bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of postoperative adjuvant chemotherapy on the prognosis of patients with ypT0-3N0 rectal cancer undergoing neoadjuvant chemoradiotherapy*
Authors: Huang Jueyi , Cai Yongqian , Wang Biao
Published: June 2023

Objective

The aim of this study was to investigate the effect of adjuvant chemotherapy (AC) on the prognosis of patients with ypT0-3N0 rectal cancer undergoing neoadjuvant chemoradiotherapy.

Methods

The study participants were 110 patients with locally advanced rectal cancer. Thirty-four patients did not receive postoperative AC treatment, and the other 76 patients received postoperative AC treatment. The differences in the 5-year overall survival (OS) and disease-free survival (DFS) between the two groups were compared.

Results

Age was an important determinant of the patients’ decision to undergo postoperative treatment. Patients who did not receive AC treatment were significantly older than those who received AC treatment (P < 0.05). The tumor location (distance above anal margin) in the AC group was significantly larger than that in the non-AC group (P < 0.05). Moreover, there was no significant difference in the 5-year DFS and OS between the two groups. Postoperative AC did not significantly improve the prognosis of patients with rectal cancer. Age, tumor differentiation, and the number of resected lymph nodes were independent factors affecting the OS of patients (P < 0.05). Older patients, patients with lower degree of tumor differentiation, and patients with <12 resected lymph nodes showed worse prognosis (P < 0.05).

Conclusion

Patients with rectal cancer whose ypT0-3N0 stage is reduced after neoadjuvant chemoradiotherapy, especially those without adverse prognostic factors, do not need AC after surgery.
Occurrence of No.12 lymph node micrometastasis in gastric cancer and its effect on clinicopathological parameters and prognosis*
Authors: Dong Tianzeng , Zhang Lirong
Published: June 2023

Objective

This study aimed to investigate the occurrence of No.12 lymph node micrometastasis in patients with gastric cancer and its relationship with clinicopathological parameters and prognosis.

Methods

A cohort of 160 gastric cancer patients who underwent gastrectomy and lymph node dissection were selected as the research subjects. The immunohistochemical method was used to detect the micrometastasis of No.12 lymph node sections with negative routine pathological detection. At the same time, the clinical data of patients were collected and followed up to analyze the clinical significance of No.12 lymph node micrometastasis.

Results

A total of 370 No.12 lymph nodes were detected in 160 surgical specimens. Among 160 patients, 27 patients were found to be positive for No.12 lymph nodes during routine pathological examination, with a positive rate of 16.8%. A total of 308 lymph nodes from 133 patients with negative routine pathological examinations were stained by immunohistochemistry. A total of 17 lymph nodes from 10 patients were found to be positive. The results showed that 37 of the 160 patients had No.12 lymph node metastasis, and the positive rate was 23.1%, which was 6.3% higher than that of routine pathological examination. Logistic multivariate analyses showed that the depth of invasion, lymph node metastasis in other groups, and clinical stage were independent risk factors for No.12 lymph node metastasis. The average follow-up time was 79.3 months, and the overall median survival time was 47.9 months. The survival time of the No.12 lymph node-negative group was 67.3 ± 2.5 Â months, the median survival time was 73.2 months; the survival time of the No.12 lymph node-positive group was (28.4 ± 5.4) months, and the median survival time was 31.3 months. The survival time of the No.12 lymph node-negative group was significantly longer than that of the positive group (χ2 = 12.75, P = 0.000).

Conclusion

No.12 lymph node micrometastasis is a signal affecting the prognosis of patients with gastric cancer. Standardized dissection of No.12 lymph nodes is recommended for patients with gastric cancer who can undergo radical resection.
Difference in the effects of three nutritional pathways on postoperative rehabilitation in patients with gastric cancer and type 2 diabetes mellitus*
Authors: Li Yan , Zhou Yan , Chen Mao
Published: June 2023

Objective

To explore the difference in the effects of three nutritional pathways on the rehabilitation of patients with gastric cancer and diabetes mellitus after operation.

Methods

Overall, 120 patients were randomly divided into the partial parenteral nutrition (PPN), early enteral nutrition (EEN), and diabetes mellitus special enteral nutritional emulsion (DEN) groups. The differences in the effects of three nutritional modes were compared.

Results

(1) On postoperative day four, the total protein level in the EEN and DEN groups was significantly higher than that in the PPN group (P < 0.05). On postoperative day ten, body mass index, lymphocyte count, total protein level, and pre-albumin level in the DEN group were significantly higher than those in the PPN group (P < 0.05). (2) On postoperative day four, there was no significant difference in the fasting blood glucose level between the EEN and DEN groups (P > 0.05), but this level was significantly lower than that in the PPN group (P < 0.05). On postoperative day ten, fasting and postprandial blood glucose levels in the DEN group were significantly lower than those in the PPN group. (3) On postoperative day four, the C-reactive protein level in the DEN group was significantly lower than that in the other groups (P < 0.05). (4) The incidence rates of complications in the PPN, EEN, and DEN groups were 25.0%, 10.0%, and 5.0%, respectively. The incidence of complications in the PPN group was significantly higher than that in the other groups. However, there was no significant difference in perioperative indexes among the three groups (P > 0.05).

Conclusion

Enteral nutrition is more conducive to the recovery of patients with gastric cancer and type 2 diabetes mellitus after operation; the special enteral nutrition emulsion for diabetes mellitus is more effective than the conventional nutrition solution in stabilizing blood sugar levels and reducing the degree of inflammation.
Effects of rearranged during transfection mutation on calcitonin and procalcitonin expression in sporadic medullary thyroid carcinoma*
Authors: Ni Yaqiong , Yao Wei , Wang Yunsheng , Wang Hui , Liu Qinjiang
Published: June 2023

Objective

The aim of this study was to investigate the effects of rearranged during transfection (RET) mutation on the expressions of calcitonin (CTn) and procalcitonin (PCT) in sporadic medullary thyroid carcinoma (SMTC).

Methods

RET mutation was detected by polymerase chain reaction direct sequencing in 64 cases of SMTC, and the expression levels of CTn and PCT in SMTC tissues were detected using the immunohistochemical streptavidin-perosidase (SP) method. The effect of RET mutations on the expression of CTn and PCT along with its relationship with clinicopathological parameters were analyzed.

Results

The expression rates of CTn and PCT in SMTC tissues were 90.6% (58/64) and 67.2% (43/64), respectively. CTn and PCT expression were found to be associated with tumor size and lymph node metastasis (P < 0.05) but not with gender, age, or tumor capsule invasion (P > 0.05). There was a significant correlation between CTn and PCT expression (r = 0.269, P = 0.041), and the intensity of positive CTn expression was positively correlated with RET mutation (r = 0.507, P = 0.000). However, PCT expression was not associated with RET mutation (r = 0.188, P = 0.136).

Conclusion

High expression of CTn and PCT was associated with the progression of medullary carcinoma, and the intensity of CTn expression was associated with RET mutation. PCT may provide valuable information for the diagnosis and prognosis of SMTC.
Effects of sorafenib and regorafenib on the expression of hypoxia-inducible factors in hepatocellular carcinoma-transplanted nude mice
Authors: Wang Ganxin , Wei Bai , Ma Qian , Huang Shu , Wu Qi
Published: June 2023

Objective

The objective of this study was to investigate the inhibitory effects of sorafenib and regorafenib on the growth of hepatocellular carcinoma (HCC) using a subcutaneous transplantation tumor model in nude mice and exploring the effects of sorafenib and regorafenib on the expression of hypoxia-inducible factor (HIF)-1α, HIF-2α, and HIF-1β in HCC tissues collected from HCC-transplanted nude mice.

Methods

HepG2 cells were inoculated intradermally into nude mice. The mice were randomly assigned to either sorafenib treatment (100 mg/kg), regorafenib treatment (20 mg/kg), or solvent control group (dimethylsulfoxide) (n = 8 per group) and received once-daily treatment for 14 days. The tumor volumes were recorded every 3 days after the initiation of treatment. The expression levels of HIF-1α, HIF-1β, HIF-2α, and SART1 in the HCC tissues were examined via quantitative real-time PCR (qRT-PCR) analysis and Western blotting.

Results

The tumors in the sorafenib and regorafenib treatment groups grew slower and smaller than did the tumors in the solvent control group. qPCR analysis and western blotting demonstrated that the mRNA and protein expressions of HIF-1α and HIF-1β were down-regulated. The expression of HIF-2α and SART1 was up-regulated in the sorafenib treatment group (P < 0.05); meanwhile, the expression of HIF-1α and HIF-1β was up-regulated, and that of HIF-2α and SART1 was down-regulated in the regorafenib treatment group (P < 0.05).

Conclusion

The expression of hypoxia-associated factor is up-regulated by sorafenib and down-regulated by regorafenib, which may induce the different effects of sorafenib on the expression of HIFs.
Prognostic role of plasma levels of γ-glutamyl transpeptidase in patients with advanced gastric cancer treated with anti-PD-1 immunotherapy*
Authors: Xu Shaojie , Feng Yiming , Li Xingyin , Huang Zaozao , Li Hewei , Wang Ganxin
Published: June 2023

Objective

Antibodies targeting programmed cell death protein 1 (PD-1) have become the mainstay of treatment for chemotherapy-refractory gastric cancer, characterized by high levels of programmed cell death ligand-1 (PDL-1) expression. However, the routine clinical implementation of PDL-1 testing is currently limited by the lack of robust detection methods. In this regard, the role of plasma γ-glutamyl transpeptidase (GGT), an N-terminal nucleophilic hydrolase, as an independent predictor of the efficacy of anti-PD-1 therapy remains unknown. In this study, we aimed to assessed the prognostic role of changes in plasma GGT levels (6 weeks vs. baseline) in patients with advanced gastric cancer treated with anti-PD-1 immunotherapy.

Methods

We retrospectively analyzed data from 57 patients with gastric cancer treated with anti-PD-1 antibodies (camrelizumab, sintilimab, nivolumab, tislelizumab, and toripalimab) at the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, from July 2018 to February 2021.

Results

We found that after 6 weeks of treatment, there were significant differences between responders and non-responders with respect to plasma GGT levels (P < 0.001). Multivariate logistic regression analysis revealed that the continuous value of the 6-week difference in GGT levels (OR = 1.437, 95% CI = 1.116-1.849, P = 0.005) and 6-week difference in GGT ≥ 0 or < 0 (OR = 53.675, 95% CI = 6.379-451.669, P < 0.001) were independent predictors of disease control. Survival analysis indicated that a reduction in plasma GGT6 levels during treatment was significantly associated with a favorable progression-free survival (PFS) and overall survival (P < 0.001). Consistently, univariate and multivariate Cox regression analyses revealed that a reduction in plasma GGT6 levels during treatment was an independent predictor of PFS (HR = 1.033, 95% CI = 1.013-1.053, P = 0.001).

Conclusion

Alterations in plasma GGT levels during treatment can be used as a predictor of disease progression and survival in patients with advanced gastric cancer undergoing treatment with anti-PD-1 antibodies.
Primary malignant melanoma of the esophagus successfully treated with camrelizumab: A case report and literature review*
Authors: Lin Gaoyang , Zheng Xin , Wang Fuman , Xing Daijun , Cao Yufeng
Published: June 2023

An 83-year-old Chinese woman presented with a 3-month history of dysphagia. She also had a history of hypertension, type 2 diabetes, fundus hemorrhage, and cataract but no history of cutaneous, ocular, or other-site melanomas. Upper gastrointestinal tract angiography revealed gastritis and duodenal diverticulum; thus, an endoscopic review was recommended. Enhanced computed tomography of the chest and upper abdomen revealed the following: (1) Esophageal space-occupying lesions and mediastinal lymph node enlargement (considering the high possibility of esophageal cancer, further endoscopy was recommended) and (2) A small amount of right pleural effusion, with no significant lymph node infiltration or distant metastasis. Esophagoscopy identified a bulge mass blocking the esophagus from 23 to 30 cm from the incisors. The upper mass had a spherical clustering, while the lower mass significantly festered. Pathological biopsy samples were obtained from the esophagus 23 and 28 cm from the incisors. Tissue biopsy showed proliferation of large round tumor cells and melanocytes. Immunohistochemistry showed positive findings for HMB45 and MelanA; partially positive findings for S100, CK7, CK5/6, CAM5.2, LCA, P63, and TTF-1; and negative findings for Syn. The Ki-67 positivity index was approximately 60%. Based on these findings, the patient was diagnosed with malignant esophageal melanoma with enlarged mediastinal lymph nodes. She was then treated with five cycles of camrelizumab therapy combined with chemotherapy from October 18, 2019, to May 5, 2020. Gastroscopy review following two courses of combination therapy revealed that the esophagus was 23-25 cm away from the incisors, and there were two continuous uplifted and beaded masses that had a smooth and black surface, with each of them having a length and diameter of approximately 1 cm. Melanosis of the mucosa around the lumen was observed at 40 cm from the incisors to the cardia; the dentate margin was clear; and the cardia had no stenosis. The patient then received five courses of combination therapy and became consistently stable after partial remission. No severe adverse events related to the immunotherapy were recorded. Camrelizumab may be a viable treatment option for patients with PMME. Additional evidence from future clinical trials and research is necessary to fully validate our findings.
The interaction between end-metabolites and immune escape
Authors: Zhu Tong , Wang Guihua
Published: June 2023

Emerging data from metabolites-relating trails in cancers demonstrate that a common mechanism of resistance to many novel classes of immune therapeutics is the emergence of immune escape due to the reprogramming of cellular metabolism. Among them, current work about end-metabolites mostly focuses on the intersection between lactate acid, adenosine, reactive oxygen species (ROS), and tumour immune escape. In this article, we aim to review the evidence to date for the dynamic interplay between the three end-metabolites and tumour immune escape for potential approaches to overcome obstacles in the efficacy and durability of immune cancer therapies. We have organized known end-metabolites-associated immune escape mechanisms into three hallmarks: (1) decreased immunogenicity of cancer cells which constitutes defective antigen presentation and the attenuated expression of costimulatory molecules on tumour cells, (2) immunosuppressive microenvironment with aberrant angiogenesis inhibits the differentiation, maturation, and immune deviation of immune cells while drives the activation of immunosuppressive cells by immune-suppressive mediators (cytokines and other factors), (3) immune tolerance retained by inhibitory molecules and depletion of immune cells.
Construction and validation of a prognostic risk model for uterine corpus endometrial carcinoma based on alternative splicing events*
Authors: Cheng Yi , Li Long , Gong Chen , Qin Kai
Published: June 2023

Objective

To establish a prognostic risk model for uterine corpus endometrial carcinoma (UCEC) based on alternative splicing (AS) event data from The Cancer Genome Atlas (TCGA) and assess the accuracy of the model.

Methods

TCGA and SpliceSeq databases were used to acquire a summary of AS events and clinical data related to UCEC. Bioinformatic analysis was performed to identify differentially expressed AS events in UCEC. Least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox regression analyses were used for constructing a prognostic risk model. Next, using the receiver operating characteristic (ROC) curve, Kaplan-Meier survival analysis, and independent prognostic analysis, we assessed the accuracy of the model. In addition, a splicing network was established based on the association between potential splicing factors and AS events.

Results

We downloaded clinical data and AS events of 527 UCEC cases from TCGA and SpliceSeq databases, respectively. We obtained 18,779 survival-associated AS events in UCEC using univariate Cox regression analysis and 487 AS events using LASSO regression analysis. Multivariate Cox regression analysis established a prognostic risk model for UCEC based on the percentage splicing value of 13 AS events. Independent prognostic effect on UCEC risk was then assessed using multivariate and univariate Cox regression analyses (P < 0.001). The area under the curve was 0.827. The pathological stage and risk score were independent prognostic factors for UCEC. Herein, we established a regulatory network between alternative endometrial cancer-related splicing events and splicing factors.

Conclusion

We constructed a prognostic model of UCEC based on 13 AS events by analyzing datasets from TCGA and SpliceSeq databases with medium accuracy. The pathological stage and risk score were independent prognostic factors in the prognostic risk model.
Development of a redox-related prognostic signature for predicting biochemical-recurrence-free survival of prostate cancer*
Authors: Hu Peng , Song Guoda , Chen Bingliang , Miao Jianping
Published: June 2023

Objective

Prostate cancer (PCa) is one of the most common malignancies among elderly males. However, effective prognostic biomarkers are currently lacking. Bioinformatic analysis was used to identify patients at high risk of biochemical recurrence (BCR).

Methods

In our study, RNA sequencing and clinical data were downloaded from The Cancer Genome Atlas (TCGA) dataset to serve as the training and internal validation sets. The GSE84042 dataset was used as the external validation set. Batch effects were removed and normalized for the two datasets using “sva” package. Univariate Cox, least absolute shrinkage and selection operator (LASSO) Cox, and multivariate Cox regression analyses were successively performed to identify the redox-related gene (RRG) signature. After performing univariate Cox, LASSO Cox, and multivariate Cox regression analyses, a signature consisting of seven RRGs was established to predict BCR of patients with PCa, which included TP53, ADH5, SRRT, SLC24A2, COL1A1, CSF3R, and TEX19. Kaplan-Meier and receiver operating characteristic curve analyses showed good performance for the prognostic signature in the training and validation datasets.

Results

Univariate and multivariate Cox analyses showed that the RRG signature was an independent prognostic factor for BCR of patients with PCa. Thereafter, the nomogram results revealed that it was able to predict BCR of patients with PCa with high efficiency.

Conclusion

This study identified an independent prognostic signature and established a nomogram to predict BCR in PCa. This signature can be used to identify patients with PCa with a high risk of BCR, and personalized treatment can be applied.
Advances in pharmacotherapies in cancer-related cachexia*
Authors: Ouyang Ze , Tao Weili , Yu Shiying , Zou Man
Published: June 2023

Cancer-related cachexia is highly prevalent in patients with advanced cancer, affecting approximately 50%-80% of patients and seriously interfering with active therapy, quality of life, and survival time. There are currently no effective treatments for cachexia. Therefore, new therapeutic strategies are required. In recent years, advances in understanding the mechanisms underlying cachexia have been made, and new drugs have been developed to combat cachexia muscle wasting and weight loss due to cancer. In this systematic review, we discuss these novel targets and drug treatments.
Morphological plasticity of six tree species with different light demands growing in multi-layered deciduous forests in Central Europe
Authors: Bartkowicz Leszek , Paluch Jarosław
Published: June 2023

Tree allometry is a plastic feature, and scaling parameters can vary considerably depending on phylogeny, life strategies, growth conditions and ontogeny. We hypothesized that in multi-layered forests growing on rich sites and driven by stand dynamics without stand-replacing disturbances, light is a primary driver of allometric relationships and that the morphological plasticity of tree species is closely associated with their shade tolerance. We quantified and compared the morphological properties of six species that form a shade tolerance gradient: Alnus glutinosa (L.) Gaertner, Quercus robur L., Fraxinus excelsior L., Ulmus laevis Pall., Tilia cordata Miller and Carpinus betulus L. The relationships between tree height and local stand density as predictors and dbh, crown width, crown length and crown volume as response variables were characterized. We found that in the lower stand layer the values of crown parameters increased with tree height at a lower rate in light-adapted than in shade-tolerant species. Conversely, the response of morphological traits on competition was stronger in light-adapted species than in shade-tolerant species. The ratio of crown width-to-crown length was not associated with light demand. Apart from ash, which demonstrated a different allocation pattern, between-species differences in the slenderness ratio were insignificant. Allometry and sensitivity to competition varied in trees growing in the upper and lower stand layers. Our results indicate that the dichotomy of basic growth strategies of stress tolerance versus stress avoidance is overly simplistic and fails to consider social status and species-specific features such as apical control.
European forest sinks and climate targets: past trends, main drivers, and future forecasts
Authors: Hyyrynen Matti , Ollikainen Markku , Seppälä Jyri
Published: June 2023

We examine the evolution of European net sinks towards 2030 and the European Union’s (EU) climate neutrality target by 2050. The EU’s current land use policy for 2021–2030 is divided into two periods: 2021–2025 and 2026–2030. The national inventory data from several databases and statistical analyses are used to examine the trends and drivers and to forecast future forest sinks and the net sinks of the land use, land use change and forestry (LULUCF) sector. Our forecasts suggest that national forest sinks will be short of the agreed forest reference levels in most member states in 2021–2025, with a total of 128 MtCO2eq. For 2026–2030, the net sink for the whole EU LULUCF sector will be short of the EU target by 298 MtCO2eq. Thus, most member states must design more efficient LULUCF policies to fulfil their national targets. Furthermore, the decreasing trends in the LULUCF sinks also emphasize the need to reduce emissions and to increase the sinks in most member states so that the EU can achieve its climate neutrality goal by 2050.
Impact of smartphone use at bedtime on sleep quality and academic activities among medical students at Al -Azhar University at Cairo
Authors: Elsheikh Asmaa Abdelghany , Elsharkawy Safaa Abdelfattah , Ahmed Doaa Sadek
Published: June 2023

Aim

Smartphone use has become prevalent and rapidly expanding. Therefore, it is essential to determine the potential adverse effects. This study aims to assess the prevalence of smartphone use at bedtime and its association with sleep quality and educational-related activities among medical students.

Subject and methods

The current cross-sectional study included 1184 male and female undergraduate medical students at Al-Azhar University in Cairo. We used a self-administered questionnaire to collect data on personal characteristics, smartphone use, and academic activities. The Pittsburgh sleep quality index ((PSQI) was used for the assessment of sleep quality.

Results

The result revealed that bedtime smartphone use was highly prevalent (96.5 %), with nearly half (46.9%) of studied medical students using them for more than 2 hours. Social media was at the top of the usage list (74.2%), followed by communication (48.8%). Smartphone users at bedtime had a significantly higher prevalence of poor sleep quality, increased sleep latency, difficulty in maintaining sleep, and shorter sleep duration compared to non-user (p-value<0.05). The probability of poor sleep quality is significantly increased by bedtime smartphone use, regular coffee drinking, hostel residence, and proximity of the phone during sleep, whereas the likelihood of poor sleep quality is significantly decreased by physical activity. A significant association between poor sleep quality and academic performance was also reported.

Conclusion

This study emphasizes the negative impact of smartphone use at bedtime on sleep quality and quantity, which in turn has a negative effect on academic performance. Therefore, medical students are strongly encouraged to limit their smartphone use before bedtime for better sleep and academic performance.
4MIDable: Flexible Network Offloading For Security VNFs
Authors: Lewis Benjamin , Broadbent Matthew , Rotsos Charalampos , Race Nicholas
Published: June 2023

The ever-growing volume of network traffic and widening adoption of Internet protocols to underpin common communication processes augments the importance of network security. In order to enforce network security policies, network managers adopt a widening set of middleboxes and network appliances to improve traffic monitoring and processing capabilities. The resource requirements to support network security appliances are constantly increasing, making efficiency of these systems an essential aspect. The move toward Software-Defined Networking and programmable data planes offers a mean to offload traffic processing functionalities to within the network itself. To this end, we present the 4MIDable framework: a platform that facilitates the integration of existing middleboxes and monitoring appliances with an SDN (P4) network infrastructure. We also present P4Protect, a 4MIDable agent that protects the network from control plane DoS attacks with negligible impact on control plane latency, and P4ID (P4-Enhanced Intrusion Detection), a 4MIDable agent that offers stateful processing and feedback to unmodified Intrusion Detection System middleboxes and reduces traffic processing by over 80% without affecting threat detection rates.
Applicability of leadership modes outside the negotiation framework: insights from China
Authors: Hurri Karoliina , Kopra Sanna
Published: June 2023

Drawing insights from a qualitative content analysis of China’s national climate reports between 2016 and 2019, this article examines the extent to which classical leadership typologies introduced by Oran Young, Arild Underdal, and Raino Malnes in the early 1990s have explanatory power outside of international climate negotiation frameworks. Mode by mode, we assess the strengths and weaknesses of four classical leadership modes—directional, ideational, instrumental, and structural—to grasp the manifestation of international climate leadership in a domestic context. While the analysis points out some substantial weaknesses in classical leadership modes, it indicates that China has taken consistent efforts to offer climate leadership in a domestic context. Given the huge gap between the leadership literature and the planetary reality; however, the article concludes that the key shortcoming of the leadership literature is that it tends to focus exclusively on the negotiation phase of international climate politics. Therefore, prospective studies on climate leadership have to pay more attention to the locus of leadership.
Steady-State Transitions in Ordered Porous Media
Authors: Forslund T. O. M. , Larsson I. A. S. , Hellström J. G. I. , Lundström T. S.
Published: June 2023

Previously performed experiments on flow through an ordered porous media cell with tomographic particle image velocimetry reveal a complex three-dimensional steady-state flow pattern. This flow pattern emerge in the region where inertial structures have been previously reported for a wide range of packings. The onset of these steady-state inertial flow structures is here scrutinized for three different types of packing using a finite difference method. It is concluded that the onset of the flow structure coincides with a symmetry break in the flow field and discontinuities in the pressure drop, volume averaged body forces and heat transfer. A quantity for identifying the transition is proposed, namely the pressure integral across the solid surfaces. It is also shown that the transition can both increase and decrease the heat transfer dependent on the actual geometry of the porous medium.
Mechanical Characterisation and Simulation of the Tensile Behaviour of Polymeric Additively Manufactured Lattice Structures
Authors: Bruson D. , Galati M. , Calignano F. , Iuliano L.
Published: June 2023

Background

The mechanical properties of lattice structures have been primarily investigated using uniaxial compression loads. Particularly for polymers, tensile properties are rarely considered because of the difficulties of defining a suitable specimen design in which the fracture occurs within the gauge length.

Objective

This work proposes a novel formulation to obtain a specimen for the tensile test with a gradation of the lattice density at the interface with the bulk portion, which realises a uniform stress distribution. The aim is to combine a localisation of the fracture in the gauge length with a specimen geometry accomplishing the EN ISO 527 standard and analyse the correlation between the mechanical performance and the defects induced by the process on such thin structures.

Methods

The formulation is experimentally and numerically (FEM) tested by designed specimens with different cell topology, cell size, strut diameter, and number of cells in the sample thickness. Also, results from uniaxial compression tests are used to validate the tensile properties. The specimens are manufactured in different orientations in the building volume by laser powder bed fusion with Polyamide 12. The effects of the pores morphology, distribution, and inherent anisotropy are investigated using X-ray computed tomography analysis. This data is also used to tune a numerical model.

Results

The numerical analysis showed a uniform stress distribution; experimentally, the fracture is localised inside the gauge length in respect of the ISO standard. Remarkably, among the different strut-based architectures, the elongation at break is, in the best case, 50% of the corresponding bulk material, while the tensile strengths are comparable. Vertical printed specimens exhibited a slight decrease in tensile strength, and the elongation at break was lower than 50% compared to the counterparts built along the horizontal orientation. Modifying the numerical model according to process-related dimensional deviations between the actual and the nominal structures significantly improved the numerical results. The remaining deviation highlighted the incorrectness of modelling the lattice material from the bulk properties.

Conclusion

Density gradation is a reliable approach for describing the tensile behaviour of polymeric lattice structures. However, the lower amount of porosity and the different shape in the lattice led to a different material mechanical performance with respect to the corresponding bulk counterpart. Therefore, for polymeric lattice structures, the relationship between process-design-material appears crucial for correctly representing the structure behaviour.
Prediction of quality-adjusted life years (QALYs) after bariatric surgery using regularized linear regression models: results from a Swedish nationwide quality register
Authors: Sun Sun , Stenberg Erik , Lindholm Lars , Salén Klas-Göran , Franklin Karl A. , Luo Nan , Cao Yang
Published: June 2023

Purpose

To investigate whether the quality-adjusted life years (QALYs) of the patients who underwent bariatric surgery could be predicted using their baseline information.

Materials and Methods

All patients who received bariatric surgery in Sweden between January 1, 2011 and March 31, 2019 were obtained from the Scandinavian Obesity Surgery Registry (SOReg). Baseline information included patients’ sociodemographic characteristics, details regarding the procedure, and postsurgical conditions. QALYs were assessed by the SF-6D at follow-up years 1 and 2. The general and regularized linear regression models were used to predict postoperative QALYs.

Results

All regression models demonstrated satisfactory and comparable performance in predicting QALYs at follow-up year 1, with R2 and relative root mean squared error (RRMSE) values of about 0.57 and 9.6%, respectively. The performance of the general linear regression model increased with the number of variables; however, the improvement was ignorable when the number of variables was more than 30 and 50 for follow-up years 1 and 2, respectively. Although minor L1 and L2 regularization provided better prediction ability, the improvement was negligible when the number of variables was more than 20. All the models showed poorer performance for predicting QALYs at follow-up year 2.

Conclusions

Patient characteristics before bariatric surgery including health related quality of life, age, sex, BMI, postoperative complications within six weeks, and smoking status, may be adequate in predicting their postoperative QALYs after one year. Understanding these factors can help identify individuals who require more personalized and intensive support before, during, and after surgery.

Graphical Abstract
Self-reported symptoms after COVID-19 vaccination. Distinct sex, age, and geographical outcomes in Lebanese and Italian cohorts
Authors: Khalil Mohamad , Bonfrate Leonilde , Di Ciaula Agostino , Portincasa Piero ,   The LEITvax Group^, Abdallah Hala , Capurso Michela , Galerati Ilaria , Hayek Soukayna , Khalifeh Hala , Mastandrea Edoardo , Noto Antonino
Published: June 2023

Following the COVID-19 discovery in December 2019, different vaccines were authorized in 2021 in Italy and Lebanon, but side effects and the impact of sex and age remained partly explored. We designed a web-based “Google Form” questionnaire to record self-reported systemic and local side effects up to 7 days after 1st and 2nd dose of the vaccine in two distinct Italian and Lebanese cohorts. Twenty-one questions in Italian and Arabic languages explored the prevalence and severity of 13 symptoms. Results were compared with respect to living country, timing, sex, and age classes. A total of 1,975 Italian subjects (age 42.9 ± SD16.8 years; 64.5% females) and 822 Lebanese subjects (age 32.5 ± SD15.9 years; 48.8% females) joined the study. The most common symptoms in both groups were injection site pain, weakness, and headache after the 1st and 2nd doses. The rate of post-vaccinal symptoms and the severity score were significantly higher in females than in males and progressively decreased with increasing age following both doses. We find that among two populations from the Mediterranean basin, the anti-COVID-19 vaccine generates mild age and sex-dependent adverse effects, with ethnic differences and prevalent symptoms rate and severity in females.
General remarks on the entropy-inspired MCAT (manufacturing complexity assessment tool) model to assess product assembly complexity
Authors: Capponi Matteo , Mastrogiacomo Luca , Franceschini Fiorenzo
Published: June 2023

Assembly complexity assessment is a widely addressed topic in manufacturing. Several studies proved the correlation between assembly complexity and the occurrence of defects, thus justifying this increasing attention. A measure of complexity provides control over quality costs and performances. Over the years, many methods have been proposed to provide an objective measure of complexity. One of the most widely diffused is the so-called MCAT (i.e., “Manufacturing Complexity Assessment Tool”) modified by Samy and ElMaraghy H. for assessing product assembly complexity. Although this method highlights some interesting aspects, it presents some critical issues. This work aims to thoroughly analyse this method, focusing on its strengths and limitations.
Insights and risk factors of involuntary hospitalizations through a retrospective analysis of police records: differences between involuntarily and non-hospitalized patients
Authors: Chatzisymeonidis Stavros , Kioskli Kitty
Published: June 2023

Involuntary psychiatric admission poses a challenge in terms of providing the most effective yet least restrictive care in accordance with each country's regulations. Effective communication and coordination between the justice, police, and healthcare systems are essential for the successful implementation of this process. This study examines the sociodemographic, clinical, and parametric factors involved in the status of involuntary admission. A retrospective analysis of 292 cases grounded in the Hellenic Police records was conducted to indicate differences between involuntarily and non-hospitalized patients as well as risk and protective factors for the status of compulsory admission in psychiatric units located in Athens, Greece. Out of a total of 292 cases, 240 (77.4%) concerned involuntarily hospitalized patients, compared to 52 (16.8%) non-hospitalized. The most prevalent diagnosis among involuntarily hospitalized patients was schizophrenia, schizotypal, and delusional disorders (53.5%), in contrast to non-hospitalized patients, for whom it was affective disorders (33.3%). Affective disorders, along with neurotic, stress-related, and somatoform disorders, were found to offer a protective factor against involuntary hospitalizations. Our findings indicate that involuntary hospitalizations are associated with procedural downsides, detrimentally affecting mental health treatment recipients. Therefore, community-based compulsory therapeutic interventions should be incorporated into the mental health agenda of Greece.
Spontaneous Change: Applying Zhuangzi’s Concept of Hua (化) to Global Citizenship
Authors: Dang Jing
Published: June 2023

In the modern globalised world, there is a growing realisation that global awareness and transnational efforts are required to address global challenges. One attempt to foster this is through global citizenship and education. However, to be truly global, global citizenship education must draw on diverse traditions beyond Western-European paradigms. This article adds to this endeavour by drawing on Zhuangzi’s philosophy of hua—change or transformation—to develop an account of global identity that is both familiar and innovative. It begins with an overview of global ‘citizenship’ understood as a figurative form of citizenship orientated towards ethical and educational values. This is followed by an introduction to the concept of hua in Daoism, especially in the Zhuangzi, whereby all things are seen as changing according to their own nature and environment. Such an understanding of hua guides us toward “spontaneous” and “noncoercive” actions that reflect the true nature of an entity and its changing circumstances. These ideas are then applied to global citizenship (GC) and global citizenship education (GCE) via two sets of examples: first, they are applied at the local level in diverse contexts (such as schools and cultural groups) to illustrate the utility of Zhuangzi’s dynamic approach; and second, the article explores examples that highlight when it is “noncoercive” to implement or fail to implement GC. In sum, this article utilises Zhuangzi’s concept of spontaneous change to develop some suggestions of how to foster GC identity in a way that responds meaningfully to the dynamism and complexity of the modern globalised world, and that looks beyond the voices that have traditionally dominated the discourse.
Role of Taxa Age and Geologic Range: Survival Analysis of Marine Biota over the Last 538 Million Years
Authors: Pérez-Sosa Lilian B. , Nakamura Miguel , Del Monte-Luna Pablo , Vicente Alba
Published: June 2023

Understanding past extinction processes is an important and current matter, and regression methods in the domain of survival analysis can be applied to fossil data. The chief goal of this study is to relate genus-level lifetimes to ancient environmental conditions (e.g., sea level and surface temperatures or carbon dioxide concentration). The Cox proportional hazards model was used to characterize the extinction risks of marine genera, enabling quantitative and graphical comparisons between selected taxonomic groups over geologic time. The environment was confirmed to be a significant factor, and both age-dependent coefficients and time-dependent covariates were required to accommodate the data. The Cox model analyzed in this study provides new insights into the extinction patterns of marine biota over the past 538.8 million years (Ma). Previous works focusing on specific groups at certain geologic times suggest that the extinction risk is related to taxa age, taxonomic group, and, in some particular cases, geologic time. Here, this idea is confirmed for a larger taxonomic group, during a larger time span (ca. 530 Ma), providing a more complete and complex scenario than previous works. After applying survival analyses, conjoint effects were observed between taxa and their age, their time of existence, and the prevailing environmental conditions found at any particular moment.
Impact of Drone Regulations on Drone Use in Geospatial Applications and Research: Focus on Visual Range Conditions, Geofencing and Privacy Considerations
Authors: Alamouri Ahmed , Lampert Astrid , Gerke Markus
Published: June 2023

The European Aviation Safety Agency (EASA) laid down the new EU drone regulations in December 2020, which are seen as a development step towards enabling a reliable legal framework for drone operation and use. At the same time, it is still not clear how the new rules will influence drone usage in various drone-based applications and sectors. Therefore, the paper aims to discuss and analyse how recent rules may influence drone use and affect its economic viability with the focus on the geospatial sector. The discussion of rules’ impact is achieved based on three key items: visual range limitations, geofencing systems (virtual geographic boundary around specific areas of interest) and, finally, the effect of privacy considerations. To enrich the discussion and get more insight into rules’ impact, important issues from different technical and economic aspects were distributed in a questionnaire to collect data from participants who are actively developing or using the drone technology. The questionnaire results revealed that the majority of participants (75%) were of the opinion that it is somehow difficult to judge how the new regulations will help/hinder the drone use at least in the current stage of rules implementation. In addition, there is a tendency in conducting drone flights under visual line of sight conditions even if there are difficulties in keeping a continuous contact with the drone during flight operations. Finally, the results pointed out that 44% of participants faced problems with privacy issues that affected their flight missions, and as a consequence some of the projects even got cancelled.
An invitation to distributed quantum neural networks
Authors: Pira Lirandë , Ferrie Chris
Published: June 2023

Deep neural networks have established themselves as one of the most promising machine learning techniques. Training such models at large scales is often parallelized, giving rise to the concept of distributed deep learning. Distributed techniques are often employed in training large models or large datasets either out of necessity or simply for speed. Quantum machine learning, on the other hand, is the interplay between machine learning and quantum computing. It seeks to understand the advantages of employing quantum devices in developing new learning algorithms as well as improving the existing ones. A set of architectures that are heavily explored in quantum machine learning are quantum neural networks. In this review, we consider ideas from distributed deep learning as they apply to quantum neural networks. We find that the distribution of quantum datasets shares more similarities with its classical counterpart than does the distribution of quantum models, though the unique aspects of quantum data introduce new vulnerabilities to both approaches. We review the current state of the art in distributed quantum neural networks, including recent numerical experiments and the concept ofcircuit-cutting.
Approaches to Address New ABET Diversity, Equity, and Inclusion Criteria in Biomedical Engineering Curricula
Authors: Bansal Sonia , Kyle Aaron M. , Brightman Andrew O. , Amos Jennifer R.
Published: June 2023

The lack of diversity in engineering is a persistent problem with few signs of pending improvement. Efforts to promote diversity in engineering schools have produced modest gains. Based on a commitment to be a change leader and fueled by recent updates in ABET criteria to include diversity, equity, inclusion, and justice (DEI-J) as tenets of engineering education, the biomedical engineering (BME) community needs to find new ways to address the issues of DEI for all groups in our curricula. In an attempt to redesign engineering departments to be more inclusive of all student populations, institutions of higher learning are reviewing programs, policies, and the ways they engage students. This paper provides BME programs with some thinking about the integration of DEI into areas of curriculum, assessment, faculty practice and faculty support, infrastructure, and climate for change. This study reports on curricular innovations attempted to date in order to serve as a resource for biomedical undergraduate engineering curricula. The authors have collected critical resources and literature related to integrating DEI into courses and content as well as assessment and evaluation approaches. Sections include resources for BME design, diverse anatomy and physiology, person-centered language, ethics, and assessment and evaluation approaches to measuring climate, faculty, and student impacts. In addition to providing resources, we propose that the ABET DEI framework is missing a critical component: justice. We feel that justice should be emphasized, particularly in biomedical engineering programs because our field has the unique opportunity to promote awareness of injustices and racial disparities in the design, development, and delivery of healthcare and medical technologies. While this paper presents examples of integration in several course types and across different topics, it is intended to inspire additional efforts by the BME community to make more concerted changes to promote DEI in our educational programs.

Graphical abstract

Graphical abstract demonstrating main themes and connections between different themes in the DEI-J framework presented in the paper. Created with BioRender.com.