bluuebunny/crossref_metadata_2025 huggingface dataset:
Serial Neuroendoscopic Lavage for the Treatment of Elevated Cerebrospinal Fluid Protein Levels in Infants with Gram-Negative Rod Ventriculitis
Authors: Hect Jasmine L. , Sefcik Roberta K. , Nowicki Kamil W. , Katz Joel , Greene Stephanie
Published: October 2023

Introduction: Gram-negative rod (GNR) bacterial ventriculitis is a rare complication of shunt-dependent hydrocephalus, often requiring an extended and invasive treatment course. Accumulation of purulent material, as well as empyema and septation formation, limits circulation of antibiotics and infection clearance. Supplementation of standard care with neuroendoscopic-guided intraventricular lavage with lactated Ringer solution and fenestration of septations may facilitate infection clearance and simplify the eventual shunt construct required. Here, the utility of serial lavage for ventriculitis is described in a population of shunt-dependent neonates and infants at high risk for morbidity and mortality. Methods: Five infants with shunt-dependent hydrocephalus and subsequent GNR ventriculitis were treated with standard care measures with the addition of serial neuroendoscopic lavage. A retrospective chart review was performed to collect patient characteristics, shunt dependency, and shunt revisions within a year of ventriculitis resolution. Results: Patients demonstrated a mean 74% decrease in cerebrospinal fluid (CSF) protein following each neuroendoscopic lavage and trended toward a shorter time to infection clearance in comparison to previously published literature. Patients required 0–2 shunt revisions at 1-year follow-up following hospitalization for shunt-related ventriculitis (mean 0.8 +/− 0.8). Conclusions: Serial neuroendoscopic lavage is an effective technique, used alone or in combination with fenestration of septations, to reduce the CSF protein and bacterial load in the treatment of ventriculitis, decreasing time until eradication of infection. Serial lavage may reduce the risk of future shunt malfunction, simplify the future shunt construct, and decrease duration of infection.
Green Tea Polyphenols Alleviate Kidney Injury Induced by Di(2-Ethylhexyl) Phthalate in Mice
Authors: Shi Heng , Zhao Xinhai , Peng Qin , Zhou Xianling , Liu Sisi , Sun Chuanchuan , Cao Qiuyu , Zhu Shiping , Sun Shengyun
Published: October 2023

Introduction: Di(2-ethylhexyl) phthalate (DEHP) is a common plasticizer. Studies have revealed that DEHP exposure can cause kidney damage. Green tea is among the most popular beverages in China. Green tea polyphenols (GTPs) have been proven to have therapeutic effects on organ damage induced by heavy metal exposure. However, few studies have reported on GTP-relieving DEHP-induced kidney damage. Methods: C57BL/6J male mice aged 6–8 weeks were treated with distilled water (control group), 1,500 mg/kg/d DEHP + corn oil (model group), 1,500 mg/kg/d DEHP + corn oil + 70 mg/kg GTP (treatment group), corn oil (oil group), and 70 mg/kg GTP (GTP group) by gavage for 8 weeks, respectively. The renal function of mice and renal tissue histopathology of each group were evaluated. The renal tissues of mice in the model, treatment, and control groups were analyzed using high-throughput sequencing. We calculated the differentially expressed microRNAs (miRNAs) and messenger RNAs (mRNAs) using the limma R package, the CIBERSORT algorithm was used to predict immune infiltration, the starBase database was used to screen the miRNA-mRNA regulatory axis, and immunohistochemical analyses were performed to verify protein expression. Results: GTP alleviated the deterioration of renal function, renal inflammation and fibrosis, and mitochondrial and endoplasmic reticulum lesions induced by DEHP in mice. Differential immune infiltrations of plasma, dendritic, T, and B cells were noted between the model and treatment groups. We found that three differentially expressed miRNAs (mmu-miR-383-5p, mmu-miR-152-3p, and mmu-miR-144-3p), three differentially expressed mRNAs (Ddit4, Dusp1, and Snx18), and three differentially expressed proteins (Ddit4, Dusp1, and Snx18) played crucial roles in the miRNA-mRNA-protein regulatory axes when GTPs mitigate DEHP-induced kidney damage in mice. Conclusion: GTP can alleviate DEHP-induced kidney damage and regulate immune cell infiltration. We screened four important miRNA-mRNA-protein regulatory axes of GTP, mitigating DEHP-induced kidney damage in mice.
Coexistent GLIM-Defined Malnutrition and Sarcopenia Increase the Long-Term Mortality Risk in Hospitalized Patients with Decompensated Cirrhosis
Authors: Wang Han , Wang Sipu , Li Chaoqun , Yang Wanting , Guo Gaoyue , Hui Yangyang , Wang Xiaoyu , Cui Binxin , Fan Xiaofei , Jiao Huanli , Sun Chao
Published: October 2023

Introduction: The synergistic impact of coexistent malnutrition and sarcopenia on morality in hospitalized patients with decompensated cirrhosis remains elusive. This prospective cohort study aimed to delineate the prevalence concerning coexistence of malnutrition and sarcopenia and the prognosticating role on long-term mortality among cirrhosis. Methods: Adult cirrhotic patients with decompensated episodes between 2019 and 2021 were consecutively enrolled. Malnutrition and sarcopenia were diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and the European Working Group on Sarcopenia in Older People (EWGSOP2) algorithm, respectively. The entire cohort was divided into three groups: non-malnutrition and non-sarcopenia (NN), malnutrition or sarcopenia, and coexistent malnutrition and sarcopenia (MS). Log-rank test and multivariate Cox regression model were utilized to evaluate survival status and independent risk factors for mortality, respectively. Results: Our findings indicated that malnutrition manifested in 44.6% of inpatients with decompensated cirrhosis, while sarcopenia presented in 16.4% of the entire cohort, indicative of a prevalence of 14.7% regarding coexistent malnutrition and sarcopenia. The Kaplan-Meier graphic demonstrated a significant difference regarding survival curves among the three groups, referring to the MS group presented with the lowest survival rate (log-rank test: p < 0.001). Moreover, coexistent malnutrition and sarcopenia were associated with nearly 4 times higher mortality risk (model 1: hazard ratio [HR] = 3.31, 95% confidence interval [CI]: 1.20–9.13, p = 0.020; model 2: HR = 4.34, 95% CI: 1.52–12.4, p = 0.006) in comparison with patients without any condition (NN group). Conclusions: Malnutrition and sarcopenia had superimposed negative impacts on inpatients with decompensated cirrhosis. It is imperative to identify this vulnerable subset to provide prompt therapeutic intervention for better prognosis.
Prospects and Pitfalls of Plasma Complement C4 in Schizophrenia: Building a Better Biomarker
Authors: Severance Emily G. , Prandovszky Emese , Yang Shuojia , Leister Flora , Lea Ashley , Wu Ching-Lien , Tamouza Ryad , Leboyer Marion , Dickerson Faith , Yolken Robert H.
Published: October 2023

Complex brain disorders like schizophrenia may have multifactorial origins related to mis-timed heritable and environmental factors interacting during neurodevelopment. Infections, inflammation, and autoimmune diseases are over-represented in schizophrenia leading to immune system-centered hypotheses. Complement component C4 is genetically and neurobiologically associated with schizophrenia, and its dual activity peripherally and in the brain makes it an exceptional target for biomarker development. Studies to evaluate the biomarker potential of plasma or serum C4 in schizophrenia do so to understand how peripheral C4 might reflect central nervous system-derived neuroinflammation, synapse pruning, and other mechanisms. This effort, however, has produced mostly conflicting results, with peripheral C4 sometimes elevated, reduced, or unchanged between comparison groups. We undertook a pilot biomarker development study to systematically identify sociodemographic, genetic, and immune-related variables (autoimmune, infection-related, gastrointestinal, inflammatory), which may be associated with plasma C4 levels in schizophrenia (SCH; n = 335) and/or in nonpsychiatric comparison subjects (NCs; n = 233). As with previously inconclusive studies, we detected no differences in plasma C4 levels between SCH and NCs. In contrast, levels of general inflammation, C-reactive protein (CRP), were significantly elevated in SCH compared to NCs (ANOVA, F = 20.74, p < 0.0001), suggestive that plasma C4 and CRP may reflect different sources or causes of inflammation. In multivariate regressions of C4 gene copy number variants, plasma C4 levels were correlated only for C4A (not C4B, C4L, C4S) and only in NCs (R Coeff = 0.39, CI = 0.01–0.77, R2 = 0.18, p < 0.01; not SCH). Other variables associated with plasma C4 levels only in NCs included sex, double-stranded DNA IgG, tissue-transglutaminase (TTG) IgG, and cytomegalovirus IgG. Toxoplasma gondii IgG was the only variable significantly correlated with plasma C4 in SCH but not in NCs. Many variables were associated with plasma C4 in both groups (body mass index, race, CRP, N-methyl-D-aspartate receptor (NMDAR) NR2 subunit IgG, TTG IgA, lipopolysaccharide-binding protein (LBP), and soluble CD14 (sCD14). While the direction of most C4 associations was positive, autoimmune markers tended to be inverse, and associated with reduced plasma C4 levels. When NMDAR-NR2 autoantibody-positive individuals were removed, plasma C4 was elevated in SCH versus NCs (ANOVA, F = 5.16, p < 0.02). Our study was exploratory and confirmation of the many variables associated with peripheral C4 requires replication. Our preliminary results point toward autoimmune factors and exposure to the pathogen, T. gondii, as possibly significant contributors to variability of total C4 protein levels in plasma of individuals with schizophrenia.
Diagnosis and Management of 2 Cases of Spontaneous Septostomy: Monochorionic/Dichorionic Hybrid Twin Gestation and Dichorionic Triamniotic Triplet Gestation
Authors: Layoun Vanessa R. , Sohaey Roya , Edwards Emily , Sun Raphael C. , Chon Andrew H.
Published: October 2023

Introduction: Spontaneous septostomy is a rare complication of multiple gestations. Related complications include cord entanglement and preterm delivery. Limited data exist to guide the management of these high-risk patients. The majority of spontaneous septostomy cases have been reported in monochorionic diamniotic twins. We present 2 cases of spontaneous septostomy occurring in a monochorionic/dichorionic hybrid twin gestation (chorionicity transitions from dichorionicity to monochorionicity within the placenta) and in a dichorionic triamniotic triplet gestation. Case Presentation: Case 1 was a monochorionic/dichorionic hybrid twin gestation with a septostomy complicated by fetal parts of one twin protruding into the co-twin’s sac as well as symptomatic polyhydramnios. Fetal magnetic resonance imaging confirmed the septostomy. Case 2 was a dichorionic triamniotic triplet gestation with septostomy and cord entanglement. Both patients were managed akin to a pseudo-monoamniotic gestation with serial ultrasound surveillance and eventual inpatient admission for heightened fetal monitoring. Case 1 underwent elective scheduled cesarean delivery at 33 weeks, and case 2 underwent emergent cesarean delivery for fetal heart rate decelerations at 28 weeks. Conclusion: With a high degree of clinical suspicion, spontaneous septostomy can be diagnosed in uncommon settings such as hybrid twin gestations and higher order multiples. Management of such patients is individualized and may include a combination of heightened outpatient and inpatient surveillance.
Dill Extract Preserves Dermal Elastic Fiber Network and Functionality: Implication of Elafin
Authors: Aimond Géraldine , Nicolle Stéphane , Debret Romain , Oréa Valérie , Josset-Lamaugarny Audrey , Palierne Jean-François , Sommer Pascal , Sigaudo-Roussel Dominique , Fromy Bérengère
Published: October 2023

Introduction: Elastic skin fibers lose their mechanical properties during aging due to enzymatic degradation, lack of maturation, or posttranslational modifications. Dill extract has been observed to increase elastin protein expression and maturation in a 3D skin model, to improve mechanical properties of the skin, to increase elastin protein expression in vascular smooth muscle cells, to preserve aortic elastic lamella, and to prevent glycation. Objective: The aim of the study was to highlight dill actions on elastin fibers during aging thanks to elastase digestion model and the underlying mechanism. Methods: In this study, elastic fibers produced by dermal fibroblasts in 2D culture model were injured by elastase, and we observed the action of dill extract on elastic network by elastin immunofluorescence. Then action of dill extract was examined on mice skin by injuring elastin fibers by intradermal injection of elastase. Then elastin fibers were observed by second harmonic generation microscopy, and their functionality was evaluated by oscillatory shear stress tests. In order to understand mechanism by which dill acted on elastin fibers, enzymatic tests and real-time qPCR on cultured fibroblasts were performed. Results: We evidence in vitro that dill extract is able to prevent elastin from elastase digestion. And we confirm in vivo that dill extract treatment prevents elastase digestion, allowing preservation of the cutaneous elastic network in mice and preservation of the cutaneous elastic properties. Although dill extract does not directly inhibit elastase activity, our results show that dill extract treatment increases mRNA expression of the endogenous inhibitor of elastase, elafin. Conclusion: Dill extract can thus be used to counteract the negative effects of elastase on the cutaneous elastic fiber network through modulation of PI3 gene expression.
Effects of Cell-Adhesive Ligand Presentation on Pentapeptide Supramolecular Assembly and Gelation: Simulations and Experiments
Authors: Thede Andrew T. , Tang James D. , Cocker Clare E. , Harold Liza J. , Amelung Connor D. , Kittel Anna R. , Taylor Phillip A. , Lampe Kyle J.
Published: October 2023

The extracellular matrix (ECM) is a complex, hierarchical material containing structural and bioactive components. This complexity makes decoupling the effects of biomechanical properties and cell-matrix interactions difficult, especially when studying cellular processes in a 3D environment. Matrix mechanics and cell adhesion are both known regulators of specific cellular processes such as stem cell proliferation and differentiation. However, more information is required about how such variables impact various neural lineages that could, upon transplantation, therapeutically improve neural function after a central nervous system injury or disease. Rapidly Assembling Pentapeptides for Injectable Delivery (RAPID) hydrogels are one biomaterial approach to meet these goals, consisting of a family of peptide sequences that assemble into physical hydrogels in physiological media. In this study, we studied our previously reported supramolecularly-assembling RAPID hydrogels functionalized with the ECM-derived cell-adhesive peptide ligands RGD, IKVAV, and YIGSR. Using molecular dynamics simulations and experimental rheology, we demonstrated that these integrin-binding ligands at physiological concentrations (3–12 mm) did not impact the assembly of the KYFIL peptide system. In simulations, molecular measures of assembly such as hydrogen bonding and pi-pi interactions appeared unaffected by cell-adhesion sequence or concentration. Visualizations of clustering and analysis of solvent-accessible surface area indicated that the integrin-binding domains remained exposed. KYFIL or AYFIL hydrogels containing 3 mm of integrin-binding domains resulted in mechanical properties consistent with their non-functionalized equivalents. This strategy of doping RAPID gels with cell-adhesion sequences allows for the precise tuning of peptide ligand concentration, independent of the rheological properties. The controllability of the RAPID hydrogel system provides an opportunity to investigate the effect of integrin-binding interactions on encapsulated neural cells to discern how hydrogel microenvironment impacts growth, maturation, or differentiation.
SARS-CoV-2-Pneumonie: Nasale Highflowtherapie als etablierter Baustein der Therapie des akuten hypoxämischen Atmungsversagens
Authors: Knoch Johannes
Published: October 2023

Introduction and objectives: High-flow nasal cannula oxygen therapy (HFNC) has been successfully used for the treatment of acute hypoxaemic respiratory failure (AHRF) secondary to SARS-CoV-2 pneumonia and being effective in reducing progression to invasive mechanical ventilation. The objective of this study was to assess the usefulness of HFNC on a hospital ward for the treatment of AHRF secondary to SARS-CoV-2 pneumonia and its impact on the need for intensive care unit (ICU) admission and endotracheal intubation. Other objectives include identifying potential physiological parameters and/or biomarkers for predicting treatment failure and assessing the clinical course and survival. Methods: Observational study based on data collected prospectively between March 2020 and February 2021 in a single hospital on patients diagnosed with AHRF secondary to SARS-CoV-2 pneumonia who received HFNC outside an ICU. Results: One hundred and seventy-one patients out of 1090 patients hospitalised for SARS-CoV-2 infection. HFNC was set as the ceiling of treatment in 44 cases; 12 survived (27.3%). Among the other 127 patients, intubation was performed in 25.9% of cases with a mortality of 11.8%. Higher creatinine levels (OR 1.942, 95% CI 1.04; 3.732; p = 0.036) and Comorbidity-Age-Lymphocyte-LDH (CALL) score (OR 1.273, 95% CI 1.033; 1.617; p = 0.033) were associated with a higher risk of intubation. High platelet count at HFNC initiation was predictive of good treatment response (OR 0.935, 95% CI 0.884; 0.983; p = 0.012).
Perifoveal Microvascular Changes following Internal Limiting Membrane Peeling Surgery for Epiretinal Membrane and Macular Hole
Authors: Kim Kiyoung , Yoon Kyungwoo , Park Jong Beom , Kang Min Seok , Kim Eung Suk , Yu Seung-Young
Published: October 2023

Introduction: The aim of the study was to evaluate perifoveal microvasculature changes following pars plana vitrectomy with internal limiting membrane peeling for the epiretinal membrane (ERM) and macular hole (MH). Methods: This retrospective study included 59 eyes from 59 patients. Subjects were divided into two groups: an ERM group (n = 43) and an MH group (n = 16) based on the initial diagnosis. Swept-source optical coherence tomography angiography (SS-OCTA) was performed in the macular area, pre- and postoperatively. Perifoveal microvascular changes were calculated using MATLAB from the 6 × 6 mm SS-OCTA images, excluding the foveal avascular zone. Pre- and postoperative perifoveal vessel densities (pfVDs) were separately analyzed in six sectors (superior, superotemporal, inferotemporal, inferior, inferonasal, and superonasal) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). The baseline characteristics and other clinical factors were compared between the ERM and MH groups. Results: The postoperative best-corrected visual acuity significantly improved in both groups (p < 0.05). One year after surgery, the pfVD in the SCP of the ERM group significantly decreased in the inferotemporal sector (p = 0.049). The postoperative pfVD in the DCP of the MH group significantly decreased in temporal sectors (p < 0.05). The postoperative mean pfVD in the SCP in the MH group was significantly lower than that in the ERM group (p = 0.003). The presence of a dissociated optic nerve fiber layer (DONFL) was 75% in the MH group and 22% in the ERM group (p = 0.018). The correlation between the pfVD and DONFL was not statistically significant. Conclusion: Postoperative pfVD reduction in the temporal sector, a corresponding area in which DONFL is present after MH surgery, was significantly observed. After vitreoretinal surgery in MH patients, OCTA may serve as a useful tool for monitoring perifoveal microvascular changes, especially in temporal sectors.
Proteomics to Metabolomics: A New Insight into the Pathogenesis of Hypertensive Nephropathy
Authors: Eshraghi Yasin , Abedi Maryam , Gheisari Yousof
Published: October 2023

Background: Hypertensive nephropathy (HN) is a high-burden disorder and a leading cause of end-stage renal disease. Despite huge investigations, the underlying mechanisms are yet largely unknown. Systems biology is a promising approach to providing a comprehensive insight into this complex disorder. Methods: Proteome profiles of kidney tubulointerstitium and outer and inner cortex from a rat model of HN were retrieved from the proteomics identification database, and the quality of the datasets was assessed. Proteins that exhibited differential expression were detected and their interactions were analyzed in the kidney sub-compartments. Furthermore, enzymes were linked to the attributed metabolites. Functional enrichment analyses were performed to identify key pathways and processes based on the differentially expressed proteins and predicted metabolites. Results: Proteasome-mediated protein degradation, actin cytoskeleton organization, and Rho GTPase signaling pathway are involved in the pathogenesis of HN. Furthermore, tissue hypoxia and dysregulated energy homeostasis are among the key underlying events. The metabolism of purine and amino acids is also affected in HN. Conclusion: Although the proposed pathogenic mechanisms remain to be further validated in experimental studies, this study contributes to the understanding of the molecular mechanisms of HN through a systematic unsupervised approach. Considering the significant alterations of metabolic pathways, HN can be viewed as an “acquired error of metabolism.”
Fluid Management during Continuous Renal Replacement Therapy: A Case-Based Approach
Authors: Neyra Javier A. , Mehta Ravindra L. , Murugan Raghavan
Published: October 2023

Continuous renal replacement therapy (CRRT) is frequently used for fluid management of critically ill patients with acute or chronic kidney failure. There is significant practice variation worldwide in fluid management during CRRT. Multiple clinical studies have suggested that both the magnitude and duration of fluid overload are associated with morbidity and mortality in critically ill patients. Therefore, timely and effective fluid management with CRRT is paramount in managing critically ill patients with fluid overload. While the optimal method of fluid management during CRRT is still unclear and warrants further investigation, observational data have suggested a U-shape relationship between net ultrafiltration rate and mortality. Furthermore, recent clinical data have underpinned a significant gap in prescribed versus achieved fluid balance during CRRT, which is also associated with mortality. This review uses a case-based approach to discuss two fluid management strategies based on net ultrafiltration rate and fluid balance goals during CRRT and harmonizes operational definitions.
The Catabolic Network of Aromatoleum aromaticum EbN1T
Authors: Becker Patrick , Wünsch Daniel , Wöhlbrand Lars , Neumann-Schaal Meina , Schomburg Dietmar , Rabus Ralf
Published: October 2023

The denitrifying betaproteobacterium Aromatoleum aromaticum EbN1T is a facultative anaerobic degradation specialist and belongs to the environmental bacteria studied best on the proteogenomic level. This review summarizes the current state of knowledge about the anaerobic and aerobic degradation (to CO2) of 47 organic growth substrates (23 aromatic, 21 aliphatic, and 3 amino acids) as well as the modes of respiratory energy conservation (denitrification vs. O2-respiration). The constructed catabolic network is comprised of 256 genes, which occupy ∼7.5% of the coding regions of the genome. In total, 219 encoded proteins have been identified by differential proteomics, yielding a proteome coverage of ∼74% of the network. Its degradation section is composed of 31 peripheral and 4 central pathways, with several peripheral modules (e.g., for 4-ethylphenol, 2-phenylethylamine, indoleacetate, and phenylpropanoids) discovered only after the complete genome [Arch Microbiol. 2005 Jan;183(1):27–36] and a first proteomic survey [Proteomics. 2007 Jun;7(13):2222–39] of A. aromaticum EbN1T were reported. The activation of recalcitrant aromatic compounds involves a suite of biochemically intriguing reactions ranging from C−H-bond activation (e.g., ethylbenzene dehydrogenase) via carboxylation (e.g., acetophenone carboxylase) to oxidative deamination (e.g., benzylamine), reductive dearomatization (benzoyl-CoA), and epoxide-forming oxygenases (e.g., phenylacetyl-CoA). The peripheral reaction sequences are substrate-specifically induced, mediated by specific transcriptional regulators with in vivo response thresholds in the nanomolar range. While lipophilic substrates (e.g., phenolics) enter the cells via passive diffusion, polar ones require active uptake that is driven by specific transporters. Next to the protein repertoire for canonical complexes I−III, denitrification, and O2-respiration (low- and high-affinity oxidases), the genome encodes an Ndh-II, a tetrathionate reductase, two ETF:quinone oxidoreductases, and two Rnf-type complexes, broadening the electron transfer flexibility of the strain. Taken together, the detailed catabolic network presented here forms a solid basis for future systems biology-level studies with A. aromaticum EbN1T.
The Types and Frequencies of X Chromosome Abnormalities in Women with Reproductive Problems
Authors: Kouvidi Elisavet , Tsarouha Haralambia , Zachaki Sophia , Katsidi Christina , Tsimela Hara , Pantou Amelia , Kanavakis Emmanuel , Mavrou Ariadni
Published: October 2023

Introduction: X chromosome architecture and integrity are essential for normal ovarian function. Both numerical and structural X chromosome abnormalities play an important role in female infertility. This study aimed to determine the types and frequency of X chromosome aberrations detected in women referred for cytogenetic investigation due to reproductive problems. Methods: 2,936 women (average age: 37.5 years) were enrolled in the present study. Peripheral blood karyotyping was performed by conventional cytogenetic techniques. For each woman, 20 G-banded metaphases were studied and in case of suspected mosaicism, analysis was extended to 100 metaphases. Results: 2,588/2,936 (88.15%) of women had a normal karyotype (46,XX), while 348/2,936 (11.85%) had an abnormal one. Thirty-two women (1.09%) carried autosomal chromosome abnormalities and 316 (10.76%) had X chromosome rearrangements. In 311/2,936 women (10.59%), X chromosome numerical aberrations were detected (low-level mosaicism), and in 5/2,936 cases (0.17%), X structural abnormalities (two with pericentric inversion, one with Xq deletion and two 45,X mosaics, one with an Xp deletion cell line and the other with isochromosome Xq cell line). Low-level X mosaicism was a common finding in women >35 years as compared to younger ones (92.93% vs. 7.07%), a finding consistent with loss of chromosome X with aging. Other X chromosome abnormalities were detected in younger women (32.3 ± 4.13 vs. 41.04 ± 4.5 years). The mean age of women with Turner-like phenotype was 28.75 ± 6.6 years. Conclusion: The study confirms that the incidence of X chromosome abnormalities is increased in women with fertility problems and that karyotype is the gold standard for their identification. Genetic counseling is recommended in these cases to provide information concerning available treatment and fertility options.
Electronic Patient-Reported Outcomes in Hidradenitis Suppurativa: Content Validity and Usability of the Electronic Hidradenitis Suppurativa Symptom Daily Diary, Hidradenitis Suppurativa Symptom Questionnaire, and Hidradenitis Suppurativa Quality of Life Questionnaire
Authors: Ingram John R. , Ciaravino Valerie , Rolleri Robert , Pansar Ingrid , Dias-Barbosa Carla , Kirby Joslyn S.
Published: October 2023

Background: Hidradenitis suppurativa (HS), a chronic skin condition that causes pain and physical dysfunction, can impact significantly on quality of life. Disease-specific tools have been designed to assess the impact of HS on patients, including the HS Symptom Daily Diary (HSSDD), the HS Symptom Questionnaire (HSSQ), and the HS Quality of Life (HiSQOL©) questionnaire, which have been developed into electronic instruments (eHSSDD, eHSSQ, and eHiSQOL©). Objectives: The objective of this study was to establish the content validity of the electronic version of the HSSDD and HSSQ, and the acceptability and usability of the HSSDD, HSSQ, and HiSQOL©, using concept elicitation and cognitive debriefing interviews. Methods: This was a non-interventional qualitative video interview study involving participants aged ≥18 years with moderate to severe HS recruited from a single clinical site in the USA. Interviews gathered feedback on participants’ symptom experience, followed by training and completion of the eHSSDD, eHSSQ, and eHiSQOL© questionnaires on electronic handheld devices. Participants were then interviewed on the content of the eHSSDD and eHSSQ and the acceptability and usability of all three instruments. Interviews were transcribed and qualitatively analysed. Results: Twenty participants with moderate to severe HS (median age: 41.5 [range: 20.0–64.0]; n = 16/20 female) were included. All participants found the eHSSDD, eHSSQ, and eHiSQOL© instructions clear and described the instruments as “easy”, “simple” and “self-explanatory”. Overall understanding of individual items within the eHSSDD and eHSSQ was high; however, 6/20 participants had difficulty in understanding the average skin pain item in the eHSSDD. All participants were able to accurately recall their symptoms within the recall periods of the eHSSDD and eHSSQ, although 4/20 participants found the 24-h recall period of the eHSSDD limiting. Completion time was quick across all instruments, and usability was high, with the majority of participants reporting no difficulty in completing questionnaires on electronic devices. Conclusion: The concepts covered in the eHSSDD and eHSSQ are relevant and important to patients, supporting their content validity. The findings also provide evidence of acceptability and usability of the eHSSDD, eHSSQ, and eHiSQOL©. A limitation was that all participants were recruited from a single site, which may have introduced selection bias and thus limited the generalisability of results.
Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion
Authors: Donepudi Roopali , Jouannic Jean-Marie , Maisonneuve Emeline , Sananes Nicolas , Muller Celine , Sánchez-Durán MA , Molina Francisca , Carretero Pilar , Antolin Eugenia , Duyos Inmaculada , Fabietti Isabella , Khalil Asma , Coutinho Conrado M. , Sangi-Haghpeykar Haleh , Sanz Cortes Magdalena
Published: October 2023

Introduction: Fetal anemia from hemolytic disease treated by intrauterine transfusion (IUT) can be performed by intraperitoneal, intracardiac, and intravascular transfusion (IVT). Objective of our study was to compare different transfusion techniques. Methods: Retrospective review of IUT secondary to red cell alloimmunization was conducted at eight international centers from 2012 to 2020. Severe anemia suspected if middle cerebral artery peaks systolic velocity ≥1.5 multiples of the median. Demographic, delivery, and postnatal variables were analyzed. Results: Total of 344 procedures, 325 IVT and 19 other techniques (non-IVT) included. No difference in demographics, history of stillbirth (20.5 vs. 15.8%, p = 0.7), prior pregnancy IUT (25.6 vs. 31.6%, p = 0.5) or neonatal transfusion (36.1 vs. 43.8%, p = 0.5). At first IUT, non-IVT had higher hydrops (42.1% vs. 20.4%, p = 0.03), lower starting hematocrit (13.3% [±6] vs. 17.7% [±8.2], p = 0.04), and trend toward lower gestational age (24.6 [20.1–27] vs. 26.4 [23.2–29.6] weeks, p = 0.08). No difference in birthweight, neonatal phototherapy, exchange, or simple transfusion was observed. Conclusion: This is one of the largest studies comparing techniques to treat fetal anemia. IVT was most performed, other techniques were more likely performed in hydrops, and lower starting hematocrit was seen. Neither technique affected outcomes. This study may suggest that physician’s experience may be the strongest contributor of outcomes.
A radio frequency identification based smart shopping trolley system for automated billing
Authors: Kamil Naji Maham , Desher Farhood Alaa , Fadhil Fahad Hayder , Hussein Ali Adnan
Published: October 2023

On holidays and weekends, we can notice a large rush at shopping centres in metro areas. This is exacerbated when there are substantial discounts and deals. By applying the notion of internet of thing (IoT) for concerning all things in the grocery store, an automated smart shopping system is created. Each product within such scheme had an economical radio frequency identification (RFID) tag positioned with it. Once an item has been added to a smart cart, the information about the merchandise is quickly read by the RFID reader on the cart. The outcome is, direct invoicing is done out from shopping cart, saving clients from having to wait in a long line at the checkout. The product's expiration date is also displayed and broken products can be determined by their weight. As a result, expired and damaged products will not be taken into account when calculating the cost. Furthermore, this system gains the addition of smart shelves incorporating RFID readers which may check stock and possibly update a central server. Inventory control becomes simpler as a result. Finally, cashier stations could verify a customer's purchase. As a result, billing may be done right in the trolley, saving clients a lot of time.
Implementation of a P&E management system for a dual-source EV powered by different batteries
Authors: Thakre Mohan P. , C. Tapre Pawan , Somnath Kadlag Sunil , Prakash Kadam Deepak , S. Thorat Jayawant , N. Nandeshwar Rahul , S. Gaikwad Rohit
Published: October 2023

There is an era started in the field of power energy (PE) management in the electric vehicles (EVs) application cloud, which impacts the smart grid in significant ways and necessitates the collaboration of multiple branches of engineering. Most of the problems with EVs stem from their limited range, which can be improved by incorporating additional forms of energy storage. This paper makes an effort to bring a fresh viewpoint to the description of the power and energy management problem facing EV, taking into account all the needs of such a vehicle. Using a novel power and energy management system, the proposed methodology enables a systematic approach to this multidisciplinary problem. Implementing a power and energy management system for a dual-source EV using lead-acid batteries and ultra-capacitors (UCs) exemplifies the novel framework's capabilities. The electronic power development architecture is outlined in detail, along with the implementing modular blocks that make up the entire system architecture.
Machine learning-based pavement crack detection, classification, and characterization: a review
Authors: Ashraf Arselan , Sophian Ali , Shafie Amir Akramin , Gunawan Teddy Surya , Ismail Norfarah Nadia
Published: October 2023

The detection, classification, and characterization of pavement cracks are critical for maintaining safe road conditions. However, traditional manual inspection methods are slow, costly, and pose risks to inspectors. To address these issues, this article provides a comprehensive overview of state-of-the-art machine vision and machine learning-based techniques for pavement crack detection, classification, and characterization. The paper explores the process flow of these systems, including both machine learning and traditional methodologies. The paper focuses on popular artificial intelligence (AI) techniques like support vector machines (SVM) and neural networks. It underscores the significance of utilizing image processing methods for feature extraction in order to detect cracks. The paper also discusses significant advancements made through deep learning strategies. The main objectives of this research are to improve efficiency and effectiveness in pavement crack detection, reduce inspection costs, and enhance safety. Additionally, the article presents data gathering approaches, various datasets for developing road crack detection models, and compares different models to demonstrate their advantages and limitations. Finally, the paper identifies open challenges in the field and provides valuable insights for future research and development efforts. Overall, this paper highlights the potential of AI-based techniques to revolutionize pavement maintenance practices and significantly improve road safety.
Predicating depression on Twitter using hybrid model BiLSTM-XGBOOST
Authors: Kamil Rula , Abbas Ayad R.
Published: October 2023

Nowadays, depression is a common mental illness. Failure to recognize depression early or guarantee that a depressed individual receives prompt counseling can lead to serious issues. Social media allow us to monitor people's thoughts, daily activities, and emotions, including persons with mental illnesses. This study suggested novel hybrid models that combine one of the deep learning techniques with one of the machine learning approaches. This paper used a dataset from the Kaggle website to predict depression. Two deep learning techniques were chosen to conduct the experiments: bidirectional long short-term memory (Bi-LSTM), and convolutional neural network (CNN). Three machine learning techniques were also selected, which are support vector machine (SVM), light gradient boosting machine (LGBM), and extreme gradient boosting (XGBOOST). Deep learning methods were applied to extract important features from input data and training, and then machine learning was utilized to predict the class. The performance of the hybrid models was compared against that of five single models. The results showed that Bi-LSTM-XGBOOST is better than single models and achieve the highest performance, with 94% for all evaluation metrics. The proposed model can improve the performance of machine learning techniques and increase the detection rate of depression.
Tracking controller for uncertain wheel mobile robot: adaptive sliding mode control approach
Authors: Pham Sen Huong Thi , Nguyen Cuong Duc , Giap Khanh Dang , Vu Nga Thi-Thuy
Published: October 2023

This paper presents a technique for developing a sliding mode controller (SMC) using the state model of wheel mobile robot (WMR). The control scheme which consists of a controller and a disturbances observer can eliminate system uncertainties, disturbances, and unknown wheel slips. To successfully implement the sliding mode tracking controller algorithm, first, the transformation is utilized to convert the kinematic and dynamic models to an equation of state, and then create a controller based on Lyapunov function. Subsequently, a disturbance observer is formulated based on a stable sliding surface, followed by the development of an adaptive sliding mode control (ASMC) for the system. Moreover, to verify the efficacy of the given strategy, simulations have been performed under the aforementioned disturbance conditions. Finally, the simulation results show that chattering effect is eliminated, and the impact of disturbances is also diminished, thus proving the viability and correctness of the proposed control algorithm.
Comparative study of moisture treatment techniques for mineral insulating oil
Authors: Sutan Chairul Imran , Ab Ghani Sharin , Abu Bakar Norazhar , Shahril Ahmad Khiar Mohd , Hidayah Rahim Nor , Nazri Mohamad Din Mohamad
Published: October 2023

The presence of moisture is one of the factors that promote degradation of transformer insulating oils and deterioration of cellulose insulation materials in oil-immersed power transformers, which affect the lifespan of the transformers. Realizing the importance of moisture in transformer insulating oils, this study compares the effectiveness of three moisture treatment techniques nitrogen bubbling technique (NBT), molecular sieve technique (MST), and vacuum oven technique (VOT)) for mineral oil (MO). The moisture content and AC breakdown voltage of the MO samples before and after moisture treatment were measured using Karl Fischer coulometric titrator and portable oil tester, respectively, in accordance with the American Society for Testing and Materials (ASTM) D1533 and ASTM D1816 standards. The results showed that NBT is the best moisture treatment technique for the MO, where the NBT reduced 80.79% of moisture present in the oil, followed by MST and VOT, which reduced 72.87 and 42.28% of moisture, respectively. The results also showed that the AC breakdown voltage of the MO samples after moisture treatment was improved owing to the reduction in moisture content.
Anti-windup modified proportional integral derivative controller for a rotary switched reluctance actuator
Authors: Md Ghazaly Mariam , Tee Siau Ping , Zainal Nasharuddin
Published: October 2023

Over the last decade, industrial applications and promising research domains including robotics and automotive engineering have adopted the rotary switched reluctance actuator (SRA). SRA's fault tolerance, simple, strong structure, and high-frequency operation make it popular. However, the SRA's nonlinear magnetic flux flow and saturation operation negate its benefits. Several control systems have been developed; however, they often need extensive mechanism models and advanced control theory, making them impracticable. This paper proposes a modified proportional integral derivative (PID) controller to evaluate the control performance, which comprises of PID controller with an anti-windup, a linearizer unit, and switching mechanism to activate the SRA phases. The linearizer unit aids to compensate for the nonlinear current-displacement relationship. The anti-windup element helps to halt the integral action during the starting motion. At the fully aligned position, 60°, the modified PID reduced positioning steady-state error by 4.3 times at 76.9%, overshoot by 48.8%, and settling time by 25.3%. Both the modified PID and conventional PID showed zero steady-state error at intermediate position, 70°, however the modified PID controller depicted an improved percentage overshoot by 54.5% and settling time by 74.5%. The results show that the modified PID outperforms conventional PID in transient response, steady-state error, overshoot, and settling time.
A novel method for estimating propagation pathloss in millimeter-wave communication systems
Authors: Thanh Quang Vu , Huu Duc Do , Van Yem Vu , Phuong Thao Hoang Thi
Published: October 2023

In millimeter wave communication systems, the construction of a path loss model that is close to empirical one plays an important role in planning coverage, system capacity, and link budgets. In this paper, we propose a novel approach applied unsupervised machine learning for propagation pathloss estimation in millimeter wave communication systems based on the iterative procedure of cooperative and iterative evaluation exchange (Co-IEE) algorithm. The propagation path loss models of the time city–an urban area in the center of Hanoi, Vietnam in both line-of-sight (LOS) and non line-of-sight (NLOS) are estimated and calculated using the proposed approach and then they are compared to the minimum mean square error (MMSE). The estimated results of the proposed model show the approximation with the optimum one returned by MMSE method. Moreover, the proposed model of estimating path loss can solve the problem of sensitivity with outliers existing in MMSE and give more choices for path loss exponents.
Abstract 118: Effects Of Aprocitentan, A Dual Endothelin Receptor Antagonist, On Blood Pressure In Black/African American Patients With Resistant Hypertension: Results From A Randomized, Controlled Study (PRECISION) Including A Withdrawal Phase
Authors: Flack John M , Schlaich Markus , Weber Michael , Bakris George , Lu Wentao , Sassi-Sayadi Mouna , Haskell Lloyd , Narkiewicz Krzysztof , Dreier Roland F , Wang Ji-Guang
Published: October 2023

Background:
Resistant hypertension is prevalent among Black/African American drug-treated hypertensives and may increase cardiovascular risk. We evaluated aprocitentan (APRO) for BP lowering in Black patients with resistant hypertension.

Methods:
Patients had sitting unattended automated office systolic BP (SBP) ≥140 mmHg despite use of ≥3 antihypertensives of different classes in the year prior. After 4 weeks of combination therapy (amlodipine, valsartan, hydrochlorothiazide), those still hypertensive could enter a 4-week single-blind placebo (PBO) run-in period, followed by a 4-week double-blind period wherein patients were randomized 1:1:1 to APRO 12.5 mg, 25 mg, or PBO.

A 32-week single-blind period on APRO 25 mg followed. Patients were then re-randomized 1:1 to APRO 25 mg or PBO in a 12-week withdrawal period.

The primary endpoint was change from baseline to Week 4 in mean trough SBP. Changes in SBP from withdrawal baseline (Week 36) to Week 40 and in 24-hour, daytime (09:00-21:00), and nighttime (01:00-06:00) ambulatory BP monitoring (ABPM) measures at Weeks 4 and 40 were also assessed.

Results:
Eighty-two of 730 patients (11.2%) were Black (APRO 12.5 mg, n = 28; 25 mg, n = 28; PBO, n = 26).

At Week 4, APRO and PBO produced similar office SBP reductions (least squares mean difference from PBO, 12.5 mg: 0.63 mmHg; 25 mg: 0.12 mmHg). However, APRO produced pronounced reductions vs PBO in mean 24-hour (12.5 mg: –3.23 mmHg; 25 mg: –7.85 mmHg), daytime (12.5 mg: –6.16 mmHg; 25 mg: –9.13 mmHg), and nighttime (12.5 mg: –2.63 mmHg; 25 mg: –8.53 mmHg) ambulatory SBP.

Four weeks after withdrawal, office SBP increased with PBO vs APRO 25 mg (difference: +9.87 mmHg), which was confirmed with ambulatory SBP (difference, 25 mg; 24-hour: +8.13 mmHg, daytime: +3.39 mmHg, nighttime: +9.70 mmHg).

Safety in Black patients was comparable to the overall population, with no new signals. During the double-blind period, treatment-emergent adverse events were reported in 6/28 (21.4%), 9/29 (31.0%), and 4/25 (16.0%) patients with APRO 12.5 mg, APRO 25 mg, and PBO. Edema or fluid retention occurred in 3/29 patients (10.3%) on APRO 25 mg, and no patients on APRO 12.5 mg or PBO.

Conclusion:
APRO was well tolerated and produced clinically relevant reductions in SBP by ABPM in Black patients.