bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Registry of Acute Coronary Events Score Underestimates Post-Acute Coronary Syndrome Mortality among Cancer Patients
Authors: Koo Chieh-Yang , Zheng Huili , Tan Li-Ling , Foo Ling-Li , Shih E’Ching , Hausenloy Derek J. , Soo Ross A. , Wong Alvin S. , Richards Arthur M. , Lee Chi-Hang , Chan Mark Y.
Published: October 2023

Background Patients with prior cancer are at increased risk of acute coronary syndrome (ACS) with poorer post-ACS outcomes. We aimed to ascertain if the Global Registry of Acute Coronary Events (GRACE) score accurately predicts mortality risk among patients with ACS and prior cancer. Methods We linked nationwide ACS and cancer registries from 2007 to 2018 in Singapore. A total of 24,529 eligible patients had in-hospital and 1-year all-cause mortality risk calculated using the GRACE score (2471 prior cancer; 22,058 no cancer). Results Patients with prior cancer had two-fold higher all-cause mortality compared to patients without cancer (in-hospital: 22.8% versus 10.3%, p < 0.001; 1-year: 49.0% vs. 18.7%, p < 0.001). Cardiovascular mortality did not differ between groups (in-hospital: 5.2% vs. 4.8%, p = 0.346; 1-year: 6.9% vs. 6.1%, p = 0.12). The area under the receiver operating characteristic curve of the GRACE score for prediction of all-cause mortality was less for prior cancer (in-hospital: 0.64 vs. 0.80, p < 0.001; 1-year: 0.66 vs. 0.83, p < 0.001). Among patients with prior cancer and a high-risk GRACE score > 140, in-hospital revascularization was not associated with lower cardiovascular mortality than without in-hospital revascularization (6.7% vs. 7.6%, p = 0.50). Conclusions The GRACE score performs poorly in risk stratification of patients with prior cancer and ACS.
Machine Learning Allows for Distinguishing Precancerous and Cancerous Human Epithelial Cervical Cells Using High-Resolution AFM Imaging of Adhesion Maps
Authors: Petrov Mikhail , Sokolov Igor
Published: October 2023

Previously, the analysis of atomic force microscopy (AFM) images allowed us to distinguish normal from cancerous/precancerous human epithelial cervical cells using only the fractal dimension parameter. High-resolution maps of adhesion between the AFM probe and the cell surface were used in that study. However, the separation of cancerous and precancerous cells was rather poor (the area under the curve (AUC) was only 0.79, whereas the accuracy, sensitivity, and specificity were 74%, 58%, and 84%, respectively). At the same time, the separation between premalignant and malignant cells is the most significant from a clinical point of view. Here, we show that the introduction of machine learning methods for the analysis of adhesion maps allows us to distinguish precancerous and cancerous cervical cells with rather good precision (AUC, accuracy, sensitivity, and specificity are 0.93, 83%, 92%, and 78%, respectively). Substantial improvement in sensitivity is significant because of the unmet need in clinical practice to improve the screening of cervical cancer (a relatively low specificity can be compensated by combining this approach with other currently existing screening methods). The random forest decision tree algorithm was utilized in this study. The analysis was carried out using the data of six precancerous primary cell lines and six cancerous primary cell lines, each derived from different humans. The robustness of the classification was verified using K-fold cross-validation (K = 500). The results are statistically significant at p < 0.0001. Statistical significance was determined using the random shuffle method as a control.
Maladaptive T-Cell Metabolic Fitness in Autoimmune Diseases
Authors: Antony Irene Rose , Wong Brandon Han Siang , Kelleher Dermot , Verma Navin Kumar
Published: October 2023

Immune surveillance and adaptive immune responses, involving continuously circulating and tissue-resident T-lymphocytes, provide host defense against infectious agents and possible malignant transformation while avoiding autoimmune tissue damage. Activation, migration, and deployment of T-cells to affected tissue sites are crucial for mounting an adaptive immune response. An effective adaptive immune defense depends on the ability of T-cells to dynamically reprogram their metabolic requirements in response to environmental cues. Inability of the T-cells to adapt to specific metabolic demands may skew cells to become either hyporesponsive (creating immunocompromised conditions) or hyperactive (causing autoimmune tissue destruction). Here, we review maladaptive T-cell metabolic fitness that can cause autoimmune diseases and discuss how T-cell metabolic programs can potentially be modulated to achieve therapeutic benefits.
Training the Vessels: Molecular and Clinical Effects of Exercise on Vascular Health—A Narrative Review
Authors: Königstein Karsten , Dipla Konstantina , Zafeiridis Andreas
Published: October 2023

Accelerated biological vascular ageing is still a major driver of the increasing burden of cardiovascular disease and mortality. Exercise training delays this process, known as early vascular ageing, but often lacks effectiveness due to a lack of understanding of molecular and clinical adaptations to specific stimuli. This narrative review summarizes the current knowledge about the molecular and clinical vascular adaptations to acute and chronic exercise. It further addresses how training characteristics (frequency, intensity, volume, and type) may influence these processes. Finally, practical recommendations are given for exercise training to maintain and improve vascular health. Exercise increases shear stress on the vascular wall and stimulates the endothelial release of circulating growth factors and of exerkines from the skeletal muscle and other organs. As a result, remodeling within the vascular walls leads to a better vasodilator and -constrictor responsiveness, reduced arterial stiffness, arterio- and angiogenesis, higher antioxidative capacities, and reduced oxidative stress. Although current evidence about specific aspects of exercise training, such as F-I-T-T, is limited, and exact training recommendations cannot be given, some practical implications can be extracted. As such, repeated stimuli 5–7 days per week might be necessary to use the full potential of these favorable physiological alterations, and the cumulative volume of mechanical shear stress seems more important than peak shear stress. Because of distinct short- and long-term effects of resistance and aerobic exercise, including higher and moderate intensities, both types of exercise should be implemented in a comprehensive training regimen. As vascular adaptability towards exercise remains high at any age in both healthy individuals and patients with cardiovascular diseases, individualized exercise-based vascular health prevention should be implemented in any age group from children to centenarians.
Integrating “Top-Down” and “Community-Centric” Approaches for Community-Based Flood Early Warning Systems in Namibia
Authors: Josè Moisès Deolfa , Kgabi Nnenesi , Kunguma Olivia
Published: October 2023

The United Nations Office for Disaster Risk Reduction (UNDRR) resolutely endorses the development of people-centred early warning systems. Moreover, several scientific studies have deprecated the vast technology-driven technocratic approaches to implementing these systems, contending the prioritisation of communities and their contextualised needs for systems that ensure effective risk protection and resilience building. However, both the UNDRR and the scientific literature have failed to define appropriate means of implementation (MoI) for community-based early warning system (CBEWS) development. Floods are a major hazard annually impacting several communities in rural sub-Saharan Africa, and though several opportunities for participatory systems have been identified, investment in developing countries is often lagging, and no defined mechanism for developing these systems exists. Adopting a modified Integrated Emergency Management Framework, this study demonstrates that an impact-based CBEWS can be established by leveraging existing resources, institutions and stakeholders, essentially merging last-mile and first-mile approaches. The study further reveals that directly linking technical capacities with community-based efforts allows communities to define system development parameters, strengthen risk knowledge and response, and build resilience for improved physical, economic and environmental protection, essentially bridging the gap between first and last-mile approaches. The study also highlights the need for governments to appropriately streamline DRR to improve coordination and communication.
Children and Young People with Long COVID—Comparing Those Seen in Post-COVID Services with a Non-Hospitalised National Cohort: A Descriptive Study
Authors: Newlands Fiona , Goddings Anne-Lise , Juste Maude , Boyd Holly , Nugawela Manjula D. , Pinto Pereira Snehal M. , Whelan Emily , Whittaker Elizabeth , Stephenson Terence , Heyman Isobel , Chalder Trudie , Dalrymple Emma ,   CLoCk Consortium, Segal Terry , Shafran Roz
Published: October 2023

Background: Post-COVID services have been set up in England to treat children with ongoing symptoms of Long COVID. To date, the characteristics of children seeking treatment from these services has not been described. Purpose: (1) to describe the characteristics of children aged 11–17 referred to the Pan-London Post-COVID service and (2) to compare characteristics of these children with those taking part in the United Kingdom’s largest research study of Long COVID in children (CLoCk). Design: Data from 95 children seeking treatment from the Post-COVID service between May 2021 and August 2022 were included in the study. Their demographic characteristics, symptom burden and the impact of infection are described and compared to children from CLoCk. Results: A high proportion of children from the Post-COVID service and CLoCk reported experiencing health problems prior to the pandemic. Almost all Post-COVID service children met the research Delphi definition of Long COVID (94.6%), having multiple symptoms that impacted their lives. Symptoms were notably more severe than the participants in CLoCk. Conclusions: This study describes the characteristics of children seeking treatment for Long COVID compared to those identified in the largest longitudinal observational study to date. Post-COVID service children have more symptoms and are more severely affected by their symptoms following infection with COVID-19 than children in the CLoCk study. Research to understand predisposing factors for severity and prognostic indicators is essential to prevent this debilitating condition. Evaluation of short- and long-term outcomes of interventions by clinical services can help direct future therapy for this group.
Early Respiratory Physiotherapy versus an Individualized Postural Care Program for Reducing Mechanical Ventilation in Preterm Infants: A Randomised Controlled Trial
Authors: Tana Milena , Bottoni Anthea , Cota Francesco , Papacci Patrizia , Di Polito Alessia , Del Vecchio Arianna , Vento Anna Laura , Campagnola Benedetta , Celona Sefora , Cricenti Laura , Bastoni Ilaria , Tirone Chiara , Aurilia Claudia , Lio Alessandra , Paladini Angela , Nobile Stefano , Perri Alessandro , Sbordone Annamaria , Esposito Alice , Fattore Simona , Ferrara Paola Emilia , Ronconi Gianpaolo , Vento Giovanni
Published: October 2023

Background: Tactile stimulation manoeuvres stimulate spontaneous breathing in preterm newborns. The aim of this study is to evaluate the effect of early respiratory physiotherapy on the need for mechanical ventilation during the first week of life in preterm infants with respiratory failure. Methods: This is a monocentric, randomised controlled trial. Preterm infants (gestational age ≤ 30 weeks) not intubated in the delivery room and requiring non-invasive respiratory support at birth were eligible for the study. The intervention group received early respiratory physiotherapy, while the control group received only a daily physiotherapy program (i.e., modifying the infant’s posture in accordance with the patient’s needs). Results: between October 2019 and March 2021, 133 preterm infants were studied, 68 infants in the study group and 65 in routine care. The study group showed a reduction in the need for mechanical ventilation (not statistically significant) and a statistically significant reduction in hemodynamically significant patent ductus arteriosus with respect to the control group (19/68 (28%) vs. 35/65 (54%), respectively, p = 0.03). Conclusions: early respiratory physiotherapy in preterm infants requiring non-invasive respiratory support at birth is safe and has proven to be protective against haemodynamically significant PDA.
Neuromodulation in Pediatric Migraine using Repetitive Neuromuscular Magnetic Stimulation: A Feasibility Study
Authors: Börner-Schröder Corinna , Lang Magdalena , Urban Giada , Zaidenstadt Erik , Staisch Jacob , Hauser Ari , Hannibal Iris , Huß Kristina , Klose Birgit , Lechner Matthias F. , Sollmann Nico , Landgraf Mirjam N. , Heinen Florian , Bonfert Michaela V.
Published: October 2023

Migraine has a relevant impact on pediatric health. Non-pharmacological modalities for its management are urgently needed. This study assessed the safety, feasibility, acceptance, and efficacy of repetitive neuromuscular magnetic stimulation (rNMS) in pediatric migraine. A total of 13 patients with migraine, ≥6 headache days during baseline, and ≥1 myofascial trigger point in the upper trapezius muscles (UTM) received six rNMS sessions within 3 weeks. Headache frequency, intensity, and medication intake were monitored using headache calendars; headache-related impairment and quality of life were measured using PedMIDAS and KINDL questionnaires. Muscular involvement was assessed using pressure pain thresholds (PPT). Adherence yielded 100%. In 82% of all rNMS sessions, no side effects occurred. All participants would recommend rNMS and would repeat it. Headache frequency, medication intake, and PedMIDAS scores decreased from baseline to follow-up (FU), trending towards statistical significance (p = 0.089; p = 0.081, p = 0.055). A total of 7 patients were classified as responders, with a ≥25% relative reduction in headache frequency. PPT above the UTM significantly increased from pre- to post-assessment, which sustained until FU (p = 0.015 and 0.026, respectively). rNMS was safe, feasible, well-accepted, and beneficial on the muscular level. The potential to reduce headache-related symptoms together with PPT changes of the targeted UTM may underscore the interplay of peripheral and central mechanisms conceptualized within the trigemino-cervical complex.
Predicting Chronic Hyperplastic Candidiasis Retro-Angular Mucosa Using Machine Learning
Authors: Moztarzadeh Omid , Liska Jan , Liskova Veronika , Skalova Alena , Topolcan Ondrej , Jamshidi Alireza , Hauer Lukas
Published: October 2023

Chronic hyperplastic candidiasis (CHC) presents a distinctive and relatively rare form of oral candidal infection characterized by the presence of white or white–red patches on the oral mucosa. Often mistaken for leukoplakia or erythroleukoplakia due to their appearance, these lesions display nonhomogeneous textures featuring combinations of white and red hyperplastic or nodular surfaces. Predominant locations for such lesions include the tongue, retro-angular mucosa, and buccal mucosa. This paper aims to investigate the potential influence of specific anatomical locations, retro-angular mucosa, on the development and occurrence of CHC. By examining the relationship between risk factors, we present an approach based on machine learning (ML) to predict the location of CHC occurrence. In this way, we employ Gradient Boosting Regression (GBR) to classify CHC lesion locations based on important risk factors. This estimator can serve both research and diagnostic purposes effectively. The findings underscore that the proposed ML technique can be used to predict the occurrence of CHC in retro-angular mucosa compared to other locations. The results also show a high rate of accuracy in predicting lesion locations. Performance assessment relies on Mean Squared Error (MSE), Root Mean Squared Error (RMSE), R-squared (R2), and Mean Absolute Error (MAE), consistently revealing favorable results that underscore the robustness and dependability of our classification method. Our research contributes valuable insights to the field, enhancing diagnostic accuracy and informing treatment strategies.
Thickness-Dependent Terahertz Permittivity of Epitaxially Grown PbTe Thin Films
Authors: Kawahala Nicolas M. , Matos Daniel A. , Rappl Paulo H. O. , Abramof Eduardo , Baydin Andrey , Kono Junichiro , Hernandez Felix G. G.
Published: October 2023

The exceptional thermoelectric properties of PbTe are believed to be associated with the incipient ferroelectricity of this material, which is caused by strong electron–phonon coupling that connects phononic and electronic dynamics. Here, we have used terahertz time-domain spectroscopy measurements to generate complex permittivity spectra for a set of epitaxially grown PbTe thin films with thicknesses between 100 nm and 500 nm at temperatures from 10 K to 300 K. Using a Drude–Lorentz model, we retrieved the physical parameters of both the phononic and electronic contributions to the THz permittivity. We observed a strong decrease, or softening, of the transverse optical phonon mode frequency with decreasing temperature, determining a thickness-independent negative ferroelectric-transition critical temperature, while we found a thickness-dependent anharmonic phonon decay lifetime. The electronic contribution to the permittivity was larger in thinner films, and both the carrier density and mobility increased with decreasing temperature in all films. Finally, we detected a thickness-dependent longitudinal optical phonon mode frequency, indicating the presence of plasmon–phonon coupling.
Effects of the Second Anodization Parameters on the Hydrophobicity and Anti-Icing Properties of Al Surface with Composite Nanopore Structure
Authors: Li Bo , Bai Jie , Yang Liuqing , Zhang Lusong , Dai Xu , Zhang Cheng , Hua Xujiang , Zhu Tao , Xiang Huiying , Liao Ruijin , Yuan Yuan
Published: October 2023

Icing on transmission lines often causes potential electric damage in power systems. Superhydrophobic anodized Al conductors have been proposed to have good anti-icing properties. In this study, superhydrophobic anodized Al conductors with composite nanopore structures were prepared by a two-step anodization. The microstructure, hydrophobicity, and anti-icing properties of composite nanopore structures were compared and studied. The optimal preparation parameter was determined as a current density of 0.04375 A/cm2 and anodization time of 15 min. Compared with the bare substrate, the optimal anodized Al surface of the composite nanopore structures show excellent hydrophobic and anti-icing properties, including a contact angle of 173°, a contact angle hysteresis of 0.122°, an ice adhesion strength of 0.71 kPa, and a glaze icing weight of 0.1 g after the 8 h. Therefore, the prepared anodized Al surface of composite nanopore structures with good anti-icing properties has profound application potential for overhead transmission lines.
Mechanical Properties and Optimal Mix Design of Phosphogypsum Cement Mineral Admixture Foam Light Soil
Authors: Xu Bin , Gao Aodong , Chen Zhouxiang , Zhou Yingxin , Lu Kaiji , Zheng Qi
Published: October 2023

With the rapid growth of road transportation, the increase in road subgrade and pavement diseases has become a pressing issue, requiring the development of cost-effective filling materials that meet both strength and economic requirements. Foam lightweight soil, as a novel construction material, offers excellent characteristics such as adjustability in density and strength, high fluidity, and self-supporting capabilities. It has been widely utilized in various engineering applications, including road subgrade backfilling and retaining wall fillings. However, the conventional application of foam lightweight soil, predominantly cement-based, has raised concerns about pollution and high energy consumption due to large cement dosages. To address this issue, this study proposes the integration of phosphogypsum, a byproduct of wet-process phosphoric acid production, into foam lightweight soil. Phosphogypsum has a significant annual discharge and accumulation, but its comprehensive utilization rate remains relatively low. The research investigates the combination of phosphogypsum and foam lightweight soil by introducing mineral admixtures such as microsilica and slag powder to improve early strength development and reduce the influence of fluoride impurities on early strength. The optimal mix proportions for two types of foam lightweight soil, namely phosphogypsum cement microsilica foam (PGCF) and phosphogypsum cement slag powder foam (PGCS), were determined based on single-factor tests. The key parameters considered for optimization were water–binder ratio, foam content, and phosphogypsum dosage. The findings indicate that both PGCF and PGCS foam lightweight soil possess superior mechanical properties and thermal conductivity. By incorporating phosphogypsum into the mix, the early strength development of foam lightweight soil is effectively improved. Moreover, with suitable mix proportions, the maximum phosphogypsum dosage can be achieved, demonstrating potential economic and environmental benefits. In conclusion, this research provides valuable insights into the effective utilization of phosphogypsum in foam lightweight soil, offering a promising solution for the challenges associated with phosphogypsum disposal and the demand for sustainable construction materials in highway engineering.
Transformer-Based Model for Predicting Customers’ Next Purchase Day in e-Commerce
Authors: Grigoraș Alexandru , Leon Florin
Published: October 2023

The paper focuses on predicting the next purchase day (NPD) for customers in e-commerce, a task with applications in marketing, inventory management, and customer retention. A novel transformer-based model for NPD prediction is introduced and compared to traditional methods such as ARIMA, XGBoost, and LSTM. Transformers offer advantages in capturing long-term dependencies within time series data through self-attention mechanisms. This adaptability to various time series patterns, including trends, seasonality, and irregularities, makes them a promising choice for NPD prediction. The transformer model demonstrates improvements in prediction accuracy compared to the baselines. Additionally, a clustered transformer model is proposed, which further enhances accuracy, emphasizing the potential of this architecture for NPD prediction.
Controllable Growth of Large-Scale Continuous ReS2 Atomic Layers
Authors: Sun Xingdong , Alim Ezimetjan , Wen Yang , Wu Sumei , Cai Yongqing , Wei Zheng , Wang Yingying , Liang Yao , Zhang Zhihua
Published: October 2023

In recent years, two-dimensional (2D) layered transition metal dichalcogenides (TMDs) have received significant attention due to their exceptional electrical and optical properties. Among these 2D materials, ReS2 distinguishes itself through its unique optical and conductance anisotropy. Despite concerted efforts to produce high-quality ReS2, the unique interlayer decoupling properties pose substantial challenges in growing large-area ReS2 thin films, with the preparation of single layers proving even more complex. In this work, large-scale continuous monolayer and bilayer ReS2 films were successfully grown on mica substrates using low-pressure chemical vapor deposition (LPCVD). Photodetectors were fabricated using the prepared high-quality ReS2 films, and the devices presented stable photoresponse and enhanced response sensitivity. The production of continuous ReS2 atomic layers heralds promising prospects for large-scale integrated circuits and advances the practical application of optoelectronics based on 2D layered materials.
Overlooked Solid State Structure of 1,3-I2C6F4—The Meta-Member of an Iconic Halogen Bond Donors Trio
Authors: Torubaev Yury V. , Skabitsky Ivan V.
Published: October 2023

The solid-state structure of the meta-isomer of diiodotetrafluorobenzene (DITFB), the sole liquid DITFB at 25 °C, is reported. Computational and comparative analyses of its crystal packing have elucidated potential factors contributing to its lower melting point and reduced affinity as a halogen bond donor conformer as compared to the para-isomer. This discussion also addresses the lower melting points of ortho- and meta-isomers in general. The platelet crystal habit of 1,3-DITFB is examined in relation to its energy framework pattern, proposing a comprehensive and illustrative predictive model for its faster growth in the [001] direction. This growth aligns with the maximum attachment energy.
The Neuropsychological and Emotional Profile of Adults with Parasomnia: A Case Series
Authors: Ntafouli Maria , Bargiotas Panagiotis , Bonakis Anastasios , Lourentzos Konstantinos , Vagiakis Emmanouil , Minaritzoglou Aliki , Dikeos Dimitris , Bassetti Claudio Lino
Published: October 2023

Although parasomnias are nocturnal phenomena occurring during sleep or during arousals from sleep, there is increasing evidence that they are associated with daytime dysfunction as well. However, systematic studies in this field are scarce. The aim of the current case series was to investigate the sleep–wake, neuropsychological and emotional profiles of patients with parasomnias. Thirty patients with parasomnia (13 NREM, 17 REM) and 30 healthy subjects matched for age, sex and educational status were included. All participants underwent comprehensive neuropsychological, cognitive and behavioral evaluation. We found that parasomnia patients scored higher in all neuropsychological, emotional, sleep–wake and quality of life scales compared to healthy subjects. The presence of a parasomnia was associated with major impact on daytime functioning across several domains with increased levels of fatigue (FSS > 4) in 56%, sleepiness (ESS > 10) in 47%, depressive symptoms (BDI > 20) in 17%, anxiety (PSWQ > 52) in 17%, anger expression out (STAXI A > 16) in 27% and anger expression in (STAXI B > 16) in 23%, as well as a reduced average quality of life score (RAND derived from SF-36). Sleep–wake disturbances were significantly correlated with QoL scores. In the intergroup analysis between REM/NREM, we found that the REM group had worse cognitive performance and lower levels of fatigue/energy compared to NREM patients. These findings suggest that parasomnia is associated with difficulties in several aspects of daytime functioning (cognitive, affective/emotional and physical) and, therefore, parasomnia diagnostic workup should not be limited only to nocturnal phenomena.
Update on the Management of Stage III NSCLC: Navigating a Complex and Heterogeneous Stage of Disease
Authors: Sathiyapalan Arani , Baloush Ziad , Ellis Peter M.
Published: October 2023

Background: Stage III nonsmall cell lung cancer (NSCLC) represents a heterogeneous group of patients. Many patients are treated with curative intent multimodality therapy, either surgical resection plus systemic therapy or chemoradiation plus immunotherapy. However, many patients are not suitable for curative intent therapy and are treated with palliative systemic therapy or best supportive care. Methods: This paper is a review of recent advances in the management of patients with curative intent disease. Results: There have been significant advances in curative intent therapy for patients with stage III NSCLC in recent years. These include both adjuvant and neoadjuvant systemic therapies. For patients with resectable NSCLC, two trials have demonstrated that adjuvant atezolizumab or pembrolizumab, following chemotherapy, significantly improved disease-free survival (DFS). In patients with tumours harbouring a common mutation of the EGFR gene, adjuvant osimertinib therapy was associated with a large improvement in both DFS and overall survival (OS). Five randomized trials have evaluated chemotherapy plus nivolumab, pembrolizumab, durvalumab, or toripalimab, either as neoadjuvant or perioperative (neoadjuvant plus adjuvant) therapy. All five trials show significant improvements in the rate of pathologic complete response (pCR) and event-free survival (EFS). OS data are currently immature. This would now be considered the standard of care for resectable stage III NSCLC. The addition of durvalumab to chemoradiation has also become the standard of care in unresectable stage III NSCLC. One year of consolidation durvalumab following concurrent chemoradiation has demonstrated significant improvements in both progression-free and overall survival. Conclusions: Immune checkpoint inhibitor (ICI) therapy has become a standard recommendation in curative intent therapy for stage III NSCLC.
Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury
Authors: Rauchman Steven H. , Pinkhasov Aaron , Gulkarov Shelly , Placantonakis Dimitris G. , De Leon Joshua , Reiss Allison B.
Published: October 2023

Mild traumatic brain injury (TBI) and concussion can have serious consequences that develop over time with unpredictable levels of recovery. Millions of concussions occur yearly, and a substantial number result in lingering symptoms, loss of productivity, and lower quality of life. The diagnosis may not be made for multiple reasons, including due to patient hesitancy to undergo neuroimaging and inability of imaging to detect minimal damage. Biomarkers could fill this gap, but the time needed to send blood to a laboratory for analysis made this impractical until point-of-care measurement became available. A handheld blood test is now on the market for diagnosis of concussion based on the specific blood biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl terminal hydrolase L1 (UCH-L1). This paper discusses rapid blood biomarker assessment for mild TBI and its implications in improving prediction of TBI course, avoiding repeated head trauma, and its potential role in assessing new therapeutic options. Although we focus on the Abbott i-STAT TBI plasma test because it is the first to be FDA-cleared, our discussion applies to any comparable test systems that may become available in the future. The difficulties in changing emergency department protocols to include new technology are addressed.
Association of Chondrolabral Lesions with Ultrasound-Guided Detection of Pathological Head–Neck Contour
Authors: Schamberger Christian T. , Tuffs Christopher , Suda Arnold J. , Grossner Tobias , Schmidmaier Gerhard , Stein Stephan
Published: October 2023

Objective: This study aimed to investigate whether the asphericity of the neck–head junction of the femur confirmed via ultrasound is associated with further pathology due to femoro-acetabular impingement (FAI). Methodology: After a clinical examination with positive FAI tests, an ultrasound examination of the hip was performed. In the case of asphericity, a quantitative ultrasound-assisted assessment of the hip was performed, followed by contrast-enhanced arthro-MRI with the question of cartilage or labral damage. Results and Conclusions: We included 51 patients with a mean age of 35.25. According to the examination algorithm, asphericity was present in all patients via ultrasonography. The average anterior alpha angle (AAA) determined in ultrasonography was 43.49°. The average AAA on the arthro-MRI was 44.19°. The mean anterior head neck offset (AHNO) in ultrasound was 5.27 mm, and in arthro-MRI, it was 5.36 mm. Arthro-MRI confirmed a bump in 47 patients and a talization disorder in 4 patients. In 49 patients, a labral lesion was found, with one being a re-rupture. Furthermore, in one patient, labral degeneration was identified. Cartilage damage to the hip joint was found in 25 patients. Two patients had neither labral nor cartilage damage in the arthro-MRI. In our study, sonographically confirmed asphericity of the head–neck junction was found in 49 cases, which was associated with further pathology and, according to the current doctrine, was attributable to the FAI and required surgical intervention. This study shows that the detection of a pathologic head and neck contour via ultrasound in combination with positive clinical signs, as present in FAI, is associated with chondrolabral lesions detected via arthro-MRI in 96.1% of cases.
A Novel Algorithm for Evaluating Bone Metastatic Potential of Breast Cancer through Morphometry and Computational Mathematics
Authors: Duca-Barbu Simona-Alina , Bratei Alexandru Adrian , Lisievici Antonia-Carmen , Georgescu Tiberiu Augustin , Nemes Bianca Mihaela , Sajin Maria , Pop Florinel
Published: October 2023

Bone metastases represent about 70% of breast cancer metastases and are associated with worse prognosis as the tumor cells acquire more aggressive features. The selection and investigation of patients with a high risk of developing bone metastasis would have a significant impact on patients’ management and survival. The patients were selected from the database of Carol Davila Clinical Nephrology Hospital of Bucharest. Their tumor specimens were pathologically processed, and a representative area was selected. This area was scanned using an Olympus VS200 slide scanner and further analyzed using QuPath software v0.4.4. A representative group of approximately 60–100 tumor cells was selected from each section, for which the following parameters were analyzed: nuclear area, nuclear perimeter, long axis and cell surface. Starting from these measurements, the following were calculated: the mean nuclear area and mean nuclear volume, the nucleus to cytoplasm ratio, the length of the two axes, the long axis to short axis ratio, the acyclicity and anellipticity grade and the mean internuclear distance. The tumor cells belonging to patients known to have bone metastasis seemed to have a lower nuclear area (<55 µm2, p = 0.0035), smaller long axis (<9 µm, p = 0.0015), smaller values for the small axis (<7 µm, p = 0.0008), smaller mean nuclear volume (<200 µm3, p = 0.0146) and lower mean internuclear distance (<10.5 µm, p = 0.0007) but a higher nucleus to cytoplasm ratio (>1.1, p = 0.0418), higher axis ratio (>1.2, p = 0.088), higher acyclicity grade (>1.145, p = 0.0857) and higher anellipticity grade (>1.14, p = 0.1362). These parameters can be used for the evaluation of risk category of developing bone metastases. These results can be useful for the evaluation of bone metastatic potential of breast cancer and for the selection of high-risk patients whose molecular profiles would require further investigations and evaluation.
Quantitative Study on the Breast Density and the Volume of the Mammary Gland According to the Patient’s Age and Breast Quadrant
Authors: Shim Sojin , Unkelbach Jan , Landsmann Anna , Boss Andreas
Published: October 2023

Objectives: Breast density is considered an independent risk factor for the development of breast cancer. This study aimed to quantitatively assess the percent breast density (PBD) and the mammary glands volume (MGV) according to the patient’s age and breast quadrant. We propose a regression model to estimate PBD and MGV as a function of the patient’s age. Methods: The breast composition in 1027 spiral breast CT (BCT) datasets without soft tissue masses, calcifications, or implants from 517 women (57 ± 8 years) were segmented. The breast tissue volume (BTV), MGV, and PBD of the breasts were measured in the entire breast and each of the four quadrants. The three breast composition features were analyzed in the seven age groups, from 40 to 74 years in 5-year intervals. A logarithmic model was fitted to the BTV, and a multiplicative inverse model to the MGV and PBD as a function of age was established using a least-squares method. Results: The BTV increased from 545 ± 345 to 676 ± 412 cm3, and the MGV and PBD decreased from 111 ± 164 to 57 ± 43 cm3 and from 21 ± 21 to 11 ± 9%, respectively, from the youngest to the oldest group (p < 0.05). The average PBD over all ages were 14 ± 13%. The regression models could predict the BTV, MGV, and PBD based on the patient’s age with residual standard errors of 386 cm3, 67 cm3, and 13%, respectively. The reduction in MGV and PBD in each quadrant followed the ones in the entire breast. Conclusions: The PBD and MGV computed from BCT examinations provide important information for breast cancer risk assessment in women. The study quantified the breast mammary gland reduction and density decrease over the entire breast. It established mathematical models to estimate the breast composition features—BTV, MGV, and PBD, as a function of the patient’s age.
Segmentation of Brain Tumor Using a 3D Generative Adversarial Network
Authors: Kalejahi Behnam Kiani , Meshgini Saeed , Danishvar Sebelan
Published: October 2023

Images of brain tumors may only show up in a small subset of scans, so important details may be missed. Further, because labeling is typically a labor-intensive and time-consuming task, there are typically only a small number of medical imaging datasets available for analysis. The focus of this research is on the MRI images of the human brain, and an attempt has been made to propose a method for the accurate segmentation of these images to identify the correct location of tumors. In this study, GAN is utilized as a classification network to detect and segment of 3D MRI images. The 3D GAN network model provides dense connectivity, followed by rapid network convergence and improved information extraction. Mutual training in a generative adversarial network can bring the segmentation results closer to the labeled data to improve image segmentation. The BraTS 2021 dataset of 3D images was used to compare two experimental models.
Ash Dieback in Forests and Rural Areas—History and Predictions
Authors: Pacia Artur , Borowik Piotr , Hsiang Tom , Marozau Aleh , Matić Slavica , Oszako Tomasz
Published: October 2023

Ash trees are an important component of both forests and the countryside. Emerging new diseases like ash dieback poses new challenges to Fraxinus spp., which not only have to adapt to global warming but also defend themselves against new threats from pathogenic fungi and insect pests. A new species of fungus, Hymenoscyphus fraxineus, has arrived in Europe from Asia and has severely damaged shoots which alters the structure of ash tree crowns. While some older trees have survived, younger trees are dying en masse, so the only hope is that the surviving trees will produce a younger generation that may be more resistant to the new diseases. The fine roots of ash trees are also attacked by pathogenic oomycetes, and others by Armillaria spp. The current stressed condition of ash trees in Europe is exacerbated by a new threat from insects. Agrillus planipennis, emerald ash borer, migrating from the east (from near Moscow airport) towards the borders of the European Union, killing thousands of ash trees on its way. This raises the question of future prospects for ash cultivation in Europe. This article takes a closer look at the information described in the literature.
Soil Moisture, Nutrients, and Plant Growths under Various Irrigation and Fertilization Regimes during the Crop Replacement Period in an Alley Intercropping System on the Loess Plateau of China
Authors: Luo Chengwei , Wang Ruoshui , Dou Xiaoyu , Zheng Chenghao
Published: October 2023

The uneven rainfall distribution, limited soil nutrients, and continuous cropping effect in the Loess Plateau restrict the sustainable development of fruit tree/crop (soybean and maize) intercropping systems. A two-year field experiment was conducted to investigate the effects of different water and fertilizer regimes on the soil nutrients and growth of intercropping systems during the crop replacement period. The experiment involved three irrigation levels (0% (I0), 50% (I1), and 80% (I2) of field capacity), two irrigation methods (drip irrigation (DI) and flood irrigation (FI)), and three fertilizer application rates (0 (F0), 375 (F1), and 750 (F2) kg/hm2). The results showed that in 2020 and 2021, the soil water contents increased with increasing irrigation and fertilization. The soil ammonium nitrogen, nitrate nitrogen, and soil organic matter contents in 2021 were 21.0%–68.4% higher than those in 2020. Increasing the fertilizer application rate improved the photosynthesis rate and transpiration rate of apples and maize in 2020 but had a reverse U-shape effect on soybeans in 2021. Irrigation and fertilization increased soybean and maize yields by 2.9%–30.5% compared with the I0F0 treatment. The maize root indicators generally showed an increasing trend followed by a decreasing trend with increasing fertilizer application in 2020, while soybean exhibited an opposite pattern in 2021. The FI1F1 and DI2F2 treatments yielded the optimal economic benefit in 2020 and 2021, respectively. Therefore, from an economic standpoint, FI and DI would have been recommended in 2020 and 2021, respectively. Factor analysis suggested that the DI2F2 treatments had the highest comprehensive benefits over the two years studied. Therefore, we recommend using DI combined with 80% field capacity irrigation and 750 kg/hm2 fertilization to maximize the comprehensive benefits of intercropping systems during the crop replacement period.
ForestFireDetector: Expanding Channel Depth for Fine-Grained Feature Learning in Forest Fire Smoke Detection
Authors: Sun Long , Li Yidan , Hu Tongxin
Published: October 2023

Wildfire is a pressing global issue that transcends geographic boundaries. Many areas, including China, are trying to cope with the threat of wildfires and manage limited forest resources. Effective forest fire detection is crucial, given its significant implications for ecological balance, social well-being and economic stability. In light of the problems of noise misclassification and manual design of the components in the current forest fire detection model, particularly the limited capability to identify subtle and unnoticeable smoke within intricate forest environments, this paper proposes an improved smoke detection model for forest fires utilizing YOLOv8 as its foundation. We expand the channel depth for fine-grain feature learning and retain more feature information. At the same time, lightweight convolution reduces the parameters of the model. This model enhances detection accuracy for smoke targets of varying scales and surpasses the accuracy of mainstream models. The outcomes of experiments demonstrate that the improved model exhibits superior performance, and the mean average precision is improved by 3.3%. This model significantly enhances the detection ability while also optimizing the neural network to make it more lightweight. These advancements position the model as a promising solution for early-stage forest fire smoke detection.
Genetic Structure and Diversity of Dalbergia nigra from Brazilian Atlantic Forest Fragments
Authors: Barreto Mariana A. , Mucherino-Muñoz Jonathan J. , Menezes Ivandilson P. P. , Tarazi Roberto , Silva Janisete G. , Gaiotto Fernanda A. , Corrêa Ronan X.
Published: October 2023

Dalbergia nigra is a long-living tree endemic to the Atlantic Rain Forest. Due to its high commercial value, this species has been widely exploited for timber production and is now endangered. It is widely known that understanding patterns of genetic structure is paramount for conserving threatened species. We analyzed the genetic diversity of 140 individuals from four different forest fragments in the southern region of Bahia, Brazil, to verify the possible effects of fragmentation on these populations and provide information for conservation initiatives. High polymorphism levels were detected from the genotyping of nine microsatellite loci (mean HE = 0.733). All populations showed high genetic diversity; however, a reduction of genetic diversity was detected in each population (HO < HE). The average fixation index was high and significant (f = 0.167), which could be due to the occurrence of inbreeding, the Wahlund effect, reproductive system, or from null alleles. Genetic differentiation among populations was high (mean θP = 0.118), suggesting strong isolation, a pattern consistent with historically low gene flow. The Bayesian analysis revealed five different genetic groups, among which three groups correspond to three different forest fragments, and two groups showed the genetic subdivision of individuals from the other forest fragment. Based on our results, the suggested conservation strategy for D. nigra populations in the southern region of Bahia, Brazil, involves high environmental investments to protect all sampled forest fragments and individuals. Another strategy would be to collect seeds from all individuals from the sampled fragments and start a new population with human interference in its evolutive history inside a protection unit.
Screening and Production of Industrially Relevant Enzymes by Bacillus paranthracis Strain MHDS3, a Potential Probiotic
Authors: Tshisikhawe Musundwa Locardia , Diale Mamonokane Olga , Abrahams Adrian Mark , Serepa-Dlamini Mahloro Hope
Published: October 2023

The digestive process and intestinal protein absorption are influenced by a variety of factors. Due to their numerous health advantages, including potential favorable effects on protein digestion and absorption, probiotics have gained increased attention in recent years. Probiotics can control the intestinal microflora, which in turn affects the intestinal bacteria responsible for proteolysis. Additionally, certain probiotics can release exoenzymes that aid in the digestion of proteins and others can stimulate the host’s digestive protease and peptidase activity. By boosting transport and enhancing the epithelium’s capacity for absorption, probiotics can also improve the absorption of tiny peptides and amino acids as well as lessen detrimental protein fermentation, which lowers the toxicity of metabolites. The present study explored the production of enzymes by Bacillus paranthracis strain MHDS3, a probiotic candidate isolated from Pellaea calomelanos. Bacillus paranthracis displayed enzyme activities of amylase (31,788.59 IU), cellulase (4487.486 IU), and pectinase (13.98986 IU) through submerged fermentation. The CAZyme analysis of B. paranthracis revealed 16 CAZyme gene clusters associated with cellulose, amylase, and pectinase activity. Thus, B. paranthracis is a promising probiotic strain that can produce enzymes with biotechnological applications.