bluuebunny/crossref_metadata_2025 huggingface dataset:
Temperature Behavior of Precursor Clusters at the Pre-Crystallization Phase of K(H2PO4) Studied by SAXS
Authors: Sukhanov Andrey E. , Ilina Kseniia B. , Konarev Petr V. , Peters Georgy S. , Pisarevsky Yury V. , Smirnova Ekaterina S. , Alekseeva Olga A. , Kovalchuk Mikhail V.
Published: December 2022

Elementary building blocks for the growth of KDP crystals were established. The solution of potassium dihydrogen phosphate (KH2PO4–KDP) has been experimentally studied by the small-angle X-ray scattering (SAXS) method. The analysis of SAXS data in the temperature range of 2.5–90 °C using a set of models of 3D fragments of the crystal structure showed that the saturated solution contains above K+, H2PO4− and KH2PO4 monomers, as well as mainly octamers. The 3D model of the octamer isolated from the crystal structure has dimensions of 17.443 Å along the [001] axis and 5.963 Å along the [100] and [010] axes. As the temperature is decreased, starting from the saturation temperature of the solution, the volume fraction of octamers sharply increases while the volume fraction of monomers decreases. The results indicate that the monomers and octamers represent major components in the solution with the presence of minor populations of other oligomers. The significant dominance of octamers in the supersaturated solution indicates that they are elementary building blocks for the growth of KDP crystals of tetragonal modification.
Tuning Growth of ZnO Nano-Arrays by the Dewetting of Gel Layer
Authors: Li Ziqian , Yan Ningzhe , Tian Yangguang , Luo Hao
Published: December 2022

The classical two-step sol-gel hydrothermal method enables the growth of nanoarrays on various substrates via a seed layer. The morphology of the nanoarrays is often tuned by changing the composition ratio of the seed solution. It is taken for granted that the number density and size of seeds will increase with the proportion of precursors. However, in this work, we found novel two-stage dependencies between the concentration of the precursor (ZnAC) and the geometric parameters (number density and diameter) of ZnO seed particles. The completely opposite dependencies illustrate the existence of two different mechanisms. Especially when the proportion of precursors is low (ϕZnAC:ϕPVA<0.22), the seed number density and diameter decrease with the increasing precursor concentration. This counterintuitive phenomenon should be caused by the destabilization and dewetting process of the thin film layers during annealing. Based on this new mechanism, we demonstrate the tuning growth of the ZnO seed layer and the nanowire array by annealing time. The number density of the nanorod array can be changed by 10 times, and the diameter of the nanorods can be changed by more than 8 times. The new mechanism we proposed can not only help people deepen their understanding of the formation and evolution of the seed layer but also provide a new way for the controllable growth of nanomaterials.
Effect of Cu on the Corrosion Behavior of 304 Stainless Steel
Authors: Wang Keping , Guo Liya , Liu Tengshi , Huang Ali , Zhao Yangyang , Wang Wurong , Peng Jingguang
Published: December 2022

The effect of a Cu addition on the corrosion behavior of 304 austenitic stainless steel in a solution was elaborately investigated through salt spray tests, FeCl3 immersion tests and characterization analyses. The corrosion behavior was further analyzed by optical microscopy, scanning electron microscopy, inductively coupled plasma mass spectrometry and an X-ray photoelectron spectroscopy analysis. 304Cu showed a higher corrosion resistance than 304 after the salt spray tests in a 5 wt.% NaCl solution for 168 h; the beneficial effect of Cu was not obvious after exposure for 480 h. Penetrating (stripped morphology in 304 and fishbone morphology in 304Cu) and non-penetrating dish-shaped pits were both observed on 304 and 304Cu after immersion in a 6 wt.% FeCl3 solution for 72 h; the corrosion rates of 304Cu were much higher than 304. Cu and Cu2+ were the main existing forms in the as-received 304Cu and Cu+ formed with the corrosion in chloride solutions. The results indicated a good corrosion resistance of 304Cu in service. The use of steel in an aggressive environment for a long exposure time should be cautiously considered.
Electronic, Elastic, and Thermoelectric Properties of Half-Heusler Topological Semi-Metal HfIrAs from First-Principles Calculations
Authors: Bamgbose Muyiwa Kehinde , Ayedun Funmilayo , Solola Gbenro Timothy , Musari Abolore Adebayo , Kenmoe Stephane , Adebayo Gboyega Augustine
Published: December 2022

The ab initio method is used to calculate the electronic, elastic, lattice-dynamic, and thermoelectric properties of the semimetal Half-Heusler compound HfIrAs. Density Functional Theory within Generalized Gradient Approximation is used to carry out calculations of lattice parameters, band structure, electronic density of states, phonon band structure, phonon density of states, elastic moduli, specific heat at constant volume, the Seebeck coefficient, electrical conductivity, the power factor, and the dimensionless figure of merit. The electronic band structure reveals that the compound is semimetal. The phonon dispersion shows that HfIrAs is dynamically stable. The projected phonon density of states, which shows the contribution of each constituent atom at every frequency level, is also reported. The ratio of bulk modulus to shear modulus is 2.89; i.e., the material is ductile, and it satisfies stability criteria. The thermoelectric properties of this compound at different temperatures of 300 K, 600 K, and 800 K are reported as a function of hole concentration for the first time to the best of our knowledge. The dimensionless figure of merit of HfIrAs is 0.57 at 800 K when the doping concentration is 0.01×1020 cm−3. Therefore, this compound is predicted to be a good thermoelectric material.
Designing Composite BaCe0.4Zr0.4Y0.1Yb0.1O3-δ-Sm0.2Ce0.8O2-δ Heterostructure Electrolyte for Low-Temperature Ceramic Fuel Cell (LT-CFCs)
Authors: Wei Wei , Mushtaq Naveed , Lu Yuzheng , Shah M. A. K. Yousaf , Ma Ligang , Yan Senlin
Published: December 2022

In recent years, tuning perovskite and fluorite-based materials and modifying them to ionic conductors has been an interesting but challenging topic for advanced low-temperature ceramic fuel cells (LT-CFCs). In this regard, we prepared a new composite heterostructure, BaCe0.4Zr0.4Y0.1Yb0.1O3-Sm0.2Ce0.8O2 (BCZYYb-SDC), and evaluated it as an electrolyte to realize the fuel cell reaction. The developed electrolyte could be a hybrid ionic conductor, possess a very small ohmic area-specific resistance, and exhibit excellent fuel cell performance of over 1.0 W/cm2 along with higher OCV of more than 1.1 V at a low operating temperature of 550 °C. The attained performance and ionic conductivity are specially accredited to constructing the heterostructure of BCZYYb-SDC. Moreover, various spectroscopy and microscopic analysis methods have been used to investigate the ions’ transportation, while on the other hand suppressing the electronic conduction. The developed composite heterostructure proposes and suggests new insight to design new electrolytes for LT-CFCs.
Moisture Photo-Thermoelasticity Diffusivity in Semiconductor Materials: A Novel Stochastic Model
Authors: Alenazi Abdulaziz , Ahmed Abdelaala , El-Bary Alaa A. , Tantawi Ramdan S. , Lotfy Khaled
Published: December 2022

A unique methodology due to the effect of stochastic heating is utilized to study the Moisture Diffusivity influence of an elastic semiconductor medium under the effect of photo-thermoelasticity theory. Accurately, random processes are applied at the boundary of the semiconductor medium. The governing equations are expressed in the one-dimensional form (1D). The boundary conditions are considered random; the additional noise is regarded as white noise. The problem is set up to investigate the interaction between moisture diffusivity, thermo-elastic waves, and plasma waves. The investigation is carried out during a photothermal transport procedure while taking moisture diffusivity into consideration. The Laplace transform is used to solve the problem. The numerical solution for field distribution is obtained using the short-time approximation while performing inverse transformations of Laplace. The Wiener process notion has been used to arrive at the solutions for the stochastic case. Silicon (Si) material is used along several sample paths in a numerical study based on stochastic simulation. Additionally, a comparison of the stochastic and deterministic field variable distributions is provided. The effects of thermoelectric, thermoelastic, and reference moisture parameters of the applied force on all physical distributions are discussed graphically.
Effects and Working Mechanisms of a Multilevel Implementation Program for Applying Shared Decision-Making while Discussing Systemic Treatment in Breast Cancer
Authors: van Veenendaal Haske , Peters Loes J. , van Weele Esther , Hendriks Mathijs P. , Schuurman Maaike , Visserman Ella , Hilders Carina G. J. M. , Ubbink Dirk T.
Published: December 2022

Background: Enhancing the application of shared decision-making (SDM) is critical for integrating patient preferences in breast cancer treatment choices. We investigated the effect of an adapted multilevel SDM implementation program in breast cancer care. Methods: Breast cancer patients qualifying for (neo)adjuvant systemic treatment were included in a multicenter before–after study. Consultations were audio recorded between June 2018 and July 2019 and analyzed using the five-item Observing Patient Involvement in Decision-Making (OPTION-5) instrument to score SDM application by clinicians. The Shared Decision-Making Questionnaire (SDM-Q-9) was used to rate patients’ perceived SDM level. Consultation duration, decision types, number of options discussed and consultations per patient were monitored. Regression analysis was used to investigate the correlated variables and program components. Results: Mean OPTION-5 scores increased from 33.9 (n = 63) before implementation to 54.3 (n = 49) after implementation (p < 0.001). The SDM-Q-9 scores did not change: 91.1 (n = 51) at baseline versus 88.9 (n = 23) after implementation (p = 0.81). Without increasing consultation time, clinicians discussed more options after implementation. The regression analysis showed that exposure to the implementation program, redistribution of tasks and discussing feedback from consultations was associated with a higher level of SDM. Conclusion: The multilevel program helped clinicians achieve clinically relevant improvement in SDM, especially when it is tailored to (individuals in) teams and includes (e-)training, discussing feedback on consultations and redistribution of tasks.
A Retrospective Study on the Efficacy of Subcutaneous Immunoglobulin as Compared to Intravenous Formulation in Patients with Chronic Lymphocytic Leukemia and Secondary Antibody Deficiency
Authors: Visentin Andrea , Molinari Maria Chiara , Pravato Stefano , Cellini Alessandro , Angotzi Francesco , Cavaretta Chiara Adele , Ruocco Valeria , Imbergamo Silvia , Piazza Francesco , Proietti Giulia , Mauro Francesca Romana , Trentin Livio
Published: December 2022

Secondary antibody deficiency (SAD) is a common complication in chronic lymphocytic leukemia (CLL) which favors the development of life-threatening infections. Subcutaneous immunoglobulins (IG) (SCIG) have been proven to be as effective as intravenous immunoglobulin (IVIG) in primary immunodeficiencies. Since only a few studies investigated SCIG in secondary antibody deficiency, the aim of this study was to assess the efficacy and safety of SCIG or IVIG in CLL patients with secondary antibody deficiency. One hundred and sixteen CLL patients were recruited, 63% were males, and the median age was 68 years; 44% had bronchiectasis and 76% never smoked. Forty-nine patients received IVIG and 88 SCIG, including 28 patients who shifted from IVIG to SCIG. Despite similar baseline IgG levels, patients receiving SCIG achieved higher IgG after at least +6 months (p = 0.0009). We observed that SCIG can decrease the cumulative incidence of first (HR 0.39 p < 0.0001) and second (HR 0.56 p = 0.0411) infection more than IVIG. The effect was remarkable in that patients were able to reach at least 6 g/L of IgG after 6 months of treatments (p < 0.0001). Replacement therapies were well tolerated with less adverse events and a lower discontinuation rate in patients was managed with SCIG than IVIG. In this study we describe the clinical features of a large cohort of CLL with secondary antibody deficiency receiving IG. We demonstrated that SCIG are active and well tolerated drugs that allows to reach higher IgG levels and decrease the rate of infections better than IVIG, in particular when IgG levels reach 6 g/L.
A Prospective Population-Based Study of Cardiovascular Disease Mortality following Treatment for Breast Cancer among Men in the United States, 2000–2019
Authors: Appiah Duke , Mai Megan , Parmar Kanak
Published: December 2022

Male breast cancer is rare but its incidence and mortality are increasing in the United States, with racial/ethnic disparities in survival reported. There is limited evidence for cardiotoxicity of cancer treatment among men with breast cancer. We evaluated the relation between breast cancer treatment and cardiovascular disease (CVD) mortality among men and investigated the salient roles that race/ethnicity play on this relation. Data were from 5216 men with breast cancer aged ≥ 40 years from the Surveillance, Epidemiology, and End Results program who were diagnosed from 2000 to 2019 and underwent surgery. Competing risk models were used to estimate hazards ratios (HR) and 95% confidence intervals (CI). During a median follow-up of 5.6 years, 1914 deaths occurred with 25% attributable to CVD. In multivariable-adjusted models, men who received chemotherapy had elevated risk for CVD (HR: 1.55, 95%CI: 1.18–2.04). This risk was higher among Hispanic men (HR: 3.96, 95%CI: 1.31–12.02) than non-Hispanic Black and non-Hispanic White men. There was no significant association between radiotherapy and CVD deaths. In this population-based study, treatment with chemotherapy was associated with elevated risk of CVD mortality in men with breast cancer. Racial/ethnic disparities in the association of chemotherapy and CVD mortality were observed.
Development and Validation of a Prediction Model for Positive Findings of Preoperative Flexible Bronchoscopy in Patients with Peripheral Lung Cancer
Authors: Li Dongyu , Li Zaishan , Li Shaolei , Zhang Hongbing , Yao Siqing , Li Yi , Chen Jun
Published: December 2022

(1) Background: It has yet to be determined whether preoperative flexible bronchoscopy (FB) should be routinely performed in patients with peripheral lung cancer. The aim of this study was to construct a model to predict the probability of positive FB findings, which would help assess the necessity of preoperative FB. (2) Methods: A total of 380 consecutive patients with peripheral lung cancer who underwent preoperative FB were recruited for this study. A prediction model was developed through univariate and multivariate logistic regression, with predictors including gender, age, body mass index (BMI), smoking, history of chronic lung diseases, respiratory symptoms, lesion size, lesion type, lesion location in the bronchi, and lesion location in the lobe. The predictive performance of the model was evaluated by validation using 1000 iterations of bootstrap resampling. Model discrimination was assessed using the area under the receiver operating characteristics curve (AUC), and calibration was assessed using the Brier score and calibration plots. (3) Results: The model suggested that male patients with respiratory symptoms, decreased BMI, solid lesions, and lesions located in lower-order bronchi were more likely to have positive FB findings. The AUC and Brier score of the model for internal validation were 0.784 and 0.162, respectively. The calibration curve for the probability of positive FB findings showed convincing concordance between the predicted and actual results. (4) Conclusions: Our prediction model estimated the pretest probability of positive FB findings in patients with peripheral lung cancers. Males and patients with lower BMI, the presence of respiratory symptoms, larger lesions, solid lesions, and lesions located in lower-order bronchi were associated with increased positive FB findings. The use of our model can be of assistance when making clinical decisions about preoperative FB.
Modeling the Ecology and Evolution of Biodiversity: Introduction to the Special Issue
Authors: Jhwueng Dwueng-Chwuan
Published: December 2022

Applying relevant statistical models to empirical data analysis has been considered a very important procedure for scientists to answer research questions in the fields of biodiversity, phylogeography, evolutionary biology, paleoecology, phylogenetics, and geography [...]
The Ant Genus Cardiocondyla (Hymenoptera: Formicidae): The Species Groups with Oriental and Australasian Origin
Authors: Seifert Bernhard
Published: December 2022

The world-wide fauna of the genus Cardiocondyla is assessed to have 79 currently recognized species and is subdivided into 14 informal species groups plus three monotypical clades. It is argued that the phylogenetic placement of Cardiocondyla next to the genus Ocymyrmex Emery, 1886 as proposed by Blaimer et al. (2018) is doubtful. The main body of the paper is a species-level taxonomic revision of those six species groups and the one monotypical clade which have their centers of origin in the Oriental and Australasian regions. The fauna of this area comprises 26 species eleven of which are described as new: Cardiocondyla schulzi n.sp., C. argentea n.sp., C. semiargentea n.sp., C. argyrotricha n.sp., C. latifrons n.sp., C. micropila n.sp., C. allonivalis n.sp., C. excavata n.sp., C. goroka n.sp., C. subspina n.sp. and C. sulcata n.sp. Recognized as junior synonyms were: Cardiocondyla tsukuyomi Terayama, 1999 and C. breviscapus Seifert, 2003 of C. minutior Forel, 1899 and C. brevispinosa (Donisthorpe, 1948) of C. paradoxa Emery, 1897. Each confirmed species is characterized by verbal descriptions, 18 numerically recorded phenotypic characters, z-stack images in three viewing positions, the key, a differential diagnosis and, if available, a brief life history. Exploratory and hypothesis-driven data analyses of phenotypic characters support the separation of the cryptic species Cardiocondyla minutior Forel, 1899, C. goa Seifert, 2003 and C. tjibodana Karavajev, 1935, two of which have dispersed as tramp species to the New World. Missing development of postzygotic isolation due to very strong prezygotic barriers is indicated in the closely related species Cardiocondyla latifrons n.sp. and C. micropila n.sp. which produce fertile hybrids in laboratory rearings but apparently do not hybridize in a natural context even if nesting in close neighborhood. The strong prezygotic isolation is supposed to be generated by the prevalence of intranidal mating and the difficulty for a mated heterospecific gyne to become accepted in a foreign colony.
The Orchids of Wetland Vegetation in the Central Balkans
Authors: Djordjević Vladan , Aćić Svetlana , Kabaš Eva , Lazarević Predrag , Tsiftsis Spyros , Lakušić Dmitar
Published: December 2022

Wetland ecosystems are important habitats for the growth and survival of numerous terrestrial orchids in Europe. This study reviews the current knowledge on the orchids of wetland vegetation in the Central Balkans. The orchid flora was analyzed from taxonomic, phytogeographical, ecological and conservation aspects. The most important taxa include the two Balkan endemics (Dactylorhiza cordigera subsp. bosniaca and D. kalopissi subsp. macedonica) and the three subendemics of the Balkans and the Carpathians (Dactylorhiza cordigera subsp. cordigera, D. maculata subsp. transsilvanica and Gymnadenia frivaldii), as well as a considerable number of Central European, Eurasian and boreal orchid representatives. Several orchid taxa occurring in the wet meadows and fens of the Central Balkans have a southern limit of their distribution in this part of Europe, suggesting that wetlands are important refuges for them. In total, 33 orchid taxa were recorded in plant communities from five classes, 10 orders and 17 alliances. Most orchid taxa grow in the following wetland vegetation types: wet meadows (class Molinio-Arrhenatheretea, order Molinietalia caeruleae, alliances Molinion caeruleae, Deschampsion cespitosae and Calthion palustris); fens (class Scheuchzerio palustris-Caricetea fuscae, order Caricetalia fuscae, alliance Caricion fuscae); tall-herb vegetation along mountain streams and springs (class Mulgedio-Aconitetea); marshes and herb-land vegetation of freshwater or brackish water bodies (class Phragmito-Magnocaricetea). This study highlights the importance of serpentine and silicate wetland vegetation types as important habitats for the survival of terrestrial orchids. In addition, detailed taxonomic, ecological and chorological studies of the wetland orchids of the Central Balkans need to be carried out in order to establish a successful plan for their conservation.
The Diversity of Deep-Sea Actinobacteria and Their Natural Products: An Epitome of Curiosity and Drug Discovery
Authors: Siro Galana , Donald Lavinia , Pipite Atanas
Published: December 2022

Bioprospecting of novel antibiotics has been the conventional norm of research fostered by researchers worldwide to combat drug resistance. With the exhaustion of incessant leads, the search for new chemical entities moves into uncharted territories such as the deep sea. The deep sea is a furthermost ecosystem with much untapped biodiversity thriving under extreme conditions. Accordingly, it also encompasses a vast pool of ancient natural products. Actinobacteria are frequently regarded as the bacteria of research interest due to their inherent antibiotic-producing capabilities. These interesting groups of bacteria occupy diverse ecological habitats including a multitude of different deep-sea habitats. In this review, we provide a recent update on the novel species and compounds of actinomycetes from the deep-sea environments within a period of 2016–2022. Within this period, a total of 24 new species of actinomycetes were discovered and characterized as well as 101 new compounds of various biological activities. The microbial communities of various deep-sea ecosystems are the emerging frontiers of bioprospecting.
The Role of Thromboprophylaxis in Patients with Portal Vein Thrombosis: A Life-Threatening Complication after Laparoscopic Sleeve Gastrectomy Following 8 Years of Experience in a Bariatric Center of Excellence
Authors: Godoroja-Diarto Daniela , Copaescu Catalin , Rusu Elena , Constantin Alina
Published: December 2022

Porto-mesenteric vein thrombosis (PVMT) is a rare but life-threatening complication after laparoscopic sleeve gastrectomy (LSG). Laparoscopic sleeve gastrectomy (LSG) is considered the most common procedure for efficiently realizing weight loss and treating obesity-related co-morbidities. This study aimed to shed light on this relatively rare complication by presenting a series of patients who developed PMVT after LSG in light of the need to change the specific protocol of thromboprophylaxis in bariatric patients. We proposed to answer two questions: whether we should perform a thrombophilia workup as a standard practice and whether we should extend chemoprophylaxis to more than 3 weeks among all bariatric patients. This study also aimed to investigate the possible risk factors and eventually present our updated protocol for PMVT management and prophylaxis.
The Association between Diabetes Mellitus, High Monocyte/Lymphocyte Ratio, and Survival in Endometrial Cancer: A Retrospective Cohort Study
Authors: Bing Ruo-Shi , Tsui Wing Lam , Ding Dah-Ching
Published: December 2022

This retrospective cohort study aimed to evaluate the factors related to endometrial cancer (EC) prognosis and survival in eastern Taiwan. The study involved 48 patients diagnosed with EC who underwent hysterectomy-based surgery at Hualien Tzu Chi hospital between January 2011 and June 2021. The patients’ medical history and laboratory examination results were reviewed. Progression-free survival and overall survival were determined. Categorical variables were analyzed using the chi-square test, and continuous variables were analyzed using the independent t-test. The receiver operating characteristic curve was used to predict diagnostic value. Factors associated with cancer mortality were identified via Cox regression analysis (p < 0.05). Patients were divided into the death (n = 7) and survival (n = 41) groups. The median age of the patients was 56 years (range: 31–71 years). The median observation period was 33.29 months. Diabetes mellitus (DM) and monocyte/lymphocyte ratio (MLR) > 0.23886 were significantly associated with cancer mortality (p = 0.024 and p = 0.028, respectively). MLR-low and MLR-high groups exhibited 5-year overall survival rates of 96% and 60%, respectively, and 5-year progression-free survival rates of 96% and 41%, respectively. DM and MLR of >0.2386 were suggested to be associated with cancer death, poor overall survival, and progression-free survival.
The Systematic Review of Artificial Intelligence Applications in Breast Cancer Diagnosis
Authors: Uzun Ozsahin Dilber , Ikechukwu Emegano Declan , Uzun Berna , Ozsahin Ilker
Published: December 2022

Several studies have demonstrated the value of artificial intelligence (AI) applications in breast cancer diagnosis. The systematic review of AI applications in breast cancer diagnosis includes several studies that compare breast cancer diagnosis and AI. However, they lack systematization, and each study appears to be conducted uniquely. The purpose and contributions of this study are to offer elaborative knowledge on the applications of AI in the diagnosis of breast cancer through citation analysis in order to categorize the main area of specialization that attracts the attention of the academic community, as well as thematic issue analysis to identify the species being researched in each category. In this study, a total number of 17,900 studies addressing breast cancer and AI published between 2012 and 2022 were obtained from these databases: IEEE, Embase: Excerpta Medica Database Guide-Ovid, PubMed, Springer, Web of Science, and Google Scholar. We applied inclusion and exclusion criteria to the search; 36 studies were identified. The vast majority of AI applications used classification models for the prediction of breast cancer. Howbeit, accuracy (99%) has the highest number of performance metrics, followed by specificity (98%) and area under the curve (0.95). Additionally, the Convolutional Neural Network (CNN) was the best model of choice in several studies. This study shows that the quantity and caliber of studies that use AI applications in breast cancer diagnosis will continue to rise annually. As a result, AI-based applications are viewed as a supplement to doctors’ clinical reasoning, with the ultimate goal of providing quality healthcare that is both affordable and accessible to everyone worldwide.
A Pain in the Neck: Lessons Learnt from Genetic Testing in Fetuses Detected with Nuchal Fluid Collections, Increased Nuchal Translucency versus Cystic Hygroma—Systematic Review of the Literature, Meta-Analysis and Case Series
Authors: Mastromoro Gioia , Guadagnolo Daniele , Khaleghi Hashemian Nader , Bernardini Laura , Giancotti Antonella , Piacentini Gerardo , De Luca Alessandro , Pizzuti Antonio
Published: December 2022

Fetal Nuchal fluid collections can manifest with two distinct presentations attributable to the same phenotypic spectrum: increased nuchal translucency (iNT) and cystic hygroma. The prenatal detection of these findings should prompt an accurate assessment through genetic counseling and testing, including karyotype, chromosomal microarray analysis (CMA) and multigene RASopathy panel. We performed a systematic review of the literature and meta-analysis, to calculate diagnostic yields of genetic testing in fetuses with iNT and cystic hygroma. We compared the results with a cohort of 96 fetuses with these isolated findings. Fetuses with isolated NT ≥ 2.5 mm showed karyotype anomalies in 22.76% of cases and CMA presented an incremental detection rate of 2.35%. Fetuses with isolated NT ≥ 3 mm presented aneuploidies in 14.36% of cases and CMA had an incremental detection rate of 3.89%. When the isolated NT measured at least 3.5 mm the diagnostic yield of karyotyping was 34.35%, the incremental CMA detection rate was 4.1%, the incremental diagnostic rate of the RASopathy panel was 1.44% and it was 2.44% for exome sequencing. Interestingly, CMA presents a considerable diagnostic yield in the group of fetuses with NT ≥ 3.5 mm. Similarly, exome sequencing appears to show promising results and could be considered after a negative CMA result.
Prognostic Utility of CD47 in Cancer of the Uterine Cervix and the Sensitivity of Immunohistochemical Scores
Authors: Yordanov Angel , Shivarov Velizar , Kostov Stoyan , Ivanova Yonka , Dimitrova Polina , Popovska Savelina , Tsoneva Eva , Vasileva-Slaveva Mariela
Published: December 2022

Introduction: Cancer of the uterine cervix (CUC) is still one of the most frequent oncological diagnoses in women. The specific interactions between the tumor cells of CUC and the cells and tissues in the tumor microenvironment can affect cancer cells’ invasive and metastatic potential and can modulate tumor’s progression and death. CD47 is a trans-membranous immunoglobulin, expressed in many cells. It protects the cells from being destroyed by the circulating macrophages. Aim: We aimed to evaluate the prognostic role of CD47 expressed in the tumor tissues of patients with CUC for tumor progression and to find the most sensitive immunohistochemical score for defining the cut-off significantly associated with tumor biology and progression. Materials and methods: Paraffin-embedded tumor tissues from 86 patients with CUC were included in the study. Clinico-morphological data for patients, such as age and stage at diagnosis according to FIGO and TNM classification, were obtained from the hospital electronic medical records. Immunohistochemical staining was performed with rabbit recombinant monoclonal CD47 antibody (Clone SP279). The final result was interpreted based on three reporting models in immunohistochemistry: H-score, Allred score and combined score. Results: The expression of CD47 was higher in tumors limited in the cervix compared with those invading other structures, and it did not depend on the nodal status. The results of immunohistochemical staining were similar regardless of which immunohistochemical method was used. The most significant correlation with TNM stage was observed with the H-score (p = 0.00018). The association with the Allred and combined score was less significant, with p values of 0.0013 and 0.0002, respectively. Conclusion: The expression of CD47 in the cancer cells is prognostic for tumor invasion in the surrounding structures, independent of lymph node engagement. The H-score is the most sensitive immunohistochemical score to describe tumor stage. To the best of our knowledge, this is the first study evaluating the significance of CD47 expression in CUC.
The Role of Positron Emission Tomography and Computed Tomographic (PET/CT) Imaging for Radiation Therapy Planning: A Literature Review
Authors: Mallum Abba , Mkhize Thokozani , Akudugu John M. , Ngwa Wilfred , Vorster Mariza
Published: December 2022

PET/CT is revolutionising radiotherapy treatment planning in many cancer sites. While its utility has been confirmed in some cancer sites, and is used in routine clinical practice, it is still at an experimental stage in many other cancer sites. This review discusses the utility of PET/CT in cancer sites where the role of PET/CT has been established in cases such as head and neck, cervix, brain, and lung cancers, as well as cancer sites where the role of PET/CT is still under investigation such as uterine, ovarian, and prostate cancers. Finally, the review touches on PET/CT utilisation in Africa.
Correlation between Microvascular Damage and Internal Organ Involvement in Scleroderma: Focus on Lung Damage and Endothelial Dysfunction
Authors: D’Oria Mario , Gandin Ilaria , Riccardo Pozzan , Hughes Michael , Lepidi Sandro , Salton Francesco , Confalonieri Paola , Confalonieri Marco , Tavano Stefano , Ruaro Barbara
Published: December 2022

Background. Systemic sclerosis (SSc) is an incurable connective tissue disease characterized by decreased peripheral blood perfusion due to microvascular damage and skin thickening/hardening. The microcirculation deficit is typically secondary to structural vessel damage, which can be assessed morphologically and functionally in a variety of ways, exploiting different technologies. Objective. This paper focuses on reviewing new studies regarding the correlation between microvascular damage, endothelial dysfunction, and internal organ involvement, particularly pulmonary changes in SSc. Methods. We critically reviewed the most recent literature on the correlation between blood perfusion and organ involvement. Results. Many papers have demonstrated the link between structural microcirculatory damage and pulmonary involvement; however, studies that have investigated correlations between microvascular functional impairment and internal organ damage are scarce. Overall, the literature supports the correlation between organ involvement and functional microcirculatory impairment in SSc patients. Conclusions. Morphological and functional techniques appear to be emerging biomarkers in SSc, but obviously need further investigation.
Low Colon Capsule Endoscopy (CCE) False Negative Rate for Polyps Excluding Reader Error
Authors: Semenov Serhiy , Costigan Conor , Ismail Mohd Syafiq , McNamara Deirdre
Published: December 2022

Background: CCE is a diagnostic tool lacking clinical data on false negative rates. We aimed to assess this rate and the reader/technical error breakdown. Methods: False negative CCEs were identified after comparing to a colonoscopy database. Missed pathology characteristics and study indications/quality were collated. Cases were re-read by experts and newly identified lesions/pathologies were verified by an expert panel and categorised as reader/technical errors. Results: Of 532 CCEs, 203 had an adequately reported comparative colonoscopy, 45 (22.2%) had missed polyps, and 26/45 (57.8%) reached the colonic section with missed pathology. Of the cases, 22 (84.6%) had adequate bowel preparation. Indications included 13 (50%) polyp surveillance, 12 (46%) GI symptoms, 1 (4%) polyp screening. CCE missed 18 (69.2%) diminutive polyps and 8 (30.8%) polyps ≥ 6 mm, 18/26 (69.2%) of these were adenomas. Excluding incomplete CCE correlates, colonoscopy total and significant polyp yield were 97/184 (52.7%) and 50/97 (51.5%), respectively. CCE total polyp and significant polyp false negative rate was 26.8% (26/97) and 16% (8/50), respectively. Following re-reading, reader and technical error was 20/26 (76.9%) and 6/26 (23.1%). Total and significant missed polyp rates were 20.6% (20/97) and 14% (7/50) for reader error, 6.2% (6/97) and 2% (1/50) for technical error. Conclusions: False negative CCE rate is not insubstantial and should be factored into clinical decision making.
Clinical Outcomes of Cataract Surgery in Patients with Sjögren’s Syndrome
Authors: Lee Donghyeon , Kim Charm , Lee Kyeongjoo , Chung Jin Kwon
Published: December 2022

This study compared the biometric accuracy and refractive outcomes, and ocular surface changes after cataract surgery in patients with Sjögren’s syndrome (SS, S group), non-SS dry eye patients (D group), and healthy controls (C group). The medical records of patients who underwent cataract surgery and met certain inclusion criteria were reviewed. In total, 167 eyes of 87 patients were enrolled. Refractive parameters were analyzed via optical biometry and combined ultrasound biometry and automated refractokeratometry. The mean absolute errors (MAEs), the uncorrected distance visual acuities (UDVAs), changes in the ocular staining score (OSS), and anterior chamber cell grades were compared for 12 months postoperatively. The S group evidenced more severe and persistent OSS exacerbation after cataract surgery; the OSS returned to baseline by 3 months postoperatively. The mean keratometric values showed a significant linear correlation. There was no significant intergroup difference in either the MAEs (p > 0.530) or anterior chamber inflammation (p > 0.436). The postoperative UDVA of the S group was poorer than that of the C group from 3 months postoperatively (p < 0.047) but not different from that of the D group (p > 0.311). With preoperative ocular surface optimization and optimal postoperative treatment of superficial keratitis, the refractive outcomes of SS patients were comparable to those of other groups and the postoperative UDVA was not inferior to that of non-SS dry eye patients.
Artificial Intelligence in Breast Ultrasound: From Diagnosis to Prognosis—A Rapid Review
Authors: Brunetti Nicole , Calabrese Massimo , Martinoli Carlo , Tagliafico Alberto Stefano
Published: December 2022

Background: Ultrasound (US) is a fundamental diagnostic tool in breast imaging. However, US remains an operator-dependent examination. Research into and the application of artificial intelligence (AI) in breast US are increasing. The aim of this rapid review was to assess the current development of US-based artificial intelligence in the field of breast cancer. Methods: Two investigators with experience in medical research performed literature searching and data extraction on PubMed. The studies included in this rapid review evaluated the role of artificial intelligence concerning BC diagnosis, prognosis, molecular subtypes of breast cancer, axillary lymph node status, and the response to neoadjuvant chemotherapy. The mean values of sensitivity, specificity, and AUC were calculated for the main study categories with a meta-analytical approach. Results: A total of 58 main studies, all published after 2017, were included. Only 9/58 studies were prospective (15.5%); 13/58 studies (22.4%) used an ML approach. The vast majority (77.6%) used DL systems. Most studies were conducted for the diagnosis or classification of BC (55.1%). At present, all the included studies showed that AI has excellent performance in breast cancer diagnosis, prognosis, and treatment strategy. Conclusions: US-based AI has great potential and research value in the field of breast cancer diagnosis, treatment, and prognosis. More prospective and multicenter studies are needed to assess the potential impact of AI in breast ultrasound.
Association between Vitamin D Status and Secondary Infections in Patients with Severe COVID-19 Admitted in the Intensive Care Unit of a Tertiary-Level Hospital in Turkey
Authors: Batur Lutfiye Karcioglu , Koç Suna
Published: December 2022

There are several studies showing that the vitamin D status can determine risk of COVID-19 infections, severity and mortality from coronavirus disease 2019 (COVID-19). However, the association between vitamin D (25(OH)D) and secondary infections in the prognosis of COVID-19 patients has not been reported yet. The aim was to investigate whether the vitamin D status affects the rates of secondary infections in patients with severe COVID-19 hospitalized in the intensive care unit (ICU) of a tertiary-level hospital in Turkey. The data of 194 patients with diagnosis of severe COVID-19 who were admitted to the ICU from March 2020 to June 2021 and older than 18 years were evaluated in this retrospective study. The patients were divided into two groups according to total serum 25(OH)D level as normal group (≥20 ng/mL) and low group (<20 ng/mL). The 25(OH)D level was low in 118 (60.8%) and normal in 76 (39.2%) patients. The mean age of the low group was significantly higher than that of the normal group (67.02 ± 14.47 vs. 61.70 ± 14.38; p = 0.013). The systolic and diastolic blood pressure as well as the Glasgow coma scale score of the low group were significantly lower than that of the normal group (p = 0.004, 0.002 and 0.001, respectively). The intubation rate and APACHE (Acute Physiology and Chronic Health Evaluation) score of the low group was significantly higher than that of the normal group (p = 0.001). The platelets number and blood pH decreased, and the neutrophil/lymphocyte ratio, procalcitonin, lactate, urea, creatinine and lactate dehydrogenase concentrations increased significantly in the low group (p < 0.05). The mortality rate was 79.7% in the low group and 22.4% in the normal group (p < 0.001). Microbiological growth was observed in 68.6% of the normal group and 52.6% of the normal group (p = 0.025). The number of cultures with resistant bacteria was significantly higher in the low group (25.9%) than that in the normal group (17.5%) (p = 0.035). The severe COVID-19 patients hospitalized with vitamin D deficiency may have increased risks of poor prognosis and mortality due to secondary infections in the ICU.
Interstitial Lung Disease in Immunocompromised Children
Authors: Gao Xianfei , Michel Katarzyna , Griese Matthias
Published: December 2022

Background: The range of pulmonary complications beyond infections in pediatric immunocompromised patients is broad but not well characterized. Our goal was to assess the spectrum of disorders with a focus on interstitial lung diseases (ILD) in immunodeficient patients. Methods: We reviewed 217 immunocompromised children attending a specialized pneumology service during a period of 23 years. We assigned molecular diagnoses where possible and categorized the underlying immunological conditions into inborn errors of immunity or secondary immunodeficiencies according to the IUIS and the pulmonary conditions according to the chILD-EU classification system. Results: Among a wide array of conditions, opportunistic and chronic infections were the most frequent. ILD had a 40% prevalence. Of these children, 89% had a CT available, and 66% had a lung biopsy, which supported the diagnosis of ILD in 95% of cases. Histology was often lymphocyte predominant with the histo-pattern of granulomatous and lymphocytic interstitial lung disease (GLILD), follicular bronchiolitis or lymphocytic interstitial pneumonitis. Of interest, DIP, PAP and NSIP were also diagnosed. ILD was detected in several immunological disorders not yet associated with ILD. Conclusions: Specialized pneumological expertise is necessary to manage the full spectrum of respiratory complications in pediatric immunocompromised patients.
Pancreatic Cystic Lesions: A Focused Review on Cyst Clinicopathological Features and Advanced Diagnostics
Authors: Chen Wei , Ahmed Nehaal , Krishna Somashekar G.
Published: December 2022

Macroscopic, endomicroscopic, and histologic findings and correlation are an integral part of the diagnostic evaluation of pancreatic cystic lesions (PCLs), as complementing morphologic features seen by different specialties are combined to contribute to a final diagnosis. However, malignancy risk stratification of PCLs with worrisome features can still be challenging even after endoscopic ultrasound guided-fine needle aspiration (EUS-FNA) with cytological evaluation. This review aims to summarize cyst clinicopathological features from the pathologists’ perspective, coupled with knowledge from advanced diagnostics–confocal laser endomicroscopy and cyst fluid molecular analysis, to demonstrate the state-of-art risk stratification of PCLs. This review includes illustrative photos of surgical specimens, endomicroscopic and histologic images, and a summary of cyst fluid molecular markers.
Correlated-Weighted Statistically Modeled Contourlet and Curvelet Coefficient Image-Based Breast Tumor Classification Using Deep Learning
Authors: Kabir Shahriar M. , Bhuiyan Mohammed I. H.
Published: December 2022

Deep learning-based automatic classification of breast tumors using parametric imaging techniques from ultrasound (US) B-mode images is still an exciting research area. The Rician inverse Gaussian (RiIG) distribution is currently emerging as an appropriate example of statistical modeling. This study presents a new approach of correlated-weighted contourlet-transformed RiIG (CWCtr-RiIG) and curvelet-transformed RiIG (CWCrv-RiIG) image-based deep convolutional neural network (CNN) architecture for breast tumor classification from B-mode ultrasound images. A comparative study with other statistical models, such as Nakagami and normal inverse Gaussian (NIG) distributions, is also experienced here. The weighted entitled here is for weighting the contourlet and curvelet sub-band coefficient images by correlation with their corresponding RiIG statistically modeled images. By taking into account three freely accessible datasets (Mendeley, UDIAT, and BUSI), it is demonstrated that the proposed approach can provide more than 98 percent accuracy, sensitivity, specificity, NPV, and PPV values using the CWCtr-RiIG images. On the same datasets, the suggested method offers superior classification performance to several other existing strategies.
A Deep CNN Transformer Hybrid Model for Skin Lesion Classification of Dermoscopic Images Using Focal Loss
Authors: Nie Yali , Sommella Paolo , Carratù Marco , O’Nils Mattias , Lundgren Jan
Published: December 2022

Skin cancers are the most cancers diagnosed worldwide, with an estimated > 1.5 million new cases in 2020. Use of computer-aided diagnosis (CAD) systems for early detection and classification of skin lesions helps reduce skin cancer mortality rates. Inspired by the success of the transformer network in natural language processing (NLP) and the deep convolutional neural network (DCNN) in computer vision, we propose an end-to-end CNN transformer hybrid model with a focal loss (FL) function to classify skin lesion images. First, the CNN extracts low-level, local feature maps from the dermoscopic images. In the second stage, the vision transformer (ViT) globally models these features, then extracts abstract and high-level semantic information, and finally sends this to the multi-layer perceptron (MLP) head for classification. Based on an evaluation of three different loss functions, the FL-based algorithm is aimed to improve the extreme class imbalance that exists in the International Skin Imaging Collaboration (ISIC) 2018 dataset. The experimental analysis demonstrates that impressive results of skin lesion classification are achieved by employing the hybrid model and FL strategy, which shows significantly high performance and outperforms the existing work.
Convenient Decision Criteria for Surgery in Elderly Patients with Oral Squamous Cell Carcinoma
Authors: Takasaki Ryo , Yamagata Kenji , Fukuzawa Satoshi , Uchida Fumihiko , Ishibashi-Kanno Naomi , Bukawa Hiroki
Published: December 2022

Elderly patients with oral squamous cell carcinoma (OSCC) have difficulty undergoing curative surgical treatment due to various factors besides age. The purpose of the present study was to study the factors determining surgery in elderly patients with OSCC. We designed and implemented a retrospective cohort study. The study sample included elderly patients aged ≥ 70 years with OSCC and they were statistically compared between the surgery and non-surgery groups. The primary outcome variable was selecting surgery as the treatment plan, while the secondary outcome was the prognosis of each group. The sample comprised 76 patients aged ≥ 70 years with OSCC, of whom 52 treated with surgery and 24 patients treated with non-surgery. As decision factors, performance status (PS), clinical stage, serum Alb level, body mass index (BMI), and Geriatric Nutritional Risk Index (GNRI) were significantly associated with the selection of surgery. Logistic multivariate analysis identified three independent predictive factors for selecting surgery: Alb (≥3.5 vs. <3.5), PS (0, 1, 2, 3), and clinical stage. According to the decision tree analysis, curative surgery is the recommended treatment strategy for elderly patients with Alb ≥ 3.5 g/dL, PS 0, and stage I, II. In conclusion, Alb, PS, and clinical stage may be the criteria for selecting surgery in elderly patients.