bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustainable ultra‐strong thermally conductive wood‐based antibacterial structural materials with anti‐corrosion and ultraviolet shielding
Authors: Ye Haoran , Shi Yang , Xu Ben Bin , Guo Zhanhu , Fan Wei , Zhang Zhongfeng , Mulvihill Daniel M. , Zhang Xuehua , Shi Pengju , He Ximin , Ge Shengbo
Published: October 2023

In light of the uprising global development on sustainability, an innovative and environmental friendly wood‐based material derived from natural pinewood has been developed as a high‐performance alternative to petrochemical‐based materials. The wood‐based functional material, named as BC‐CaCl2, is synthesized through the coordination of carboxyl groups (−COOH) present in pinewood with calcium ions (Ca2+), which facilitates the formation of a high‐density cross‐linking structure through the combined action of intermolecular hydrogen bonds. The as‐prepared BC‐CaCl2 exhibits excellent tensile strength (470.5 MPa) and flexural strength (539.5 MPa), establishing a robust structural basis for the materials. Meanwhile, BC‐CaCl2 shows good water resistance, thermal conductivity, thermal stability, UV resistance, corrosion resistance, and antibacterial properties. BC‐CaCl2 represents a viable alternative to petrochemical‐based materials. Its potential application areas include waterproof enclosure structure of buildings, indoor underfloor heating, outdoor UV resistant protective cover, and anti‐corrosion materials for installation engineering, and so forth.

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Production of sustainable biodiesel from alkaline pretreated dairy effluent using Yarrowia lipolytica
Authors: Srirajarajeshwari M. , Jeyanthi J.
Published: October 2023

Biodiesel (BD) has grown in popularity over the last few years due to the global energy crisis, in addition to the depletion of reserves and the shortage of oil. The current study investigates the utilization of dairy effluent as a substratum for Yarrowia lipolytica, an oily yeast employed in biofuel generation. The dairy effluent has high biochemical oxygen demand, dissolved solids and, low pH. In this study, based on carbon nitrogen ratio (C/N), the alkaline pretreatment method (KOH 5%) was adopted to grow Y. lipolytica in dairy effluent. After 5 days of growth at 29°C, pH 6.9 (initial pH of dairy effluent), and stirring speed 120 rpm, the growth of Y. lipolytica produced 42.3 g/L biomass. Utilizing an ex‐situ transesterification method, the biomass was metamorphosed into BD. Using a modified version of Folch, Bligh, and Dyer's approach, lipid removal was done as the initial step. Moreover, the lipid was transesterified in a KOH catalyst, yielding 61% BD. Utilizing Fourier transform infrared spectroscopy analysis, the produced fatty acid methyl ester was examined.
An experimental study on optimum temperature of B20 POBD for higher efficiency and lower emissions of a DI diesel engine in lean and ultra‐lean combustion conditions
Authors: Pourhoseini S. H. , Javadpour Seyed Morteza , Baghban M. , Ficarella A.
Published: October 2023

The impact of inlet fuel temperature on the performance and emission characteristics of a 406 cc, single‐cylinder, air‐cooled, 4‐stroke, direct injection (DI) diesel engine was investigated to determine the suitable temperature of fuel for the best conditions of the engine in lean and ultra‐lean mixture combustion mode. B20 palm oil biodiesel‐diesel blend fuel (B20 POBD), as common renewable fuel and favorite biodiesel blend ratio used in the research, was provided and injected in the engine at varying temperatures in the range of 10–40°C and the engine parameters including the output power, specific fuel consumption (SFC), thermal efficiency, flue gas heat recovery efficiency and CO and NOx pollutant emissions were measured at different air–fuel ratios corresponded to lean and ultra‐lean mixtures. The results showed that there is an optimum temperature for fuel (about 20°C) in which maximum thermal efficiency and minimum SFC and CO emission are obtained. The minimum SFC and CO emission were 0.45 Kg/kWh and 610 ppm at the optimum temperature and output power of 1.5 kW, respectively. The effect of fuel temperature on SFC and CO increases as the output power decreases and for all fuel temperatures, the output power is inversely related to the air–fuel ratio. In addition, the elevated output power reduces the CO emission in all inlet fuel temperatures. Furthermore, an ultra‐lean mixture (very high A/F ratio) can dramatically decrease the thermal efficiency of diesel engines at all fuel temperatures, such that at the inlet fuel temperature of 17°C, increase in A/F ratio from 51 to 108 decreases the thermal efficiency from 16.8% to 0.12%. Finally, low engine output power leads to low levels of NOx emission, such that decrease in output power from 1.5 to 0.5 kW reduces the NOx emission from 522 to 204 ppm, respectively.
Critical drawdown pressure prediction for sanding production of underground gas storage in a depleted reservoir in China
Authors: Song Rui , Xie Ruiyang , Zhang Ping , Pei Guihong , Liu Jianjun , Wan Xusheng
Published: October 2023

Sanding production of the underground gas storage (UGS) in the depleted reservoir will cause the decline of effective storage capacity, and the erosion of well string and auxiliary equipment, and other engineering problems. A deep understanding of the sanding production contributes to maintaining the injection and production capacity of gas storage and the long‐term safety of the UGS. In this paper, core samples of five main sedimentary microfacies were drilled from the UGS in middle China. The mechanical properties with different conditions of the moisture content in multi‐cycling injection–production process were tested. The critical drawdown pressure (CDP) calculation methods for the UGS were established based on the stress analysis near the wellbore and the Mogi–Coulomb criterion. Adopting the finite element method simulation on the geological model of the target UGS, the geo‐stress of the formation was calculated by inversed analysis and validated based on the Kaiser effect of rock. Then, the CDP of two target wells of the UGS were investigated. The effects of the water moisture and the cycling times of the injection–production process on the CDP were also analyzed. The geo‐stress distribution shows that the horizontal maximum principal stress ranges from 53 to 68 MPa, and the horizontal minimum principal stress is 46–58 MPa in the target reservoir section, and the vertical minimum principal stress is 69–77 MPa in the target reservoir. The calculated CDP changed with the types of the sedimentary microfacies in the range of [6.27, 8.77] MPa, in which the CDP of the mixed mud and sand flat sedimentary facies was the lowest. The weakness of the CDP with the increasing of the moisture content and the cycling times were analyzed quantitively.
Unravelling the morphogenesis of coastal terraces at Cape Laundi (Sumba Island, Indonesia): Insights from numerical models
Authors: Chauveau Denovan , Pastier Anne‐Morwenn , de Gelder Gino , Husson Laurent , Authemayou Christine , Pedoja Kevin , Cahyarini Sri Yudawati
Published: October 2023

The morphology of coastal sequences provides fundamental observations to unravel past sea level (SL) variations. For that purpose, converting morphometric observations into a SL datum requires understanding their morphogenesis. The long‐lasting sequence of coral reef terraces (CRTs) at Cape Laundi (Sumba Island, Indonesia) could serve as a benchmark. Yet, it epitomizes a pitfall that challenges the ultimate goal: the overall chronology of its development remains poorly constrained. The polycyclic nature of the terraces, involving marine erosion and reoccupation of old coral colonies by more recent ones hinders any clear assignment of Marine Isotope Stages (MIS) to specific terraces, in particular the reference datum corresponding to the last Interglacial maximum (i.e., MIS 5e). Thus, to overcome these obstacles, we numerically model the genesis of the sequence, testing a range of eustatic SL (ESL) reconstructions and uplift rates, as well as exploring the parameter space to address reef growth, erosion and sedimentation. A total of 625 model runs allowed us to improve the morpho‐chronological constraints of the coastal sequence and, more particularly, to explain the morphogenesis of the several CRTs associated with MIS 5e. Our results suggest that the lowermost main terrace was first constructed during the marine transgression of MIS 5e and was later reshaped during the marine regression of MIS 5e, as well as during the MIS 5c and MIS 5a highstands. Finally, we discuss the general morphology of the sequence and the implications it may have on SL reconstructions. At Cape Laundi, as elsewhere, we emphasize the necessity of addressing the development of CRT sequences with a dynamic approach, that is, considering that a CRT is a landform built continuously throughout the history of SL oscillations, and not simply during a singular SL maximum.
Efficacy mechanisms research progress of the active components in the characteristic woody edible oils
Authors: Xu Lili , Wang Wei , Bai Kaiwen , Wu Yi , Ling Yilin , Kong Xiaoyue , Agusti Romero , Qi Qianhui , Zheng Zhaisheng , Yuan Ming'an , Chen Le , Liu Lianliang , Weng Peifang , Zhang Yu
Published: October 2023

Woody edible oils are a type of vegetable oil. Woody edible oils like olive oil have greater quantities of unsaturated fatty acids (UFAs), particularly essential FAs, as well as vitamin E, phytosterols, and other nutrients that are becoming more vital in human health. As a result, finding high‐quality woody oil resource plants is critical to ensuring enough edible oil supply. As six novel woody crops, Paeonia suffruticosa, Plukenetia volubilis, Acer truncatum, Olea europaea, Camellia sinensis, and Camellia oleifera are characterized by high oil production, widespread cultivation, adaptability, and various active ingredients. The six woody crop oils contain UFAs (e.g., α‐linolenic acid, oleic acid, and linoleic acid), vitamin E, polyphenols, phytosterols, and so forth. The presence of these active ingredients confers anti‐inflammatory, antioxidant, cholesterol and lipid metabolism regulating, blood lipid lowering, immune boosting, memory improving, intestinal flora regulating, and other properties to the oils, which are beneficial to body health. This article examined in depth the seed resources, FA composition, active component kinds, active ingredient efficacy mechanism, and physiological impacts of these six novel woody crop oils. These developments lay a solid platform for further study and development of these woody oil crops.
The efficacy of Nigella sativa L. oil on serum biomarkers of inflammation and oxidative stress and quality of life in patients with knee osteoarthritis: A parallel triple‐arm double‐blind randomized controlled trial
Authors: Amirtaheri Afshar Afsaneh , Toopchizadeh Vahideh , Dolatkhah Neda , Jahanjou Fatemeh , Farshbaf‐Khalili Azizeh
Published: October 2023

The aim of this double‐blind clinical trial was to investigate the effects of Nigella sativa oil on serum inflammatory and oxidative stress biomarkers and quality of life in patients with knee osteoarthritis (OA). Forty‐five patients who met the eligibility criteria were randomly divided into three groups with a ratio of 1:1:1. The first group received 2.5 mL oral N. sativa oil twice/day plus placebo topical oil, the second group received 2.5 mL topical N. sativa oil three times/day plus placebo oral oil, and the third group received oral and topical oil placebos. There were no intergroup differences in baseline characteristics. After 6 weeks of supplementation, oral N. sativa caused a significant improvement in the serum levels of hs‐CRP (p = .003), MDA (p = .003), and TAC (p = .001). Oral N. sativa oil compared to placebo (aMD (95% CI): −0.81 (−1.45 to −0.19); p = .012) and topical N. sativa oil [aMD (95% CI): −0.76 (−1.38 to −0.15); p = .016] significantly reduced hs‐CRP serum levels. Significant improvements were observed in the general, physical, and mental health subscales in the oral and topical N. sativa oil compared to the placebo group (p < .05). The six‐week oral N. sativa oil supplementation was effective in improving inflammatory biomarkers in knee OA. Both oral and topical N. sativa oil increased the quality of life.
Golden thistle (Scolymus hispanicus L.) hydromethanolic extracts ameliorated glucose absorption and inflammatory markers in vitro
Authors: Ozel‐Tasci Cansu , Gulec Sukru
Published: October 2023

Golden thistle (GT, Scolymus hispanicus L.) is an edible plant native to the Mediterranean. Several activities have been reported for the GT, as it is used for traditional medicinal purposes in some cultures. In this study, we aimed to investigate the effects of GT crude extract on phenolic bioavailability, antidiabetic, and anti‐inflammatory activities by using colonic epithelium (CaCo‐2) and murine macrophage (RAW 264.7) cell lines. The CaCo‐2 cells were grown on the bicameral membrane system for intestinal bioavailability and glucose efflux. Lipopolysaccharide (LPS, 0.5 μg/mL) was used to induce systemic inflammation on RAW 264.7. The inflammatory medium of RAW 264.7 cells was given to Caco‐2 cells to mimic colonic inflammation. Our results showed that 5‐o‐caffeoylquinic acid had an apparent permeability of (1.82 ± 0.07) × 10−6 cm/s after 6 h. The extract lowered the glucose efflux by 39.4%–42.6%, in addition to the reductions in relative GLUT2 mRNA expressions by 49%–66% in pre‐ and co‐treatments (p < .05). Decreases in systemic inflammation markers of nitric oxide, tumor necrosis factor‐alpha, and interleukin‐6 (IL‐6) were also detected in 30%–45% range after pre‐treatments with the GT extract (p < .05). Lastly, colonic inflammation markers of IL‐6 and IL‐8 were reduced by 8.7%–19.5% as a result of GT pre‐treatments (p < .05). Thus, an in vitro investigation of GT extract revealed promising results on antidiabetic and anti‐inflammatory activities.
Mitigating physical hazards in food processing: Risk assessment and preventive strategies
Authors: Onyeaka Helen , Jalata Dassalegn Daraje , Mekonnen Solomon Abate
Published: October 2023

Physical contaminants in food, such as glass, metal, and plastic, can cause significant health risks and economic loss. This study explores these understudied physical hazards, aiming to provide comprehensive risk analysis and preventive solutions. Our research identified several key infiltration points in the food supply chain, including raw material sourcing and packaging stages. These hazards can be effectively mitigated by employing advanced technologies like metal detectors and optical sorting machines, along with stringent quality control measures. The findings offer valuable insights for stakeholders in the food industry, emphasizing the need for regulatory compliance and consumer education to ensure food safety.
Effect of cardamom consumption on inflammation and blood pressure in adults: A systematic review and meta‐analysis of randomized clinical trials
Authors: Heydarian Azadeh , Tahvilian Negin , Shahinfar Hossein , Abbas‐Hashemi Seyed Ali , Daryabeygi‐Khotbehsara Reza , Aryaeian Naheed
Published: October 2023

Cardamom has the potential to offer anti‐inflammatory and antihypertensive advantages, but the findings from clinical trials have been inconsistent. To address this knowledge gap, the present systematic review and meta‐analysis were conducted to evaluate the anti‐inflammatory and antihypertensive effects of cardamom in adults. We systematically searched databases including PubMed, Scopus, and ISI Web of Sciences, for papers published up to October 2022 to identify clinical studies. Eight eligible studies were included in the meta‐analysis. A fixed model was used to estimate weighted mean difference (WMD), standardized mean difference (SMD), and 95% confidence interval (95% CI). The results showed that cardamom significantly reduced the levels of inflammatory factors, including hs‐CRP (SMD: −0.60 mg/dL; 95% CI: −0.78 to 0.42), IL‐6 (WMD: −1.25 mg/dL; 95% CI: −1.48 to −1.03), TNF‐α (WMD: −2.10 kg; 95% CI: −2.36 to −1.84, p < .001), and measures of systolic (WMD: −0.54 mmHg, 95% CI: −0.88, −0.19, p = .002) and diastolic (WMD: −0.90 mmHg; 95% CI: −1.07 to −0.73) blood pressure. The current meta‐analysis showed that cardamom can help reduce inflammation and improve blood pressure. However, due to the limited number of studies, caution must be exercised when interpreting the current results.
Attribution of runoff and hydrological drought changes in an ecologically vulnerable basin in semi‐arid regions of China
Authors: Li Xinyue , Wang Yuntao , Xue Baolin , A Yinglan , Zhang Xiaojing , Wang Guoqiang
Published: October 2023

Climate change and human activities have been widely recognized as two major factors that deeply influence hydrological processes. Evaluating and identifying the contribution between different drivers contributes to better regional water management regulation. In this study, we used the variable infiltration capacity (VIC) model to quantify the contributions of different climatic variables and human activities to runoff in the Hunhe basin, which has a semiarid climate, in northern China. Through trend analysis, the study period is divided into the ‘baseline period’ (1982–1999) and the ‘change period’ (2000–2020). The results indicated that compared with climate change, human activities were the major factors decreasing runoff, contributing more than 86.3% to the runoff reduction in the change period. Climate change increased winter runoff but decreased summer and autumn runoff, resulting in an overall decrease in runoff. There is a trend of increasing severity of hydrological drought in the Hunhe basin, where climate change accounted for 28.2% of the total impact and human activities accounted for 72.8%. The change in runoff and hydrological drought was mainly due to human activities, including changing farmland to grassland and forest. These results would be helpful for policy‐makers and researchers to better understand the responses of runoff and hydrological drought to these changing environmental conditions and offering references for future water resource planning and management at the basin scale.
HMARNET—A Hierarchical Multi‐Attention Residual Network for Gleason scoring of prostate cancer
Authors: Karthik R. , Menaka R. , Siddharth M. V. , Hussain Sameeha , Siddharth P. , Won Daehan
Published: October 2023

Manual delineation of prostate cancer (PCa) from whole slide images (WSIs) demands requires pathologists with adequate domain knowledge. This process is generally strenuous and may be subjected to poor inter‐pathologist reproducibility. Accurate Gleason scoring is an important step in the computer‐aided diagnosis of PCa. This work proposes a novel lightweight convolutional neural networks (CNN) to extract significant hierarchical features from the histopathology images. It learns meticulous attention‐guided feature representations through the convolutional layers for precise scoring of Gleason grades. The Hierarchical Multi‐Attention Residual (HMAR) block extracts attention‐guided features and fuses the resulting feature maps from multiple levels with a reduced number of trainable parameters. We have also proposed a new lightweight channel‐attention module, enhanced channel attention (ECA) to extract inter‐channel features from different receptive fields. With the presence of different attention mechanisms, the network learns to focus on more significant features rather than unnecessary ones. Additionally, mixed FocalOHEM loss is proposed to optimize the CNN and efficiently minimize the error. While the focal loss helps to address the class imbalance present in the TCGA‐PRAD dataset, the online hard example mining (OHEM) loss focuses on optimizing hard negative samples. It achieved an accuracy of 89.19% with a Kappa score of 86% on the TCGA‐PRAD dataset.
Consequences of hygiene and sanitation limitations on physicochemical, bacteriological and parasitological quality of water for vegetable irrigation purpose in the Mbouda lowlands, Cameroon western highlands
Authors: Ntangmo Tsafack Honorine , Meli Tchoffo Auberlin , Robean Wamba Franck , Joko Tamoufé Stève , Joseline Azeufack , Azinwi Tamfuh Primus , Temgoua Emile
Published: October 2023

The aim of this study was to determine the health risk associated with vegetable irrigation using lowland water in the town of Mbouda. Watered vegetables and water from five yards and three wells used by market gardeners were analysed in the dry season using standardized methods. Bacterial levels ranging from 6.37 ± 0.71 to 9.03 ± 0.43 Log CFU/100 g/DM (dry matter) were detected in the various vegetables produced in the lowlands of Mbouda: Escherichia coli (4.10–5.03 Log CFU/100 mL), faecal coliforms (5.28–5.99 Log CFU/100 mL), Shigella spp. (4.86–6.25 Log CFU/100 mL) and Salmonella spp. (3.85–5.21 Log CFU/100 mL) in irrigation water; Ascaris spp. eggs, Entamoeba spp. cysts, Ancylostoma spp. eggs and nematode larvae were detected at levels above the standard recommended by the World Health Organization. This sets 3 Log CFU/100 mL of these bacteria in water, 1–2 Log CFU/25 g/DM on vegetables, but 3 Log CFU/25 g/DM for faecal coliforms as acceptable limits and zero for any parasitic stage (eggs, cysts, and larvae). This constitutes a real health risk for consumers. The town's virtually nonexistent sewage system could be at the root of this water pollution.
Machine-Learning Assessed Abdominal Aortic Calcification is Associated with Long-Term Fall and Fracture Risk in Community-Dwelling Older Australian Women
Authors: Dalla Via Jack , Gebre Abadi K. , Smith Cassandra , Gilani Zulqarnain , Suter David , Sharif Naeha , Szulc Pawel , Schousboe John T. , Kiel Douglas P. , Zhu Kun , Leslie William D. , Prince Richard L. , Lewis Joshua R. , Sim Marc
Published: October 2023

Abdominal aortic calcification (AAC), a recognized measure of advanced vascular disease, is associated with higher cardiovascular risk and poorer long-term prognosis. AAC can be assessed on dual-energy X-ray absorptiometry (DXA)-derived lateral spine images used for vertebral fracture assessment at the time of bone density screening using a validated 24-point scoring method (AAC-24). Previous studies have identified robust associations between AAC-24 score, incident falls, and fractures. However, a major limitation of manual AAC assessment is that it requires a trained expert. Hence, we have developed an automated machine-learning algorithm for assessing AAC-24 scores (ML-AAC24). In this prospective study, we evaluated the association between ML-AAC24 and long-term incident falls and fractures in 1023 community-dwelling older women (mean age, 75 ± 3 years) from the Perth Longitudinal Study of Ageing Women. Over 10 years of follow-up, 253 (24.7%) women experienced a clinical fracture identified via self-report every 4–6 months and verified by X-ray, and 169 (16.5%) women had a fracture hospitalization identified from linked hospital discharge data. Over 14.5 years, 393 (38.4%) women experienced an injurious fall requiring hospitalization identified from linked hospital discharge data. After adjusting for baseline fracture risk, women with moderate to extensive AAC (ML-AAC24 ≥ 2) had a greater risk of clinical fractures (hazard ratio [HR] 1.42; 95% confidence interval [CI], 1.10–1.85) and fall-related hospitalization (HR 1.35; 95% CI, 1.09–1.66), compared to those with low AAC (ML-AAC24 ≤ 1). Similar to manually assessed AAC-24, ML-AAC24 was not associated with fracture hospitalizations. The relative hazard estimates obtained using machine learning were similar to those using manually assessed AAC-24 scores. In conclusion, this novel automated method for assessing AAC, that can be easily and seamlessly captured at the time of bone density testing, has robust associations with long-term incident clinical fractures and injurious falls. However, the performance of the ML-AAC24 algorithm needs to be verified in independent cohorts. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Efficacy and Toxicity of Calcitonin Treatment in Children with Cherubism: A Single-Center Cohort Study
Authors: Schreuder Willem H. , Meijer Ethan B. , Cleven Arjen H.G. , Edelenbos Esther , Klop Cornelis , Schreurs Ruud , de Jong Renate T. , van Maarle Merel C. , Horsthuis Roy B.G. , de Lange Jan , van den Berg Henk
Published: October 2023

Cherubism is a rare autosomal dominant disease characterized by expansile osteolytic jawbone lesions. The effect and safety of off-label calcitonin treatment during the progressive phase of the disease are not well described. In this retrospective study, we present data on the radiological response and adverse effects of subcutaneously administered calcitonin in a cohort of nine cherubism children (three female, six male). Two of the nine patients underwent two separate treatment courses with a significant off-treatment interval in between; therefore, a total of 11 treatment courses with a mean duration of 17.9 months (range <1 to 35, SD 10.8) were studied. To measure the response, the cumulative volume of cherubism lesions was calculated from available three-dimensional imaging. The primary outcome was the change in the volume of lesions during calcitonin treatment and only assessed for the eight treatment courses with a minimal duration of 6 months. A statistically significant reduction in the mean cumulative volume of lesions was seen regardless of treatment duration. Average volume reduction was highest in the first half year of treatment, with a gradual, ongoing reduction thereafter. For the secondary outcome, the change in the cumulative volume of lesions after treatment cessation was assessed for the seven treatment courses with follow-up imaging available. After six of these seven treatment courses, the cumulative volume increased again but remained undoubtedly smaller than the initial volume at the start of therapy. Adverse effects were assessed for all 11 treatment courses and occurred in 73% of them. Most adverse effects were mild and low grade, with the most severe being one grade 3 symptomatic hypocalcemia requiring hospitalization and early treatment termination. Calcitonin treatment seems effective and tolerable in treating actively progressing cherubism in children. However, further research is required to better understand the pharmacological treatment of cherubism, including also other drugs, dosing, and protocols. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
A fatal Candida albicans pericarditis presenting with cardiac tamponade after COVID‐19 infection and cardiothoracic surgery
Authors: Salimi Maryam , Davoodi Lotfollah , Jalalian Rozita , Darayee Masood , Moslemi Azam , Faeli Leyla , Mirzakhani Roghayeh , Shokohi Tahereh
Published: October 2023

Background

Candida pericardial infection is a rare clinical entity usually related to recent cardiothoracic surgery and chronic debilitating conditions. During the COVID‐19 pandemic, invasive fungal infections have been on the rise, likely due to a combination of factors such as immunosuppression, underlying conditions like diabetes, and surgical procedures.

Case Presentation

Herein, we report a 67‐year‐old diabetic woman with a history of COVID‐19 infection who received a high dose of corticosteroids a few months before admission, and previous myocardial infarction for more than 12 years. The patient had a positive cardiac tamponade with signs of dyspnea, chest pain, and low blood pressure. Echocardiographic data were more in favor of constrictive pericarditis. The patient underwent urgent echocardiography‐guided pericardiocentesis and then broad‐spectrum antibiotic treatment was prescribed. Repeated echocardiography implied a persistent pericardial effusion 10 days later. Subxiphoid aspirates and biopsied tissues showed budding yeast cells and yeast colonies grew on culture media identified as Candida albicans.

Conclusion

This report should bring to the attention of physicians toward the possibility of Candida pericardial infection presenting with cardiac tamponade after COVID‐19 infection and cardiothoracic surgery. Echocardiographic assessment, prompt pericardiotomy, molecular‐based identification of causative agent, and early administration of appropriate antifungal treatment should improve the patient's survival.
Real‐world experience of novel multiple myeloma treatments in a large, single‐center cohort in Finland
Authors: Loponen Heidi , Mehtälä Juha , Ylisaukko‐oja Tero , Brück Oscar , Porkka Kimmo , Koskenvesa Perttu , Saukkonen Kirsi , Lievonen Juha
Published: October 2023

In this single‐center study, we aimed to describe the characteristics, treatment patterns, and outcomes of patients with multiple myeloma (MM) following treatment with bortezomib, carfilzomib, daratumumab, ixazomib, lenalidomide or pomalidomide‐based regimens. Data were collected retrospectively from a study cohort of patients receiving a MM treatment in the Hospital District of Helsinki and Uusimaa (HUS) in Finland between 2016–2020. In total, 472 patients were included in the study. Median age was 68.2 years and nearly 25% had a high cytogenetic risk according to the International Myeloma Working Group categorization. In 2018–2020, the spectrum of regimens used as third‐ or later‐line therapy was notably broader than in 2016–2017. The overall response rates for patients who received the most novel regimens (available ≤ 5 years) in second or third line of therapy (n = 67/430) and fourth line or later (n = 78/151) were 53.3% and 25.0%, respectively. In this real‐world MM patient cohort, the response rates for these novel agents were lower compared to those reported in clinical trials. Given the higher cytogenetic risk profile and more advanced disease stage at the time when treated with novel agents, patients could have benefited from effective novel therapies earlier in their treatment pathway.

What is the NEW aspect of your work? (ONE sentence) This study characterized the treatment of Finnish multiple myeloma patients during the era of most novel therapies (after 2016) and also included information on the cytogenetic risk profile of this real‐world population.

What is the CENTRAL finding of your work? (ONE sentence) There are clear differences between real‐world populations treated with most novel combinations and those of randomized controlled trials (RCTs), which is reflected by the poorer treatment outcomes in the real‐world setting.

What is (or could be) the SPECIFIC clinical relevance of your work? (ONE sentence) Given the high cytogenetic risk profile and advanced disease stage at the time when treated with novel agents, patients could have benefited from effective novel therapies earlier in their treatment pathway.
Field performance and cost‐effectiveness of a point‐of‐care triage test for HIV virological failure in Southern Africa
Authors: Saura‐Lázaro Anna , Bock Peter , Bogaart Erika van den , van Vliet Jessie , Granés Laura , Nel Kerry , Naidoo Vikesh , Scheepers Michelle , Saunders Yvonne , Leal Núria , Ramponi Francesco , Paulussen René , de Wit Tobias Rinke , Naniche Denise , López‐Varela Elisa
Published: October 2023

Introduction

Antiretroviral therapy (ART) monitoring using viral load (VL) testing is challenging in high‐burden, limited‐resources settings. Chemokine IP‐10 (interferon gamma‐induced protein 10) strongly correlates with human immunodeficiency virus (HIV) VL. Its determination could serve to predict virological failure (VF) and to triage patients requiring VL testing. We assessed the field performance of a semi‐quantitative IP‐10 lateral flow assay (LFA) for VF screening in South Africa, and the cost‐effectiveness of its implementation in Mozambique.

Methods

A cross‐sectional study was conducted between June and December 2021 in three primary health clinics in the Western Cape. Finger prick capillary blood was collected from adults on ART for ≥1 year for direct application onto the IP‐10 LFA (index test) and compared with a plasma VL result ≤1 month prior (reference test). We estimated the area under the receiver operating characteristic curves (AUC), sensitivity and specificity, to evaluate IP‐10 LFA prediction of VF (VL>1000 copies/ml). A decision tree model was used to investigate the cost‐effectiveness of integrating IP‐10 LFA combined with VL testing into the current Mozambican ART monitoring strategy. Averted disability‐adjusted life years (DALYs) and HIV acquisitions, and incremental cost‐effectiveness ratios were estimated.

Results

Among 209 participants (median age 38 years and 84% female), 18% had VF. Median IP‐10 LFA values were higher among individuals with VF compared to those without (24.0 vs. 14.6; p<0.001). The IP‐10 LFA predicted VF with an AUC = 0.76 (95% confidence interval (CI) 0.67–0.85), 91.9% sensitivity (95% CI 78.1–98.3) and 35.1% specificity (95% CI 28.0–42.7). Integrating the IP‐10 LFA in a setting with 20% VF prevalence and 61% VL testing coverage could save 13.0% of costs and avert 14.9% of DALYs and 55.7% new HIV acquisitions. Furthermore, its introduction was estimated to reduce the total number of routine VL tests required for ART monitoring by up to 68%.

Conclusions

The IP‐10 LFA is an effective VF triage test for routine ART monitoring. Combining a highly sensitive, low‐cost IP‐10 LFA‐based screening with targeted VL confirmatory testing could result in significant healthcare quality improvements and cost savings in settings with limited access to VL testing.
Elucidating the molecular role of MUC5B in progressive lung adenocarcinoma: Prospects for early diagnosis
Authors: Ashok Gayathri , Soundararajan Abirami , Anbarasu Anand , Ramaiah Sudha
Published: October 2023

Gel‐forming mucin MUC5B is significantly deregulated in lung adenocarcinoma (LUAD), however, its role in tumor progression is not yet clearly understood. Here, we used an integrated computational‐pipeline‐initiated with gene expression analysis followed by network, functional‐enrichment, O‐linked glycosylation analyses, mutational profiling, and immune cell infiltration estimation to functionally characterize MUC5B gene in LUAD. Thereafter, clinical biomarker validation was supported by the overall survival (OA) and comparative expression profiling across clinical stages using computational algorithms. The gene expression profile of LUAD identified MUC5B to be significantly up‐regulated (logFC: 2.36; p‐value: 0.01). Network analysis on LUAD interactome screened MUC5B‐related genes, having key enrichment in immune suppression and O‐linked glycosylation with serine–threonine‐rich tandem repeats being highly glycosylated. Furthermore, positive correlation of mutant MUC5B with immune cells in tumor microenvironment (TME) such as cancer‐associated fibroblasts and myeloid‐derived suppressor cells indicates TME‐mediated tumor progression. The positive correlation with immune inhibitors suggested the enhanced tumor proliferation mediated by MUC5B. Structural stability due to genetic alterations identified overall rigid N–H‐backbone dynamics (S2: 0.756), indicating an overall stable mutant protein. Moreover, the low median OA (<50 months) with a hazard ratio of 1.4 and clinical profile of MUC5B gene showed high median expression corresponding to lymph node (N2) and tumor (T3) stages. Our study concludes by highlighting the functional role of O‐glycosylated and mutant MUC5B in promoting LUAD by immune suppression. Further, clinical gene expression validation of MUC5B suggests its potential role as a diagnostic biomarker for LUAD metastasis.
Picture Perfect: The Status of Image Quality in Prostate MRI
Authors: Woernle Alexandre , Englman Cameron , Dickinson Louise , Kirkham Alex , Punwani Shonit , Haider Aiman , Freeman Alex , Kasivisivanathan Veeru , Emberton Mark , Hines John , Moore Caroline M. , Allen Clare , Giganti Francesco
Published: October 2023

Magnetic resonance imaging is the gold standard imaging modality for the diagnosis of prostate cancer (PCa). Image quality is a fundamental prerequisite for the ability to detect clinically significant disease. In this critical review, we separate the issue of image quality into quality improvement and quality assessment. Beginning with the evolution of technical recommendations for scan acquisition, we investigate the role of patient preparation, scanner factors, and more advanced sequences, including those featuring Artificial Intelligence (AI), in determining image quality. As means of quality appraisal, the published literature on scoring systems (including the Prostate Imaging Quality score), is evaluated. Finally, the application of AI and teaching courses as ways to facilitate quality assessment are discussed, encouraging the implementation of future image quality initiatives along the PCa diagnostic and monitoring pathway.

Evidence Level

3

Technical Efficacy

Stage 3
Global and Regional Deep Learning Models for Multiple Sclerosis Stratification From MRI
Authors: Coll Llucia , Pareto Deborah , Carbonell‐Mirabent Pere , Cobo‐Calvo Álvaro , Arrambide Georgina , Vidal‐Jordana Ángela , Comabella Manuel , Castilló Joaquín , Rodrı́guez‐Acevedo Breogán , Zabalza Ana , Galán Ingrid , Midaglia Luciana , Nos Carlos , Auger Cristina , Alberich Manel , Río Jordi , Sastre‐Garriga Jaume , Oliver Arnau , Montalban Xavier , Rovira Àlex , Tintoré Mar , Lladó Xavier , Tur Carmen
Published: October 2023

Background

The combination of anatomical MRI and deep learning‐based methods such as convolutional neural networks (CNNs) is a promising strategy to build predictive models of multiple sclerosis (MS) prognosis. However, studies assessing the effect of different input strategies on model's performance are lacking.

Purpose

To compare whole‐brain input sampling strategies and regional/specific‐tissue strategies, which focus on a priori known relevant areas for disability accrual, to stratify MS patients based on their disability level.

Study Type

Retrospective.

Subjects

Three hundred nineteen MS patients (382 brain MRI scans) with clinical assessment of disability level performed within the following 6 months (~70% training/~15% validation/~15% inference in‐house dataset) and 440 MS patients from multiple centers (independent external validation cohort).

Field Strength/Sequence

Single vendor 1.5 T or 3.0 T. Magnetization‐Prepared Rapid Gradient‐Echo and Fluid‐Attenuated Inversion Recovery sequences.

Assessment

A 7‐fold patient cross validation strategy was used to train a 3D‐CNN to classify patients into two groups, Expanded Disability Status Scale score (EDSS) ≥ 3.0 or EDSS < 3.0. Two strategies were investigated: 1) a global approach, taking the whole brain volume as input and 2) regional approaches using five different regions‐of‐interest: white matter, gray matter, subcortical gray matter, ventricles, and brainstem structures. The performance of the models was assessed in the in‐house and the independent external cohorts.

Statistical Tests

Balanced accuracy, sensitivity, specificity, area under receiver operating characteristic (ROC) curve (AUC).

Results

With the in‐house dataset, the gray matter regional model showed the highest stratification accuracy (81%), followed by the global approach (79%). In the external dataset, without any further retraining, an accuracy of 72% was achieved for the white matter model and 71% for the global approach.

Data Conclusion

The global approach offered the best trade‐off between internal performance and external validation to stratify MS patients based on accumulated disability.

Evidence Level

4

Technical Efficacy

Stage 2
Reduced neutralization and Fc effector function to Omicron subvariants in sera from SARS‐CoV‐1 survivors after two doses of CoronaVac plus one dose subunit vaccine
Authors: Chen Danying , Li Xinglin , Hao Xiaohua , Qiu Yaruo , Song Yanjun , Sun Hui , Liu Yongmei , Du Juan , Zhang Yuanyuan , Xiao Fan , Song Chuan , Yan Yonghong , Song Rui , Wang Xi , Zhao Xuesen , Jin Ronghua
Published: October 2023

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Omicron harbors more than 30 mutations of the spike protein and exhibits substantial immune evasion. Although previous study indicated that BNT162b2 messenger RNA vaccine induces potent cross‐clade pan‐sarbecovirus neutralizing antibodies in survivors of the infection by SARS‐CoV‐1, the neutralization activity and Fc‐mediated effector functions of these cross‐reactive antibodies elicited in SARS‐CoV‐1 survivors to Omicron subvariants still remain largely unknown. In this study, the neutralization activity and Fc‐mediated effector functions of antibodies boosted by a third dose vaccination were characterized in SARS‐CoV‐1 convalescents and healthy individuals. Potent cross‐clade broadly neutralizing antibodies were observed in SARS‐CoV‐1 survivors who received a three‐dose vaccination regimen consisting of two priming doses of CoronaVac followed by one booster dose of the protein subunit vaccine ZF2001. However, the induced antibodies exhibited both reduced neutralization and impaired Fc effector functions targeting multiple Omicron subvariants. Importantly, the data also support the notion that immune imprints resulted from SARS‐CoV‐1 infection may exacerbate the impairment of neutralization activity and Fc‐mediated effector functions to Omicron subvariants and provided invaluable information to vaccination strategy in future.
Amplicon size and non‐encapsidated DNA fragments define plasma cytomegalovirus DNA loads by automated nucleic acid testing platforms: A marker of viral cytopathology?
Authors: Leuzinger Karoline , Hirsch Hans H.
Published: October 2023

Management of cytomegalovirus (CMV) in transplant patients relies on measuring plasma CMV‐loads using quantitative nucleic acid testing (QNAT). We prospectively compared the automated Roche‐cobas®6800‐CMV and Roche‐CAP/CTM‐CMV with laboratory‐developed Basel‐CMV‐UL54‐95bp, and Basel‐CMV‐UL111a‐77bp. Roche‐cobas®6800‐CMV and Roche‐CAP/CTM‐CMV were qualitatively concordant in 142/150 cases (95%). In‐depth comparison revealed higher CMV‐loads of the laboratory‐developed assay and correlated with smaller amplicon size. After calibration to the 1.WHO‐approved CMV international standard, differences were reduced but remained significant. DNase‐I pretreatment significantly reduced CMV‐loads for both automated Roche‐CAP/CTM‐CMV and Roche‐cobas®6800‐CMV assays, whereby 90% and 95% of samples became undetectable. DNase‐I pretreatment also reduced CMV‐loads quantified by Basel‐CMV‐UL54‐95bp and Basel‐CMV‐UL111a‐77bp, but remaining detectable in 20% and 35%, respectively. Differences were largest for 110 samples with low‐level CMV‐DNAemia being detectable but not‐quantifiable by Roche‐cobas®6800‐CMV, whereby the smaller amplicon sizes yielded higher viral loads for concordant positives. We conclude that non‐encapsidated fragmented CMV‐DNA is the major form of plasma CMV‐loads also measured by fully‐automated platforms. Amplicons of <150 bp and calibrators are needed for reliable and commutable QNAT‐results. We hypothesize that non‐encapsidated fragmented CMV‐DNA results from lysis of CMV‐replicating cells and represent a direct marker of viral cell damage, which contribute to delayed viral load responses despite effective antivirals.
Repurposing Navitoclax to block SARS‐CoV‐2 fusion and entry by targeting heptapeptide repeat sequence 1 in S2 protein
Authors: Jiao Fanke , Andrianov Alexander M. , Wang Lijue , Furs Konstantin V. , Gonchar Anna V. , Wang Qian , Xu Wei , Lu Lu , Xia Shuai , Tuzikov Alexander V. , Jiang Shibo
Published: October 2023

Along with the long pandemic of COVID‐19 caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has come the dilemma of emerging viral variants of concern (VOC), particularly Omicron and its subvariants, able to deftly escape immune surveillance and the otherwise protective effect of current vaccines and antibody drugs. We previously identified a peptide‐based pan‐CoV fusion inhibitor, termed as EK1, able to bind the HR1 region in viral spike (S) protein S2 subunit. This effectively blocked formation of the six‐helix bundle (6‐HB) fusion core and, thus, showed efficacy against all human coronaviruses (HCoVs). EK1 is now in phase 3 clinical trials. However, the peptide drug generally lacks oral availability. Therefore, we herein performed a structure‐based virtual screening of the libraries of biologically active molecules and identified nine candidate compounds. One is Navitoclax, an orally active anticancer drug by inhibition of Bcl‐2. Like EK1 peptide, it could bind HR1 and block 6‐HB formation, efficiently inhibiting fusion and infection of all SARS‐CoV‐2 variants tested, as well as SARS‐CoV and MERS‐CoV, with IC50 values ranging from 0.5 to 3.7 μM. These findings suggest that Navitoclax is a promising repurposed drug candidate for development as a safe and orally available broad‐spectrum antiviral drug to combat the current SARS‐CoV‐2 and its variants, as well as other HCoVs.
Transmissibility quantification of norovirus outbreaks in 2016−2021 in Beijing, China
Authors: Wang Yu , Gao Zhiyong , Lu Qingbin , Liu Baiwei , Jia Lei , Shen Lingyu , Tian Yi , Li Weihong , Yan Hanqiu , Zhang Daitao , Yang Peng , Fang Liqun , Wang Quanyi , Cui Fuqiang
Published: October 2023

The transmissibility is a crucial feature for norovirus, yet its quantitative estimation has been limited. Our objective was to estimate the basic reproduction number (R0) of norovirus and investigate its variation characteristics. Norovirus outbreaks reported from September 2016 to August 2021 in Beijing were analyzed. The susceptible‐infected‐removed compartment model was established to estimate R0. Linear regression models and logistic regression models were used to explore the factors affecting the transmissibility of norovirus. The overall median R0 of norovirus was estimated as 2.1 (interquartile range [IQR] 1.8–2.5), with 650 norovirus outbreaks. The transmissibility of norovirus varied by year, outbreak setting and genotype. The R0 of norovirus during September 2019 to August 2020 (median 2.1, IQR 1.8–2.4) and September 2020 to August 2021 (median 2.0, IQR 1.7–2.3) was lower than that of September 2016 to August 2017 (median 2.3, IQR 1.8–2.7) (β = 0.94, p = 0.05; β = 0.93, p = 0.008). The R0 of norovirus for all other settings was lower than that for kindergarten (median 2.4, IQR 2.0–2.9) (primary school: median 2.0, IQR 1.7–2.4, β = 0.94, p = 0.001; secondary school: median 1.7, IQR 1.5–2.0, β = 0.87, p < 0.001; college: median 1.7, IQR 1.5–1.8, β = 0.89, p = 0.03; other closed settings: median 1.8, IQR 1.5–2.0, β = 0.90, p = 0.004). GⅡ.2[P16] outbreaks had a median R0 of 2.2 (IQR 1.8–2.7), which was higher than that for GⅡ.6[P7] outbreaks (median 1.8, IQR: 1.8–2.0, odds ratio = 0.19, p = 0.03; GⅡ.2[P16] as reference) and mixed‐genotype outbreaks (median 1.7, IQR: 1.5–1.8, β = 0.92, p = 0.02; mixed‐genotype as reference). In kindergartens and primary schools, norovirus shows increased transmissibility, emphasizing the vulnerable population and high‐risk settings. Furthermore, the transmissibility of norovirus may change over time and with virus evolution, necessitating additional research to uncover the underlying mechanisms.