region. Actions for prevention and adaptation seem triggered by media attention or experience from real high-consequence events occurring elsewhere, rather than local wildfire occurrence or climate change projections.
Thick-billed Murres in breeding pairs migrate and overwinter far apart but in similar photic environments
Authors: Huffeldt Nicholas P. , Ballesteros Manuel , Helm Barbara , Linnebjerg Jannie F. , Merkel Flemming R. , Mosbech Anders , Frederiksen Morten
Published: April 2024

Scheduling between mates in species with long-term pair bonds can be essential for positive fitness. The annual cycle in photoperiod is the primary environmental cue used by many animals to synchronize behavior and physiology among members of a population, and animals that migrate must have similar annual schedules to ensure successful breeding. However, we know little about whether members of mated pairs in migratory species experience similar photic environments across the year, which could allow for synchronization in annual phenology. Here, we used light-based geolocation to estimate positions of mated pairs of Thick-billed Murres (Uria lomvia, a seabird a.k.a. Brünnich’s Guillemot) which bred above the northern polar circle in Greenland. We tested the hypothesis that individuals in mated pairs occur in more similar locations and photic environments than randomly matched females and males. We found no difference in the amount of spatial separation or in the photic environment between mates and randomized heterosexual pairings. In general, the distance between females and males ranged from 1,198.5 km during August to 737.4 km during January. The sexes remained in photic environments with highly correlated photoperiods and moderately correlated times of solar noon in UTC. The spatial separation of, but similar photic environments experienced by, female and male murres regardless of pair status is probably adaptive by facilitating the synchronization of annual schedules between sexes, while allowing individuals in mated pairs the freedom to pursue the best foraging opportunities during migration and overwintering independent of their mate.
Toupet fundoplication to prevent progression of scleroderma-associated interstitial lung damage: a study protocol
Authors: Aiolfi Alberto , Bona Davide , Manara Michele , Ogliari Cristina , Baldessari Chiara , Resta Marco , Del Papa Nicoletta , Cirri Silvia , Baisi Alessandro , Bonitta Gianluca , Sconfienza Luca , Harari Sergio , Nosotti Mario , Vecchi Maurizio , Schoppmann Sebastian F. , Bonavina Luigi
Published: April 2024

Background

Systemic sclerosis (SSc) is a rare autoimmune and multiorgan disorder. Hallmarks of the disease include inflammation, endothelial dysfunction, and dysregulation of fibroblasts leading to fibrosis of the skin and internal organs. The esophagus is often involved, with up to 80% of patients developing gastroesophageal reflux disease (GERD). Reflux can be associated with hiatal hernia and several complications such as erosive esophagitis, peptic stricture, Barrett’s esophagus, aspiration pneumonia, and chronic microaspiration. Silent aspiration can lead to interstitial lung disease (ILD) in up to 50% of patients with scleroderma and accounts for up to 40% of mortality. Treatment of GERD in patients with SSc is challenging. Proton pump inhibitors (PPI) have been shown effective in relieving typical GERD symptoms, but up to 40% of patients are non-responders. Various antireflux surgical procedures have been proposed to treat GERD and to modify the natural course of the disease by preventing lung damage in these patients. However, current algorithms consider only the degree of esophageal dilation as a marker of disease severity/progression, and results of antireflux surgery remain controversial.

Methods

We propose a feasibility, observational, multicenter, single-arm trial including adult patients diagnosed with SSc. Criteria for inclusion are individuals with GERD symptoms refractory to PPI, absence of peptic stricture at baseline endoscopy, high-resolution computed tomography (HRCT) scan showing no or less than 10% lung fibrosis, forced vital capacity at least 40% of the predicted value, and diffusing capacity of lung for carbon monoxide 30–89% of the predicted value. A laparoscopic partial posterior fundoplication according to the Toupet technique will be performed. Primary study outcome is the efficacy of fundoplication to reduce reflux exposure measured with a pH-impedance study or 4‑day wireless pH recording. Secondary outcomes include endoscopic, HRCT, and respiratory function tests findings as well as quality of life at 12-month follow-up.

Conclusions

The expected reduction of reflux burden in SSc patients selected for Toupet fundoplication may improve GERD symptoms/complications, pulmonary function, and quality of life, and may be associated with a reduced risk for lung transplant.
Synthesis of New D–π–A Phenothiazine-Based Fluorescent Dyes: Aggregation Induced Emission and Antibacterial Activity
Authors: El-Sedik Mervat S. , Mohamed Mahmoud Basseem I. , Abdel-Aziz Mohamed S. , Aysha Tarek S.
Published: April 2024

Highly solid-state fluorescent dyes based on phenothiazine bearing sulfa-drug derivatives were successfully prepared and fully characterized by NMR, mass spectra, and elemental analysis. The prepared phenothiazine dyes bearing sulfadiazine and sulfathiazole 4-(((10-hexyl-10 H-phenothiazin-3-yl)methylene)amino)-N-(pyrimidin-2yl) benzenesulfonamide (PTZ-1) and 4-(((10-hexyl-10 H-phenothiazin-3-yl) methylene) amino)-N-(thiazol-2-yl)benzenesulfonamide (PTZ-2), showed strong emission in polycrystalline form, and significant emission in solution was observed. The quantum yield of the prepared dyes varied and decreased by increasing the solvent polarity, with the maximum recorded value being 0.63 and 0.6 in dioxane. Aggregation-induced emission (AIE) and the effect of the solvent polarity on absorption and emission spectra were investigated. The dyeing application of polyester fabrics using the prepared phenothiazine-based dyes was studied, showing very good affinity to dyed fabrics. The antibacterial affinity against gram-positive and gram-negative bacteria for the dye powder as well as the dyed PET fabric was investigated, with PTZ-2 showing better affinity against bacteria compared to PTZ-1. This multifunctional property highlights the potential uses of PTZ-1 and PTZ-2 for advanced applications in biomedicine and optoelectronics.
Hearing Difficulties Among Farmworkers in the México-US Southwest Border Region
Authors: Coco Laura , Sanchez Gabriela D. , Campuzano Gabriel A. , Keeney Annie J. , Romine James K.
Published: April 2024

Migrant and seasonal farmworkers are a vulnerable population with a potentially high risk for hearing loss due to farm-related noise exposures. Occupational noise-induced hearing loss (NIHL) is permanent, and it is associated with an increased risk for injuries on the job, as well as communication difficulties, isolation, and depression. The México/US border region is one of the most productive agricultural regions in the country, however, no known studies have explored hearing loss among farmworkers in this area. This pilot study was a first step toward measuring and addressing hearing loss and noise exposure among this region’s farmworkers. We conducted a cross-sectional survey to estimate the prevalence of subjective hearing difficulties among Yuma County, Arizona farmworkers. Survey interviews took place during a late-night farmworker health fair from 2 am to 6 am to accommodate local farms’ labor schedules. Multivariable regression adjusted for demographic and work covariates estimated subjective hearing loss prevalence ratios. Among 132 farmworker participants, 36% reported they have or might have hearing loss, and 62% reported no hearing loss. Subjective hearing loss prevalence was lower in farmworkers who report not working in noise compared to prevalence in farmworkers who work in noise [prevalence ratio, 0.44 (95% CI 0.23–0.82)]. This report contributes to understanding the perception of hearing-related health and occupational exposures among farmworkers in the México-US Southwest border region. The information from this line of research will inform appropriate safety measures known to lower the risk of experiencing occupational NIHL.
Real-time multibody simulation of vehicle wheel suspensions of different topologies with elastokinematic properties
Authors: Archut Jan-Lukas , Corves Burkhard
Published: April 2024

Driving simulators are becoming increasingly important in vehicle development, as they allow test drivers to evaluate the driving characteristics of a vehicle at an early stage of the development process. Vehicle dynamics models used for such real-time applications are usually simplified to achieve sufficiently low computation times, especially with respect to the elastokinematic properties of the wheel suspension. This contribution introduces a real-time capable multibody simulation model for wheel suspensions taking into account their elastokinematics. The underlying data model allows the parametrization of different suspension topologies. Linear-implicit integration methods enable real-time capable integration of the underlying numerically stiff equation of motion without major model simplifications. It is shown how the computational effort of linear-implicit integration can be reduced by explicitly taking the suspension topology into account. A versatile process for the analytical online-linearization of the equation of motion of arbitrary suspension topologies is presented. Both a double wishbone and a multilink suspension are simulated with very high accuracy in real-time on a standard PC.
Hot Corrosion Behavior of La2Ce2O7-Based Plasma-Sprayed Coating
Authors: Ariharan S. , Parchovianský Milan , Singh Pushpender , Rani Pooja , Maurya Rita , Sekar Anusha , Keshri Anup Kumar , Pakseresht Amirhossein
Published: April 2024

La2Ce2O7 (LC) has been identified as a promising thermal barrier coating (TBC) for use up to 1250 °C. In this study, a TBC system was deposited on grit-blasted Inconel 738 using atmospheric plasma spraying (APS) with NiCrAlY as the bond coat, followed by YSZ, and then LC as the top layer. The coatings were exposed to a mixture of molten Na2SO4 (45 wt.%) and V2O5 (55 wt.%) at 950 °C for hot corrosion. On the top LC layer, LaVO4, CeVO4 and CeO(1.66–2.00) formed as hot corrosion products after 4 h exposure. A reaction between YSZ and the corrosion products could not be observed due to the absence of YVO4. The hot corrosion mechanism of the LC-based TBC is also discussed in this study.