bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical significance of high-dose chemotherapy with autologous stem cell transplantation in the era of novel agents in patients older than 65 years with multiple myeloma
Authors: Sato Shuku , Tsunoda Shun , Kawahigashi Teiko , Kamata Wataru , Tamai Yotaro
Published: March 2023

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard treatment for symptomatic multiple myeloma (MM) in patients under 65 years of age. However, the performing of ASCT in older patients > 65 years without comorbidities or complications is controversial. Introduction of novel drugs, such as daratumumab, has improved the long-term survival of patients with MM who are ineligible for ASCT. This retrospective study aimed to evaluate the clinical significance of ASCT in older patients, even in the era of novel drugs. A total of 55 patients aged 65–74 years (15 ASCT recipients and 40 ASCT-ineligible patients) newly diagnosed with MM between March 2013 and October 2021 at our institution were analyzed in this study. There were no significant differences in the 3-year overall survival (84.6% vs. 90.6%, p = 0.72) and progression-free survival (PFS) (61.2% vs. 75.1%, p = 0.40) between ASCT recipients and ASCT-ineligible patients. There was also no significant difference in complete response (CR) with minimal residual disease (MRD)-negative rate between the two groups (27% vs. 33%, p = 1.0). Multivariate analysis showed that CR was an independent predictor of PFS (hazard ratio [HR], 0.26; 95% confidence interval, 0.08–0.76; p = 0.01). In this retrospective study, despite patients who were determined to be intolerant to ASCT, the non-ASCT group was non-inferior to the ASCT group in PFS and overall response rate. The results of this study confirm that the significance of ASCT is diminishing in patients 65 years of age and older because newer agents can achieve good responses without ASCT.
Separation of conjoined spinal cords in symmetrical pygopagus twins using intraoperative neuromonitoring: pearls and pitfalls
Authors: Mahmoud Mohamed Ashraf , Elshawady Sherif Bahaa , Korkar George H. , Hussein Samar M. , Elserry Tarek H. , Mahmoud Mohamed Wael S.
Published: March 2023

Pygopagus twin is a rare congenital malformation with a worldwide incidence of 1in 200,000. Few literature reports are published regarding the matter. In some cases, neuromonitoring is essential for safe surgical separation. We believe it is important to share our challenges and nuances in order to minimize obstacles one might encounter. We utilized neuromonitoring during our separation of both twins, and we planned a multidisciplinary approach and efficient communication system with the other teams in order to plan a successful, safe, and timely separation of the twins. We seek to highlight not our success but rather the obstacles and challenges we encountered during the separation of pygopagus twins in our institute using neuromonitoring for future reference.
On the role of wave climate temporal variability in bias correction of GCM-RCM wave simulations
Authors: Lira Loarca Andrea , Berg Peter , Baquerizo Asuncion , Besio Giovanni
Published: March 2023

This work presents the performance analysis of a multi-model ensemble of wave climate projections in the Mediterranean Sea against hindcast data. The wave projections were developed with the numerical model Wavewatch III forced by surface wind fields of 17 EURO-CORDEX GCM-RCMs providing time series of the main wave parameters on a 3-h and 10-km resolution. The performance of the wave GCM-RCM simulations during the baseline period (1979–2005) was assessed by means of the deterministic metrics RMSE and Bias. Different bias correction methodologies were analyzed by means of the application of the widespread Empirical Quantile Mapping method considering different time periods of significant wave height in order to analyze the ability of the bias-correcting methods to capture the different wave climate temporal scales ranging from storm events, monthly, seasonal and interannual variability. The results show that the use of the EQM method for the full-time series without taking into account other timescales, can lead to increased biases in some regions and seasons and that the use of time-dependent bias-correction techniques leads to an improved accurate characterization of biases considering the interannual temporal variability of significant wave height. More specifically the use of the EQM method for monthly data provides a good performance in capturing the correlation and interannual temporal variability of wave climate.
Overexpression of hypoxia-inducible factor-1α in hidradenitis suppurativa: the link between deviated immunity and metabolism
Authors: Agamia Naglaa Fathi , Sorror Osama Ahmed , Sayed Naglaa Mohamed , Ghazala Rasha Abdelmawla , Echy Sammar Mohamed , Moussa Doaa Helmy , Melnik Bodo Clemens
Published: March 2023

Hypoxia-inducible factor-1α (HIF-1α) is the master transcription factor of glycolysis, Th17 cell differentiation and suppression of regulatory T cells. In the skin and serum of patients with psoriasis vulgaris, increased expression of HIF-1α has been reported, whereas HIF-1α expression in the skin and serum of patients with hidradenitis suppurativa (HS) has not yet been studied. The objective of the study is to demonstrate is there a role for HIF-1α in the pathogenesis of hidradenitis suppurativa, and its relation to HS severity. Twenty patients suffering from hidradenitis suppurativa were included in the study. Punch biopsies were taken from lesional skin for the determination of HIF-1α expression by immunohistochemical staining, and HIF-1α gene expression by quantitative reverse transcription real time PCR. Quantification of HIF-1α protein concentration was done by enzyme-linked immunosorbent assay. Twenty socio-demographically cross-matched healthy volunteers served as controls. We found increased serum levels of HIF-1α. Literature-derived evidence indicates that the major clinical triggering factors of HS, obesity, and smoking are associated with hypoxia and enhanced HIF-1α expression. Pro-inflammatory cytokines such as tumor necrosis factor-$$a$$
a
via upregulation of nuclear factor $$\kappa$$
κ
B enhance HIF-1α expression. HIF-1α plays an important role for keratinocyte proliferation, especially for keratinocytes of the anagen hair follicle, which requires abundant glycolysis providing sufficient precursors molecules for biosynthetic pathways. Metformin via inhibition of mTORC1 as well as adalimumab attenuate HIF-1α expression, the key mediator between Th17-driven deviated immunity and keratinocyte hyperproliferation. In accordance with psoriasis, our study identifies HS as an HIF-1α-driven inflammatory skin disease and offers a new rationale for the prevention and treatment of HS by targeting HIF-1$$a$$
a
overexpression.
Comparative expression analysis of the Atoh7 gene regulatory network in the mouse and chicken auditory hindbrain
Authors: Saleh Ali Jason , Ahmed Yannis , Peters Lars-Oliver , Nothwang Hans Gerd
Published: March 2023

The mammalian and avian auditory brainstem likely arose by independent evolution. To compare the underlying molecular mechanisms, we focused on Atoh7, as its expression pattern in the mammalian hindbrain is restricted to bushy cells in the ventral cochlear nucleus. We thereby took advantage of an Atoh7 centered gene regulatory network (GRN) in the retina including upstream regulators, Hes1 and Pax6, and downstream targets, Ebf3 and Eya2. In situ hybridization demonstrated for the latter four genes broad expression in all three murine cochlear nuclei at postnatal days (P) 4 and P30, contrasting the restricted expression of Atoh7. In chicken, all five transcription factors were expressed in all auditory hindbrain nuclei at embryonic day (E) 13 and P14. Notably, all five genes showed graded expression in the embryonic nucleus magnocellularis (NM). Atoh7 was highly expressed in caudally located neurons, whereas the other four transcription factors were highly expressed in rostrally located neurons. Thus, Atoh7 shows a strikingly different expression between the mammalian and avian auditory hindbrain. This together with the consistent absence of graded expression of GRN components in developing mammalian nuclei provide the first molecular support to the current view of convergent evolution as a major mechanism in the amniote auditory hindbrain. The graded expression of five transcription factors specifically in the developing NM confirms this nucleus as a central organizer of tonotopic features in birds. Finally, the expression of all five retinal GRN components in the auditory system suggests co-options of genes for development of sensory systems of distinct modalities.
Data Augmentation techniques in time series domain: a survey and taxonomy
Authors: Iglesias Guillermo , Talavera Edgar , González-Prieto Ángel , Mozo Alberto , Gómez-Canaval Sandra
Published: March 2023

With the latest advances in deep learning-based generative models, it has not taken long to take advantage of their remarkable performance in the area of time series. Deep neural networks used to work with time series heavily depend on the size and consistency of the datasets used in training. These features are not usually abundant in the real world, where they are usually limited and often have constraints that must be guaranteed. Therefore, an effective way to increase the amount of data is by using data augmentation techniques, either by adding noise or permutations and by generating new synthetic data. This work systematically reviews the current state of the art in the area to provide an overview of all available algorithms and proposes a taxonomy of the most relevant research. The efficiency of the different variants will be evaluated as a central part of the process, as well as the different metrics to evaluate the performance and the main problems concerning each model will be analysed. The ultimate aim of this study is to provide a summary of the evolution and performance of areas that produce better results to guide future researchers in this field.
Potential role of vitamin D levels in amyotrophic lateral sclerosis cognitive impairment
Authors: De Marchi Fabiola , Saraceno Massimo , Sarnelli Maria Francesca , Virgilio Eleonora , Cantello Roberto , Mazzini Letizia
Published: March 2023

Cognitive impairment (CI) is common in amyotrophic lateral sclerosis (ALS): a keystone is identifying factors that could potentially modify the CI course. In recent years, vitamin D is becoming a potential modificatory factor for CI in many neurological disorders. This study aimed to highlight if vitamin D deficiency correlated with CI and clinical features in a cohort of ALS patients. We included 55 ALS patients with a neuropsychological evaluation (classified with the Strong Criteria) and a vitamin D dosage at the diagnosis. We also reviewed medical records and completed data for medical history, physical and neurological examination, and functional scales. At the diagnosis, 30 patients (54%) had CI. Most patients (82%) displayed low vitamin D levels (19.87 ± 9.80 ng/ml). Comparing the vitamin D level between patients with and without CI, we observed significantly lower values in the first group (15.8 ± 8.2 vs. 22.0 ± 9.7 ng/ml, p: 0.04). In the spinal female subgroup (n = 15), we found an inverse correlation between vitamin D and bizarreness score in the cognitive estimates test (r = 0.58; p: 0.04) and a positive correlation with the Corrected Raven’s Standard Progressive Matrices (r = 0.53, p: 0.04). Conversely, in the bulbar female group, we observed a correlation with the corrected direct span (r = 0.84, p: 0.03). With the log-rank survival analysis, we found that the patients with vitamin D < 10 ng/ml had a shorter disease duration (Chi: 5.78, p: 0.02). Our results indicate that levels of vitamin D can influence the cognitive status of people living with ALS and that severe deficits might be an adverse prognostic survival factor.
Gradient regularization of Newton method with Bregman distances
Authors: Doikov Nikita , Nesterov Yurii
Published: March 2023

In this paper, we propose a first second-order scheme based on arbitrary non-Euclidean norms, incorporated by Bregman distances. They are introduced directly in the Newton iterate with regularization parameter proportional to the square root of the norm of the current gradient. For the basic scheme, as applied to the composite convex optimization problem, we establish the global convergence rate of the order $$O(k^{-2})$$

O
(

k

-
2

)

both in terms of the functional residual and in the norm of subgradients. Our main assumption on the smooth part of the objective is Lipschitz continuity of its Hessian. For uniformly convex functions of degree three, we justify global linear rate, and for strongly convex function we prove the local superlinear rate of convergence. Our approach can be seen as a relaxation of the Cubic Regularization of the Newton method (Nesterov and Polyak in Math Program 108(1):177–205, 2006) for convex minimization problems. This relaxation preserves the convergence properties and global complexities of the Cubic Newton in convex case, while the auxiliary subproblem at each iteration is simpler. We equip our method with adaptive search procedure for choosing the regularization parameter. We propose also an accelerated scheme with convergence rate $$O(k^{-3})$$

O
(

k

-
3

)

, where k is the iteration counter.
Scaling multi-agent reinforcement learning to full 11 versus 11 simulated robotic football
Authors: Smit Andries , Engelbrecht Herman A. , Brink Willie , Pretorius Arnu
Published: March 2023

Robotic football has long been seen as a grand challenge in artificial intelligence. Despite recent success of learned policies over heuristics and handcrafted rules in general, current teams in the simulated RoboCup football leagues, where autonomous agents compete against each other, still rely on handcrafted strategies with only a few using reinforcement learning directly. This limits a learning agent’s ability to find stronger high-level strategies for the full game. In this paper, we show that it is possible for agents to learn competent football strategies on a full 22 player setting using limited computation resources (one GPU and one CPU), from tabula rasa through self-play. To do this, we build a 2D football simulator with faster simulation times than the RoboCup simulator. We propose various improvements to the standard single-agent PPO training algorithm which help it scale to our multi-agent setting. These improvements include (1) using a policy and critic network with an attention mechanism that scales linearly in the number of agents, (2) sharing networks between agents which allow for faster throughput using batching, and (3) using Polyak averaged opponents, league opponents and freezing the opponent team when necessary. We show through experimental results that stable training in the full 22 player setting is possible. Agents trained in the 22 player setting learn to defeat a variety of handcrafted strategies, and also achieve a higher win rate compared to agents trained in the 4 player setting and evaluated in the full game.
A systematic review of artificial intelligence impact assessments
Authors: Stahl Bernd Carsten , Antoniou Josephina , Bhalla Nitika , Brooks Laurence , Jansen Philip , Lindqvist Blerta , Kirichenko Alexey , Marchal Samuel , Rodrigues Rowena , Santiago Nicole , Warso Zuzanna , Wright David
Published: March 2023

Artificial intelligence (AI) is producing highly beneficial impacts in many domains, from transport to healthcare, from energy distribution to marketing, but it also raises concerns about undesirable ethical and social consequences. AI impact assessments (AI-IAs) are a way of identifying positive and negative impacts early on to safeguard AI’s benefits and avoid its downsides. This article describes the first systematic review of these AI-IAs. Working with a population of 181 documents, the authors identified 38 actual AI-IAs and subjected them to a rigorous qualitative analysis with regard to their purpose, scope, organisational context, expected issues, timeframe, process and methods, transparency and challenges. The review demonstrates some convergence between AI-IAs. It also shows that the field is not yet at the point of full agreement on content, structure and implementation. The article suggests that AI-IAs are best understood as means to stimulate reflection and discussion concerning the social and ethical consequences of AI ecosystems. Based on the analysis of existing AI-IAs, the authors describe a baseline process of implementing AI-IAs that can be implemented by AI developers and vendors and that can be used as a critical yardstick by regulators and external observers to evaluate organisations’ approaches to AI.
IDILIM: incident detection included linear management using connected autonomous vehicles
Authors: Gokasar Ilgin , Timurogullari Alperen , Ozkan Sarp Semih , Deveci Muhammet
Published: March 2023

Autonomous vehicle advancements and communication technologies such as V2V, V2I, and V2X have enabled the development of connected and autonomous vehicles. Because CAVs are directly effective in traffic, their application in traffic management and incident management appears promising. They can immediately begin regulating traffic and acting as sensors due to their connectivity to the infrastructure. This research proposes Incident Detection Included Linear Management (IDILIM), a CAV-based incident management algorithm that regulates CAV and traffic speeds based on dynamic and predicted shockwave speeds. The SUMO simulations are carried out on a 10.4-km-long, three-lane facility with 21 sensors every 500 m. In the scenarios, three traffic demands, eleven CAV penetration rates, and varying incident locations, duration, and lanes are used. A total of 20 simulation seeds are used in each scenario. The proposed algorithm necessitates the use of a reliable traffic prediction model. Convolutional Neural Networks, a deep learning algorithm with high estimation accuracy, are used in the prediction model. IDILIM uses the highly accurate traffic prediction output of the Pix-to-Pix model as input at 3-min intervals. Shockwave speed is calculated using model outputs and fed to CAVs. To compare with IDILIM, variable speed limits (VSL) are also modeled. When compared to uncontrolled base scenarios, IDILIM reduced density values greater than 35 veh/km in the critical region by 89.32%. In the same scenario, VSL management decreased by only 52.43%.
Market Participation, Self-respect, and Risk Tolerance
Authors: Cordasco Carlo Ludovico , Cowen Nick
Published: March 2023

How important is the experience of risk in business endeavors for self-respect and moral development? Tomasi prompts this question with his attempt to reconcile Rawls’s theory of justice as fairness with free-market capitalism, by claiming that economic activity is a way for people to exercise their autonomy, responsibility, and self-authorship, including through voluntary risk-taking. Critics argue that the social environment generated through market institutions is ill-suited for developing a sense of responsibility and autonomy among citizens. We refine the case for economic liberty by looking at the link between risk-taking and attitudes toward democratic citizenship. We highlight the critical role of ethical business practice as a contributor to the stability of liberal-democratic societies.
Management of Depression in Chronic Care Patients Using a Task-Sharing Approach in a Real-World Primary Health Care Setting in South Africa: Outcomes of a Cohort Study
Authors: Kathree Tasneem , Bachmann Max , Bhana Arvin , Grant Merridy , Mntambo Ntokozo , Gigaba Sithabisile , Kemp C. G. , Rao Deepa , Petersen Inge
Published: March 2023

Depressive symptoms are common in South African primary care patients with chronic medical conditions, but are usually unrecognised and untreated. This study evaluated an integrated, task-sharing collaborative approach to management of depression comorbid with chronic diseases in primary health care (PHC) patients in a real-world setting. Existing HIV clinic counsellors provided a manualised depression counselling intervention with stepped-up referral pathways to PHC doctors for initiation of anti-depressant medication and/ or referral to specialist mental health services. Using a comparative group cohort design, adult PHC patients in 10 PHC facilities were screened with the Patient Health Questionnaire-9 with those scoring above the validated cut-off enrolled. PHC nurses independently assessed, diagnosed and referred patients. Referral for treatment was independently associated with substantial improvements in depression symptoms three months later. The study confirms the viability of task-shared stepped-up collaborative care for depression treatment using co-located counselling in underserved real-world PHC settings.
Effect of flipped classroom and automatic source code evaluation in a CS1 programming course according to the Kirkpatrick evaluation model
Authors: Mosquera Jose Miguel Llanos , Suarez Carlos Giovanny Hidalgo , Guerrero Victor Andres Bucheli
Published: March 2023

This paper proposes to evaluate learning efficiency by implementing the flipped classroom and automatic source code evaluation based on the Kirkpatrick evaluation model in students of CS1 programming course. The experimentation was conducted with 82 students from two CS1 courses; an experimental group (EG = 56) and a control group (CG = 26). Each student in each group completed 15 programming tasks. The level of knowledge of the participants acquired between the two groups is measured using the Kirkpatrick model, taking as a source a pre-test of previous knowledge, the grade assessment, the time of the activities, and a post-test of learning achieved. When comparing the submits time between the experimental and control group, it is observed that the value of the means is similar for the EG and CG; in this case, time is not a factor for comparison between the groups. However, in the grading, the value of the means is different for the EG and CG; EG students scored better than CG students. The evaluation of the Kirkpatrick model shows that the strategy implemented, on the one hand, does not improve the time of the activities; on the other hand, it improves the grades in the CS1 course.
Latent profiles of cyberbullying among university students and its relationship with social anxiety and aggressiveness
Authors: Aparisi David , Delgado Beatriz , Bo Rosa María
Published: March 2023

Cyberbullying has generated interest for researchers in the field of psychology and education in recent years. While most studies have focused on samples of adolescents, the university environment also deserves special attention due to its serious consequences on students. It is therefore very important to prevent cyberbullying in the context of university. The objectives of this study were to identify different profiles regarding cyberbullying and cybervictimization behaviors and examine the relationship between cyberbullying, social anxiety, and aggressiveness. A total of 1,368 university students participated in the study by completing the European Bullying Intervention Project Questionnaire (EBIPQ), the Social Anxiety Questionnaire for Adults (CASO-A30), and the Aggression Questionnaire (AQ). The latent profile analysis identified three cyberbullying profiles: a first group with low scores in cyberaggression and cybervictimization (not involved; 87.6%), a second group with moderately high scores in cyberaggression and cybervictimization (victimized cyberbullies; 10%), and a third group with high scores in cybervictimization and very high scores in cyberaggression (cyberbullies; 2.4%). The profile of “victimized cyberbullies” students presents higher scores in physical, verbal, anger, and hostility than the group of “not involved” students, while no differences in social anxiety were found between the groups analysed. Cyberbullying preventive programs should focus on the management of aggressive behaviors for those who have moderate scores in cybervictimization and cyberbullying behaviors, and social anxiety may not be differentiated between cyberbullying groups at this academic stage.
Stable Möbius Bands from Isometrically Deformed Circular Helicoids
Authors: Chaurasia Vikash , Fried Eliot
Published: March 2023

We consider the problem of producing a ruled Möbius band by subjecting an unstretchable, homogeneous, isotropic, elastic material surface material surface in a circular helicoidal reference configuration to a deformation that is isometric and chirality preserving. We find that such a Möbius band is completely determined by the unit binormal of the Frenet frame of its midline, which must be a geodesic and must have uniform torsion inversely proportional to the pitch of the helicoidal reference configuration. Granted that the energy density of the material surface depends quadratically on the mean curvature of its deformed configuration, we show that the total energy stored in producing a ruled Möbius band as described reduces, in closed form and without approximation, to an integral over the midline of the Möbius band. We formulate and numerically solve a constrained variational problem for finding relative minima of the dimensionally reduced bending energy and construct corresponding stable Möbius bands. The only input parameter entering our variational problem is the number $\nu $
ν
of turns in a helicoidal reference configuration. We only find solutions if $\nu $
ν
exceeds a certain threshold, which we compute to machine precision. Above that threshold, an interplay between the operative constraints leads to a multiplicity of coexisting stable solutions with $n\ge 3$
n
≥
3
half twists. For each $n\ge 3$
n
≥
3
, we construct an energetically optimal Möbius band which exhibits $n$
n
-fold rotational symmetry. All other energy minima yield Möbius bands which lack symmetry. To our knowledge, this study contains the first examples of stable Möbius bands produced by isometrically deforming reference configurations that are not flat.
Responsible Agency and the Importance of Moral Audience
Authors: Jefferson Anneli , Sifferd Katrina
Published: March 2023

Ecological accounts of responsible agency claim that moral feedback is essential to the reasons-responsiveness of agents. In this paper, we discuss McGeer’s scaffolded reasons-responsiveness account in the light of two concerns. The first is that some agents may be less attuned to feedback from their social environment but are nevertheless morally responsible agents – for example, autistic people. The second is that moral audiences can actually work to undermine reasons-responsiveness if they espouse the wrong values. We argue that McGeer’s account can be modified to handle both problems. Once we understand the specific roles that moral feedback plays for recognizing and acting on moral reasons, we can see that autistics frequently do rely on such feedback, although it often needs to be more explicit. Furthermore, although McGeer is correct to highlight the importance of moral feedback, audience sensitivity is not all that matters to reasons-responsiveness; it needs to be tempered by a consistent application of moral rules. Agents also need to make sure that they choose their moral audiences carefully, paying special attention to receiving feedback from audiences which may be adversely affected by their actions.
Perspectives on the implications of carrying putative pathogenic variants in the medulloblastoma predisposition genes ELP1 and GPR161
Authors: Smith Miriam J , Woodward Emma R , Evans D Gareth
Published: March 2023

Recent genetic sequencing studies in large series’ of predominantly childhood medulloblastoma have implicated loss-of-function, predominantly truncating, variants in the ELP1 and GPR161 genes in causation of the MBSHH subtype specifically. The latter association, along with a report of an index case with some features of Gorlin syndrome has led to speculation that GPR161 may also cause Gorlin syndrome. We show that these genes are associated with relatively low absolute risks of medulloblastoma from extrapolating lifetime risks in the general population and odds ratios from the population database gnomAD. The projected risks are around 1 in 270–430 for ELP1 and 1 in 1600–2500 for GPR161. These risks do not suggest the need for MRI screening in infants with ELP1 or GPR161 variants as this is not currently recommended for PTCH1 where the risks are equivalent or higher. We also screened 27 PTCH1/SUFU pathogenic variant-negative patients with Gorlin syndrome for GPR161 and found no suspicious variants. Given the population frequencies of 0.0962% for GPR161 and 0.0687% for ELP1, neither of these genes can be a cause of Gorlin syndrome with an unexplained population frequency far lower at 0.0021%.
Parasternal intercostal thickening at hospital admission: a promising indicator for mechanical ventilation risk in subjects with severe COVID-19
Authors: Helmy Mina A. , Milad Lydia M. , Hasanin Ahmed M. , Mostafa Maha , Mannaa Asser H. , Youssef Marianne M. , Abdelaziz Mahmoud , Alkonaiesy Ramy , Elshal Mamdouh Mahmoud , Hosny Osama
Published: March 2023

We aimed to evaluate the ability of parasternal intercostal thickening fraction (PIC TF) to predict the need for mechanical ventilation, and survival in subjects with severe Coronavirus disease-2019 (COVID-19). This prospective observational study included adult subjects with severe COVID-19. The following data were collected within 12 h of admission: PIC TF, respiratory rate oxygenation index, $${{{\text{P}}_{{{\text{aO}}_{{\text{2}}} }} } \mathord{\left/ {\vphantom {{{\text{P}}_{{{\text{aO}}_{{\text{2}}} }} } {{\text{F}}_{{{\text{iO}}_{{\text{2}}} }} }}} \right. \kern-\nulldelimiterspace} {{\text{F}}_{{{\text{iO}}_{{\text{2}}} }} }}$$

P

aO
2

/

F

iO
2

 ratio, chest CT, and acute physiology and chronic health evaluation II score. The ability of PIC TF to predict the need for ventilatory support (primary outcome) and a composite of invasive mechanical ventilation and/or 30-days mortality were performed using the area under the receiver operating characteristic (AUC) analysis. Multivariate analysis was done to identify the independent predictors for the outcomes. Fifty subjects were available for the final evaluation. The AUC (95% confidence interval [CI]) for the right and left PIC TF ability to predict the need for ventilator support was 0.94 (0.83–0.99), 0.94 (0.84–0.99), respectively, with a cut off value of > 8.3% and positive predictive value of 90–100%. The AUC for the right and left PIC TF to predict invasive mechanical ventilation and/or 30 days mortality was 0.95 (0.85–0.99) and 0.90 (0.78–0.97), respectively. In the multivariate analysis, only the PIC TF was found to independently predict invasive mechanical ventilation and/or 30-days mortality. In subjects with severe COVID-19, PIC TF of 8.3% can predict the need to ventilatory support with a positive predictive value of 90–100%. PIC TF is an independent risk factor for the need for invasive mechanical ventilation and/or 30-days mortality.
The Brain Disorders Debate, Chekhov, and Mental Health Humanities
Authors: Valtonen Jussi , Lewis Bradley
Published: March 2023

The contemporary brain disorders debate echoes a century-long conflict between two different approaches to mental suffering: one that relies on natural sciences and another drawing from the arts and humanities. We review contemporary neuroimaging studies and find that neither side has won. The study of mental differences needsboththe sciences and the arts and humanities. To help develop an approach mindful of both, we turn to physician-writer Anton Chekhov’s story “A Nervous Breakdown.” We review the value of the arts and humanities as a coequal partner with natural sciences in the creation of a robust mental health humanities.
Gaussian Mixture Model-Based Classification of Corrosion Severity in Concrete Structures Using Ultrasonic Imaging
Authors: Mayakuntla Prasanna Kumar , Ganguli Abhijit , Smyl Danny
Published: March 2023

Corrosion in reinforced concrete (RC) structures is associated with a reduction of the rebar diameter, loss of interfacial bond, cracking, and eventual spalling and probable collapse of the structure. The negative effects of corrosion on structural safety, durability, and longevity imposes significant costs on the national economy. Therefore, planned non-destructive testing (NDT) of concrete structures is essential to enhance the safety and economic sustainability of infrastructure. Previous work by the research group has established the capability of the ultrasonic Synthetic Aperture Focusing Technique (SAFT) as a tool for detection of rebar corrosion. This work extends the previous research towards application of statistical learning for ascertaining the corrosion severity through analysis of SAFT images of the rebar. Using features extracted from images, a Gaussian mixture model (GMM) is implemented to classify the severity of corrosion damage to the rebar. The results from the research positively demonstrate the potential of the proposed technique as an enabler for decisions pertaining to maintenance and timely repair of concrete infrastructural assets.
Exponential Lag Synchronization of Cohen–Grossberg Neural Networks with Discrete and Distributed Delays on Time Scales
Authors: Kumar Vipin , Heiland Jan , Benner Peter
Published: March 2023

In this article, we investigate exponential lag synchronization results for the Cohen–Grossberg neural networks with discrete and distributed delays on an arbitrary time domain by applying feedback control. We formulate the problem by using the time scales theory so that the results can be applied to any uniform or non-uniform time domains. Also, we provide a comparison of results that shows that obtained results are unified and generalize the existing results. Mainly, we use the unified matrix-measure theory and Halanay inequality to establish these results. In the last section, we provide two simulated examples for different time domains to show the effectiveness and generality of the obtained analytical results.
A qualitative study of lived experiences and needs of advanced cancer patients in Malaysia: Gaps and steps forward
Authors: Yong Alene Sze Jing , Cheong Mark Wing Loong , Hamzah Ednin , Teoh Siew Li
Published: March 2023

Purpose

Due to the high burden of cancer-related suffering, it is paramount to understand the gaps in cancer care that lead to suffering. Advanced cancer patients have unmet needs and challenges that differ from those with early-stage cancer due to the rapid disease progression. By exploring advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects, this study aims to identify gaps in the Malaysian health system and propose contextualised measures to improve cancer care.

Methods

Semi-structured, in-depth interviews were conducted to explore advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects. The interviews were then transcribed and coded. Themes were developed from the codes using iterative thematic approach.

Results

The lived experiences and needs of nineteen patients converged into four major themes: disruption to daily lives, psychosocial and spiritual support system, information needs, and financial needs. This study described predominantly how cancer impacted patients’ lives and livelihood, how patients coped with their psychological conditions after diagnosis, the need for effective communication and trust in a multicultural society, and how finance affected access to and experience of cancer care.

Conclusion

Advanced cancer patients had different needs beyond receiving medical treatments. A concerted effort is required from clinicians, allied health professionals, social workers, support groups, and family members to understand and fulfil these needs.
Modelling of Droplet Capture in an Open-Cell Metal Foam at the Pore and Macroscopic Scales
Authors: de Carvalho Thiago P. , Hargreaves David M. , Morvan Hervé P. , Klingsporn Michael
Published: March 2023

Open-cell metal foams are often used in applications where particulate and/or droplet capture is important. Here a Computational Fluid Dynamics (CFD) modelling approach is described which models the metal foam at both the pore-scale and the macroscopic scale. At the pore-scale, the detailed internal geometry of the foam is included and the flow field and droplet tracking and capture is modelled explicitly. At this scale, a coefficient is found for each metal foam that relates the distance a droplet can freely travel through the foam to both the droplet diameter and the Darcian velocity in the porous medium. Then, at the macroscopic scale, the coefficient from the pore-scale droplet capture simulations is used in a novel stochastic particle extinction model. Here, the droplets travel through a porous zone and are removed from the model, the probability of which is determined by the coefficient from the pore-scale modelling. A test case is described in which the macroscopic model is verified against the pore-scale model with acceptable levels of accuracy.
Convergence of per capita ecological footprint among BRICS-T countries: evidence from Fourier unit root test
Authors: Bayraktar Yuksel , Koc Kenan , Toprak Metin , Ozyılmaz Ayfer , Olgun Mehmet Firat , Balsalobre-Lorente Daniel , Soylu Ozgur Bayram
Published: March 2023

In recent years there has been a great deal of research into environmental pollution using a variety of techniques in response to growing environmental concerns. Convergence analysis, one of these techniques, helps determine whether the developing countries will catch up with the rich countries in pollution using unit root tests. However, the vast majority of the research in the field has generally used conventional unit root tests. Since many economic series contain structural breaks, using unit root tests that account for structural breaks is essential for accurate prediction. More specifically, if the series has a fractional process, conventional unit root tests may erroneously conclude that the departure from linearity is permanent. Moreover, the existing literature mainly uses gas emissions, such as carbon dioxide, which represent pollution weakly. Therefore, we use per capita ecological footprint (EF hereafter) as a more comprehensive pollution indicator of environmental degradation. In this direction, the study aims to determine whether BRICS-T countries' EF converges to the average of the BRICS-T for the 1992–2017 period. Besides the ADF unit root test, we employed the Fourier ADF unit root test, which considers the structural breaks, and the Fractional Frequency Fourier ADF unit root test, which accounts for structural breaks by considering fractional values. Our results showed that EF converges in Russia and Turkey according to the conventional ADF test, in China and Russia according to the Fourier ADF test, and in Brazil and China according to the Fractional Fourier Frequency test.
Evaluation of radiation dose reduction in head CT using the half-dose method
Authors: Nakai Yoshitomo , Miyazaki Osamu , Kitamura Masayuki , Imai Rumi , Okamoto Reiko , Tsutsumi Yoshiyuki , Miyasaka Mikiko , Ogiwara Hideki , Miura Hiroshi , Yamada Kei , Nosaka Shunsuke
Published: March 2023

Purpose

The present study introduced the half-dose method (HDM), which halves the radiation dose for conventional head computed tomography (CT), for postoperative hydrocephalus and follow-up for craniosynostosis at a children’s hospital. This study aimed to evaluate the contribution of selective head CT scanning optimization towards the overall reduction of radiation exposure.

Materials and methods

We retrospectively assessed 1227 and 1352 head CT examinations acquired before and after the introduction of the HDM, respectively, in children aged 0–15 years. The radiation exposure was evaluated using the CT dose index volume (CTDI-vol), dose-length product (DLP), rate of HDM introduction, and effect of reducing in-hospital radiation dose before and after the introduction of the HDM. For an objective evaluation of the image quality, head CT scans acquired with HDM and full-dose method (FDM) were randomly selected, and the image noise standard deviation (SD) was measured for each scan. In addition, some HDM images were randomly selected and independently reviewed by two radiologists.

Results

The HDM was introduced in 27.9% of all head CTs. The mean CTDI-vol of all head CTs was 21.5 ± 6.9 mGy after the introduction, a 14.9% reduction. The mean DLP was 418.4 ± 152.9 mGy.cm after the introduction, a 17.2% reduction. Compared to the FDM images, the noise SD of the HDM ones worsened by almost 0.9; however, none of the images were difficult or impossible to evaluate.

Conclusion

The HDM yielded diagnostically acceptable images. In addition, a change in protocol for only two diseases successfully reduced the patients’ overall radiation exposure by approximately 15%. Introducing and optimizing the HDM for frequently performed target diseases will be useful in reducing the exposure dose for the hospital’s patient population.
Development and Design of the First Industrial Magnetohydrodynamic Slag-Cleaning Reactor From Execution and Analysis of Pilot Plant Tests Through Coupled CFD Simulations
Authors: Kalisch Michael , Friedrich Bernd , Reuter Markus A.
Published: March 2023

The future challenge for copper smelters is to increase metal yield by reducing copper losses and valorizing the slag as a marketable by-product. This can be achieved through further slag cleaning in a conventional submerged arc furnace (SAF) where remaining metallic oxides are reduced, and metal droplets have more settling time. Nevertheless, a significant amount of copper matte and metallic copper is still present as slight inclusions that cannot settle through the slag layer under simple gravity after SAF treatment. This work presents the development of a new industrial type of slag-cleaning concept, based on the magnetohydrodynamic (MHD) principle, that can be coupled downstream of conventional slag-cleaning technology (e.g., electric reduction furnace). The cleaning efficiency and operating conditions were evaluated in several pilot test campaigns using a SAF supplemented by an externally applied magnetic field (electromagnet), which interacts with electrodes generating Lorentz forces, which are responsible for an MHD stirring effect. In order to simulate experimental conditions and thus understand reaction kinetics and settle mechanisms during pilot tests, this work includes computational fluid dynamics (CFD) models. In order to represent these electromagnetic conditions, the focus of this work is to develop a new coupled CFD model. Numerical simulations showed the interactions between MHD flow field, slag properties, and metal recovery in an industrial slag-cleaning reactor and demonstrated the MHD cleaning effect on non-ferrous slags.
Prognostic Value of Microscopic Tumor Necrosis in Adrenal Cortical Carcinoma
Authors: Luconi Michaela , Cantini Giulia , van Leeuwaarde Rachel S. , Roebaar Rogina , Fei Laura , Propato Arianna Pia , Santi Raffaella , Ercolino Tonino , Mannelli Massimo , Canu Letizia , de Krijger Ronald R. , Nesi Gabriella
Published: March 2023

Adrenal cortical carcinoma (ACC) is an uncommon neoplasm with variable prognosis. Several histologic criteria have been identified as predictors of malignancy in adrenal cortical tumors. The Weiss score is the system most widely employed for diagnostic purposes, but also possesses prognostic value. We aim to determine the relative impact of each Weiss parameter on ACC patient survival. A multicenter retrospective analysis was conducted on a series of 79 conventional ACCs surgically treated at the Florence and Utrecht centers of the European Network for the Study of Adrenal Tumors (ENSAT). Weiss classification was recapitulated using principal component analysis (PCA). The Kaplan–Meier and Cox multivariate regression analyses were applied in order to estimate the prognostic power of Weiss versus other clinical parameters. PCA reduced the nine Weiss parameters to the best fitting 4-component model, each parameter clustering with a single component. Necrosis and venous invasion clustered together with the highest scores, thus establishing the most relevant component (Component 1) to explain Weiss distribution variability. Only Component 1 significantly predicted overall survival (OS, log-rank = 0.008) and disease-free survival (DFS, log-rank < 0.001). When considering the prognostic power of Weiss parameters, necrosis alone could independently assess OS (log-rank = 0.004) and DFS (log-rank < 0.001) at both the Kaplan–Meier and multivariate Cox regression analyses [hazard ratio (HR) = 7.8, 95% confidence interval [CI] = 1.0–63.5, p = 0.05, and HR = 12.2, 95% CI = 1.6–95.0, p = 0.017, respectively]. The presence of necrosis significantly shortened time to survival (TtS) and time to recurrence (TtR), 57.5 [31.5–103.5] vs 34 [12–78] months (p = 0.05) and 57.5 [31.5–103.5] vs 7 [1.0–31.5] months (p < 0.001), respectively. Our study suggests that, of the Weiss parameters, necrosis is the most powerful adverse factor and the best predictor of OS and DFS in ACC patients.
Pelvic floor and perineal muscles: a dynamic coordination between skeletal and smooth muscles on pelvic floor stabilization
Authors: Muro Satoru , Akita Keiichi
Published: March 2023

The purpose of this review is to present our researches on the pelvic outlet muscles, including the pelvic floor and perineal muscles, which are responsible for urinary function, defecation, sexual function, and core stability, and to discuss the insights into the mechanism of pelvic floor stabilization based on the findings. Our studies are conducted using a combination of macroscopic examination, immunohistological analysis, 3D reconstruction, and imaging. Unlike most previous reports, this article describes not only on skeletal muscle but also on smooth muscle structures in the pelvic floor and perineum to encourage new understanding. The skeletal muscles of the pelvic outlet are continuous, which means that they share muscle bundles. They form three muscle slings that pass anterior and posterior to the anal canal, thus serving as the foundation of pelvic floor support. The smooth muscle of the pelvic outlet, in addition to forming the walls of the viscera, also extends in three dimensions. This continuous smooth muscle occupies the central region of the pelvic floor and perineum, thus revising the conventional understanding of the perineal body. At the interface between the levator ani and pelvic viscera, smooth muscle forms characteristic structures that transfer the lifting power of the levator ani to the pelvic viscera. The findings suggest new concepts of pelvic floor stabilization mechanisms, such as dynamic coordination between skeletal and smooth muscles. These two types of muscles possibly coordinate the direction and force of muscle contraction with each other.