bluuebunny/crossref_metadata_2025 huggingface dataset:
BILIO-JEJUNOSTOMY STENOSIS AFTER CEPHALIC-DUODENOPANCREATECTOMY IN CHRONIC PANCREATITIS - CASE REPORT
Authors: Slavu I. , Braga V. , Bărbulescu M. , Alecu L.
Published: March 2021

We present the case of patient SC aged 44 years who underwent surgery 5 years prior to thepresentation to our clinic for a tumor in the head of the pancreas, the operation than consisted of acephalic duodenopancretectomy which was followed by a number of complications. On admissionthe patient had abdominal pain in the right flank, giant median postoperative eventration and aexternal ”a la Witzel” biliary drainage tube. Abdominal ultrasound revealed the presence of ainterhepaticodiaphragmatic collection that measured 4.6 / 3 cm. A cholangiography was donewhich showed biliary tract opacification of the left lobe with the full stop of the contrast in thedistal left main hepatic duct without intrahepatic biliary dilatation. Surgery was undertaken undertotal anesthesia – the intraoperative diagnosis consisted of: almost complete stenosis of the biliojejunostomy.After the adhesions were cut, the bilio-jejunostomy was redone using the left hepaticduct in a terminal-lateral anastomosis. The collection was drained and the abdominal defect wascorrected. The patient maintained a favorable external biliary drainage of about 200 ml per day soin the 5-th postoperative day the drainage was clamped without any complications. Conclusions: 1. Duodenopancreatectomy should be reserved for average / high volume surgical centers. 2. During the intervention the steps to achieve the biliary-digestive anastomosis should be respectedthoroughly 3. Fast reoperation may increase the chance of survival of the patient.
MANAGEMENT OF NECROTIC LESIONS IN CHRONIC LIMB ISCHEMIA
Authors: Sandu C. D. , Constantin Corina , Răducu Laura , Moraru Oriana , Vișan C. A.
Published: March 2021

Peripheral vascular disease commonly affects the arteries supplying the leg and is mostly caused by atherosclerosis. Restriction of blood flow due to arterial stenosis or occlusion often leads patients to complain of muscle pain on walking (intermittent claudication). Any further reduction in blood flow causes ischemic pain at rest, affecting by consequence the extremity. Ulceration and gangrene may then supervene and can result in loss of the limb if not treated. We present the case of a 55 year old male, C.I., with tissue necrosis of the right calf, aching pain at rest in the distal foot and disabling claudication (stage IV Fontaine PAOD).The patient’s history reveals that he is a former smoker undergoing anticoagulation and vasodilation treatment. He also suffered severe spinal cord injury leading to paraplegia in 2008, a laryngeal neoplasm surgery in 2013 and a PTA with stent placement in the proximal right CIA.
BILATERAL NEPHROBLASTOMA – CASE PRESENTATION
Authors: Iaconiță A. , Chivu L. A. , Sfrijan Doinița
Published: March 2021

Nephroblastoma is the most common pediatric abdominal malignancy, representing approximately 30% of pediatric cancers.Our case concerns a 3-year-old girl diagnosed with bilateral nephroblastoma, who presented 4 renal tumors, of which one that originated in the left kidney was occupying almost entirely the left half of her abdomen. The patient, D. A., was hospitalized in the surgery department of „Maria Sklodowska Curie” Emergency Children’s Hospital in Bucharest on 10.10.2014 in order to continue investigations regarding a right renal mass discovered incidentally during a routine abdominal echography. An abdominal CT scan revealed 2 masses in her left kidney, the largest of which measured 12/8/9 cm, and another 2 in her right kidney.Clinical and paraclinical data was suggestive for nephroblastoma, so a 4 week combined chemotherapy regimen (Vincristine and Actinomycin D) was initiated. A second abdominal CT showed a significant reduction in the size of the masses, which prompted physicians to repeat the regimen. Afterwards, a third abdominal CT scan showed an even further reduction in size, the largest mass now measuring 49/43 mm.The patient underwent a left ureteronephrectomy on 24.12.2014, along with the excision of the 2 right renal tumors. Postoperatively, a third chemotherapy regimen was initiated, with the same medication, this time lasting 27 weeks. At the time of publishing, the patient is still under chemotherapy treatment. This case presents a few interesting features, highlighting the possibility of a very positive response to treatment of nephroblastoma, despite a dire initial prognosis.
THE ROLE OF IMAGISTIC INVESTIGATIONS IN DIAGNOSING ACUTE COMPLICATED DIVERTICULITIS
Authors: Tănase I. , Păun S. , Stoica B. , Stoica I. , Beuran M.
Published: March 2021

Recent progress in medical imaging allowed higher accuracy in diagnosis of acute diverticulitis. Contrast enhanced Computed Tomography (CT) has a high sensitivity and specificity, reaching a diagnostic accuracy over 95%. Although abdominal X-ray and ultrasonography are still used, their utility is limited in this pathology. Retrospective study including patients admitted for acute diverticulitis in the Surgery Clinic of Bucharest Clinical Emergency Hospital between January 2012 and July 2014. From the total number of 29508 admissions, 156 patients were diagnosed with acute diverticulitis staged Hinchey I to IV. The imagistic investigations on admission were plain abdominal X-ray (128 cases), which identified 6 cases of pneumoperitoneum; abdominal ultrasound (112 cases) which identified colonic wall thickening and/or free peritoneal fluid in 29.4% cases. Contrast enhanced CT was performed in 97 cases, successfully establishing the diagnostic in 80% of cases. The mean waiting time interval until CT scan was under 24 hours for the patients with acute complicated diverticulitis. Patients with acute diverticulitis staged Hinchey II-III needed CT reevaluation both for monitoring the response to conservative treatment and identification of postoperative complications. Due to its high diagnostic accuracy and short waiting interval, in the studied cohort, contrast enhanced CT represents the investigation of choice in diagnosing acute diverticulitis. Abdominal ultrasound remains an alternative only in cases where CT scan is unavailable or contraindicated, having a lower accuracy in diagnosis and evaluation of diverticular disease complications.
RE-OPERATIVE SURGERY FOR RECURRENT PRIMARY HYPERPARATHYROIDISM ASSOCIATED WITH OLIGOMENORRHEA
Authors: Valea Ana , Muntean V. , Morar Andra , Carsote Mara , Căpățînă Cristina , Albu Simoa Elena
Published: March 2021

Recurrent primary hyperparathyroidism is characterized by typical symptoms and biochemical recurrence of hypercalcemia after more than 6 months of normal calcium levels after surgery. We report the case of a 39-year-old female patient presenting with menses disturbances who was diagnosed with primary hyperparathyroidism caused by a left inferior parathyroid adenoma at the age of 35. Postoperative 6-month follow-up showed normalization of biochemical and hormonal profiles, with significant improvement of clinical symptoms, dominated by muscle weakness, weight loss and oligomenorrhea. The 18-month follow-up showed elevated PTH and serum calcium levels. Imaging confirmed recurrence of primary hyperparathyroidism by highlighting a right upper parathyroid adenoma. Surgery was performed again and no major incident was seen. The particularity of this case consists in the recurrence of primary hyperparathyroidism in a young patient with no family history of the disease due to asynchronous parathyroid adenomas that were successfully removed in a female patient who in addition to classic complications such as calyceal microlithiasis and osteoporosis presented oligomenorrhea which was resolved spontaneously after the correction of hypercalcemia.
OBSTETRICS AND GYNECOLOGY PRACTICE AND PROFESSIONAL COUNSELING FOR MEDICAL STUDENTS GRANT
Authors: Pleș Liana
Published: March 2021

This year, from July to November, the Obstetrics and Gynecology Department from “Bucur” Maternity “Saint John” Hospital, Bucharest conducted the POSDRU grant “Obstetrics and Gynecology Practice and Professional Counseling for Medical Students”. The project had the financial support of both the European Social Fund and the Sectorial Operational Program for Human Resources Development 2007-2013, priority axis 2.The main objective of the Grant was to support students from University of Medicine and Pharmacy “Carol Davila” Bucharest in the transition and integration from study to real professional life. More than 160 students of the 2nd to 5th year of university were included in the project. Each student had the opportunity attend the practice for a period of 3 weeks, 6 hours per day, similar to a normal working day of a doctor.The core of the activity was real, medical practice. The students had the occasion to practice gynecological and surgical everyday gestures such as knots and sutures, to attend in the operating room during gynecological interventions or caesarian sections, but also to be involved in attending vaginal deliveries or performing obstetrics ultrasound by themselves. During that period the students spent 2 weeks of activity in “Bucur” Maternity and one week in the Medical Simulating Center “LifeSiM”. In this specialized center they had the opportunity to practice laparoscopy, hysteroscopy, knots and sutures, basic life support maneuvers and vaginal birth assistance on medical models.The originality of the program was that the physicians who trained the students had no universitary activity in their current life. They were enthusiast young specialists or residents in obstetrics . In this way the students felt closeer to their instructors and integrated easyly in the hospital life. Being trainers, the physicians experienced that challenge and had good result in teaching the students that was an aspect observed from final students feed-back.Why was the project so important? Our practice program is unique because it is the first one who developed such activity in obstetric filed in a simulating center. Moreover, we offered also professional carrier counseling to the students and the most emotional involvement that we could. We considered each student as a less experienced colleague and we tried to explain everything the best we could. The bound created during the program with some of them lead to volunteering for some of them who continued to come in our hospital.
THE HISTORY OF ANTIBIOTICS IN SURGERY
Authors: Lupașcu Gina , Radu Georgiana , Andreescu Cristina Veronica , Bolocan Alexandra
Published: March 2021

Selman Waksman is an important name that introduced for the first time the idea of some natural compounds with visible effects in treatment of diseases called- antibiotics. Its continuous and irrational utilization has been proven to make the body resistant to a future need of the antibiotic administered. This aspect did not stop the studies to shown the importance of this biosynthesized medicines in prophylaxis of surgery. During the years there were identified a lot of these natural compounds with positive results in different types of surgery. The purpose of this article is to bring to attention the evolution of antibiotics during the years, especially in surgery field, how its usage influenced the prophylaxis and which are the main principles to be respected in administration of antibiotics.
WHEN SHOULD CLEARANCE OF THE HEPATODUODENAL LIGAMENT (STATION 12) DURING RADICAL RESECTION FOR GASTRIC CANCER BE PERFORMED
Authors: Negoi I. , Păun S. , Hostiuc S. , Runcanu A. , Negoi Ruxandra Irina , Beuran M.
Published: March 2021

In Western countries gastric cancer continues to remain a biologically aggressive tumor, with poorlong-term oncological outcomes. In Romania, the estimated gastric cancer was the fifth cause ofoncological death in men and the eighth cause of oncological death in women in 2012.The objectiveof the study is to detail when should the hepatoduodenal ligament (station 12) be cleared surgicallyas a part of D2 dissection during radical gastrectomy.We have performed a review of the Englishlanguage literature using PubMed/Medline library. As keywords we used a combination of thefollowing terms: ‘gastrectomy’, ‘stomach’, ‘cancer’, and ‘lymphadenectomy’. According to theJapanese Gastric Cancer Association, the hepatoduodenal ligament includes the lymph nodesstation 12, which are further divided in 12a – along left side of the proper hepatic artery, 12b –right side of the ligament and posterior to the common bile duct, and 12p – posterior to the portalvein. For middle and lower third gastric tumors, station 12a represents the N2 tier, while for upperthird gastric tumors, it represents the N3 tier. Lymph nodes 12b and 12p represent N3, irrespectiveof the tumor location. For middle and lower third gastric tumors the clearance of the lymph nodessurrounding the proper hepatic artery is a part of the D2 dissection. Dissection of the lymph nodessurrounding the proper hepatic artery is a component of the D2 spleen and pancreas preservinglymphadenectomy, for lesions which extend further than submucosa.
NEUROMONITORING THE BRANCHES OF THE RECURRENT NERVE DURING THYROIDECTOMY
Authors: Cârstea Silvia , Nica Adriana Elena , Popescu R.
Published: March 2021

The lesions of the laryngeal nerves are the most severe long term complications after thyroidectomy. Visual identification of the recurrent laryngeal nerve during thyroid surgery has been recommended in many studies as the golden standard of RLN treatment. The non recurrent laryngeal nerve should always be taken into consideration in order to avoid accidental injury during thyroid surgery. Laryngeal recurrent nerve can be difficult to identify because of rare anatomical variants, extra laryngeal branches, or in complicated thyroid operations, such as voluminous goiter or thyroid cancer. Intraoperative nerve monitoring is secure for the patient, easy to use and useful in showing the integrity of laryngeal recurrent nerve, both during and after surgery. The Departament of Surgery, Valcea Country Hospital, from January 2014 to April 2015, developed a prospective study which enrolled 123 patients who underwent thyroid interventions with neuromonitoring and all had been treated by the same surgeon. The signal obtained from RLN localization, 215 nerves (96%), from a total of 222 , show a clear and reliable EMG response. 7 nerves (3%) were not received through EMG signal. In 3 cases involving 5 RLN there was a false negative result caused by electrode malposition and in 2 cases the RLN was injured during surgery.Clinical evolution of the procedure and more extended studies are needed to show if intraoperative monitoring decreases the rate of recurrent laryngeal nerves iatrogenic injury.
DOES ENDOMETRIAL INJURY IMPROVE THE OUTCOMES IN PATIENTS WITH RECURRENT IMPLANTATION FAILURE?
Authors: Boleac I. , Neagu Manuela , Ene R. , Busan - Pîrvoiu Alina , Codreanu Dorina , Coricovac Anca , Marinescu B.
Published: March 2021

Recurrent implantation failure refers to a failure to achieve a clinical pregnancy after transfer of atleast four good-quality embryos in a minimum of three fresh or frozen cycles in a woman under theage of 40 years. We present this retrospective study, in which we proposed local endometrial injuryfor the management of the uterine factors in the case of 30 couples with recurrent implantationfailure. Our conclusion was that local endometrial injury improved the clinical pregnancy rate forthese couples, especially when the study population met specific criteria.
RARE PRIMARY SMALL BOWEL TUMOR IN THE FORM OF CLASSIC KAPOSI’S SARCOMA: CASE PRESENTATION
Authors: Șoitu M. A. , Neștian Elena , Botezatu C. , Mastalier B.
Published: March 2021

The small bowel represents a rare site for primary neoplasms, with an incidence of less than 2% ofall that are located in the digestive tract. The early diagnosis of these tumors is often difficult due tothe lack of specificity of the clinical presentation, but it can make a difference in matters of 5-yearsurvival rates: 83% (early detection) versus 14% (late detection). We present the case of a malepatient, aged 66, with an apparently benign jejunal ulcer diagnosed endoscopically. Clinicalpresentation: diffuse abdominal pain, fatigability, melena; paraclinical evaluation: anemia,positive occult gastrointestinal bleeding test, superior and inferior endoscopy withouthemorrhagic lesions. The surgical exploration guided by intramucosal dye discovers a 2 cmtumor, 250 cm distal to the angle of Treitz with multiple mesenteric adenopathies. Segmentalresection is performed keeping oncological safety margins with the removal of the lymphaticdrainage elements. The postoperative evolution is favorable and leads to complete healing. Thehistopathological assay finds pathological changes consistent for Kaposi’s sarcoma and confirmsthe presence of HHV-8 in the nuclei of the tumor cells by means of immunohistochemistry. At theexamination of the skin, multiple purple patches were discovered. The particularity of this case isthat the Kaposi’s sarcoma manifests itself in the absence of an immunosuppressive treatment or animmunodeficiency state induced by an HIV infection. Although rare, the small intestine tumorsshould be considered when non-specific abdominal pain is accompanied by positive occult bleedingtest, with scarce endoscopic evidence. Since the Kaposi’s sarcoma is a highly angiogenic tumor, itis prudent to include it in the differential diagnosis when suspecting a source of gastrointestinalbleeding.
CHALLENGES IN THE DIAGNOSIS AND SURGICAL MANAGEMENT OF AN UNCINATE PROCESS ADENOCARCINOMA IN A PREVIOUSLY HEALTHY YOUNG ADULT
Authors: Popa Ioana T. , Dediu M. , Florescu V.
Published: March 2021

Despite the increasing numbers of young adults being diagnosed with aggressive forms ofpancreatic cancer, there is still insufficient data regarding the evolution patterns for early stagepredictors. However, a correct and timely diagnosis is of major importance in the management andthe outcome for pancreatic cancer patients.We are reporting the case of a 39 year old male whopresented to the emergency department on the Easter holiday evening with visible signs of jaundice,no abdominal pain and no history of disease. The patient was admitted due to inconclusiveparaclinical test results, the significantly elevated value of conjugated bilirubin being the onlysignaled abnormality. During the following two weeks, a number of basic and advanced imaginginvestigations were carried out due to insufficient information offered by the clinical andparaclinical investigations. During admission, EUS ( endoscopic ultrasonography) identifies animprecisely delimited hypoechoic mass, confirmed by MRCP (Magnetic Resonance Cholangio-Pancreatography) as an uncinate process nodule. The patient is informed about the pancreaticcancer diagnosis treatment options and prognosis. Surgical management of the uncinate processmass is decided and a Cephalic Pancreaticoduodenectomy (Traverso-Longmire) is performed withpara-aortic and para-caval lymphadenectomy. The patient is discharged 17 days postoperatively,without complications; due to the histopathological diagnosis of poorly differentiated pancreaticduct adenocarcinoma, the multidisciplinary oncological meeting set the indication for combinedchemotherapy and radiotherapy. Diagnosing pancreatic cancer in young adults without specificsymptoms or a prior condition is a challenging task, more so with the limited resources and meansof investigation in an emergency hospital. In conlusion, EUS had the highest sensibility whileMRCP had the highest specificity after normal endoscopy and inconclusive abdominalultrasonography and CT scan. Another predictor of probability for an uncinate process tumor isassociated with the high-low variations of direct bilirubin levels during antispasticity medication.
MANAGEMENT OF RECURRENT POSTOPERATIVE CUSHING’S DISEASE
Authors: Valea Ana , Turturea Roxana , Botezan Oana , Carsote Mara , Ghemigian Adina , Georgescu Carmen Emanuela
Published: March 2021

Although adenomectomy remains the first-line treatment in Cushing’s disease, it is not alwayscurative for most patients. Sooner or later persistent or recurrent disease can be found in somecases. Case report: A 13-year-old girl was admitted for weight gain, menstrual disturbances, andtransient headache. Hormonal profile confirmed the clinical suspicion of Cushing’s disease.Pituitary MRI highlighted a microadenoma of 5.2 mm resected through transsphenoidaladenomectomy. No complications were registered during the procedure. After a 7 dayshospitalization, the patient was discharged without any medications. Periodic evaluationsconfirmed the disease’s remission that was maintained for a period of 2 years. During this period,the patient received only thyroxine and progesterone treatment. Two years after surgery, theadrenal hormone profile confirmed the recurrence of the disease. According to the patient’s age,ketoconazole and cabergoline treatment was instituted without any significant improvement.Because no obvious tumor mass has been revealed on the pituitary MRI, pasireotide treatment wasintroduced at the age of 18. An obvious improvement in the hormonal profile was achieved afterthree months of treatment. Cushing’s disease control requires therapeutic alternatives consistentwith the patient’s age and the complications of the disease. Pasireotide treatment may be a goodchoice for adult patients with recurrent disease after transsphenoidal adenomectomy.
CUTANEOUS METASTASES UNVEILING BREST CANCER – THERAPEUTIC AND DIAGNOSTIC CONSIDERATIONS
Authors: Sandru Florica , Dumitrascu Mihai Cristian , Petca Aida , Miulescu Raluca Gabriela , Tebeica Tiberiu , Popa Adelina
Published: March 2021

Metastatic cutaneous lesions are seen more commonly in breast cancer than in any other malignancy in women. Secondary breast cancer happens when cancer cells spread from the breast to other parts of the body. Sometimes breast cancer cells can spread to the skin. This can happen through the blood or lymphatic system. The presence of skin metastases signifies widespread systemic disease and a poor prognosis. The chest wall, the abdomen, the back, and the upper extremities are common sites.We present the case of a 69-year-old woman presented to our Surgery Department in June 2019, after appearing in the Dermatology Department a week ago, for the appearance of multiple subcutaneous painless, hardened, skin-colored nodules spread to the cervical region, anterior chest walls and upper limbs. Anatomopathological examination of the skin biopsy, performed on the anterior face of the left arm, showed dermal fragment with neoplastic, suggestive for lobular breast carcinoma (stage IV). The patient was referred to the oncological surgery department where our patient underwent a left total mastectomy and sentinel lymph node biopsy. The technique of mastectomy was the Madden technique. The surgery has no healing character, being more a necessity intervention that seeks to avoid the complications of the local evolution of the disease, such as ulceration, hemorrhage or suppuration, the possibility of applying the other forms of treatment (radiotherapy and / or polychemotherapy), elimination of a source of permanent metastatic sowing thus leading to more efficient treatment.
THE IMPACT OF UTERINE FIBROMATOSIS ON THE ENDOMETRIUM AND FERTILITY
Authors: Calin F.D. , Ionescu C.A. , Dimitriu M.C.T. , Ciobanu A.M. , Badiu C.D. , Neacșu A. , Socea B. , Hudiță D.
Published: March 2021

Uterine fibroids are the most common benign tumor that can be found in a woman's reproductivesystem. The uterine fibroid affects millions of women globally each year and we can consider thispathology, without exaggerating, an important public health problem. Our study was carried outprospectively, in 5 years (2015-2019) and enrolled 480 patients selected with uterine fibroid, from anumber of 28809 women who were hospitalized during this period in the university clinic ofObstetrics and Gynecology within the „Saint Pantelimon” Emergency Hospital, Bucharest, Romania.Patients were divided into two groups of study: Group A, those with well-defined, single or multipleuterine fibroid and Group B – patients with diffuse uterine fibromatosis. The clinical,histopathological and immunohistochemical study analyzed and monitored over time, by comparisonbetween the two groups, 52 parameters for each patient, starting with the usual epidemiologicalfactors (age, weight, height, body mass index, personal or family medical history, etc.), continuingwith those related to fertility and other clinical issues (chronic pain, metrorrhagia, number of births,recurrent miscarriage, etc.), up to intraoperative parameters (duration of surgery, blood loss, pelvicdrainage, the need for blood transfusion) and finally, histopathological aspects. We present in thisarticle some of the results of our study, those related to the quality of the endometrium in thefibromatous uterus and the influence that uterine fibroid had on the fertility of our patients.
THE EFFECT OF LEARNING OUTCOMES USING THE CONTEXTUAL TEACHING AND LEARNING MODEL ON MATEMATICS
Authors: Hartanti Khusnul Tri , Basir Udjang Pairin M. , Susilo Claudya Zahrani
Published: March 2021

Many students find it difficult to accept fraction material from the teacher because student are more receptive to material through the surrounding environment such as fruit, bread, marbles, stones, etc. The purpose of this researchs to determine student learning outcome whether thereis influence when use the Contextual Teaching and Learning (CTL) model of mathematics subject matter in the 4th grade SDN Jombatan IV Jombang. This type of research is PreExperimental Design, the design used is one-group pretest -posttest design. The study focus on student learning outcomes in fraction material with the CTL model. Based on research that has been done, it can seen than more than 90% of students can achieve KKM value. In testing the test-t if the value of t is greater than t table then the hypothesis is accepted. It is evident from the results of the study that tcount = 5.344219271 and ttable = 2.178812827, which means that it has a strong signification shows that there is an influencer on student learning outcomes. The one-party test, it turns out that tcount falls in the area of acceptance of Ha, which the result test shows menunjukkan thitung ˃ ttabel so that the conclusion are Ha is accepted and Ho is rejected. So it can be said that learning uses Contextual Teaching and Learning (CTL) can affect of student learning outcomes.
Reliability Assessment of Power Systems with High Renewable Energy Penetration Using Shadow Price and Impact Increment Methods
Authors: Hou Kai , Tang Puting , Liu Zeyu , Jia Hongjie , Zhu Lewei
Published: March 2021

With the ever-increasing penetration of renewable resources, more complexities and uncertainties are introduced in power system reliability assessment. This entails an enormous number of contingency states to represent the characteristics of renewable energy. As a result, the unbearable computation burden is the main challenge toward the efficiency of the state enumeration (SE) method. To address that, this paper proposes an improved reliability evaluation approach that can not only increase the accuracy but also accelerate the analysis. In detail, the impact increment method is first employed to decrease the proportion of higher-order contingency states, leading to accuracy improvement. Then, the shadow price is used to solve the optimal power flow (OPF) problem in a faster manner. This shadow price (SP) method allows us to obtain the optimal load curtailment directly from linear functions rather than the time-consuming OPF algorithms. In addition, one hundred percent criterion is used to match shadow-price-based linear functions with system states. Case studies are performed on the RTS-79 system and IEEE 118-bus system, in which test scenarios include loads, photovoltaics (PV), and wind turbines (WT). Results indicate that the proposed method can significantly ease the computation burden and outperform traditional reliability assessment methods in terms of both computing time and accuracy.
How Bacterial Adaptation to Cystic Fibrosis Environment Shapes Interactions Between Pseudomonas aeruginosa and Staphylococcus aureus
Authors: Camus Laura , Briaud Paul , Vandenesch François , Moreau Karen
Published: March 2021

Pseudomonas aeruginosa and Staphylococcus aureus are the two most prevalent bacteria species in the lungs of cystic fibrosis (CF) patients and are associated with poor clinical outcomes. Co-infection by the two species is a frequent situation that promotes their interaction. The ability of P. aeruginosa to outperform S. aureus has been widely described, and this competitive interaction was, for a long time, the only one considered. More recently, several studies have described that the two species are able to coexist. This change in relationship is linked to the evolution of bacterial strains in the lungs. This review attempts to decipher how bacterial adaptation to the CF environment can induce a change in the type of interaction and promote coexisting interaction between P. aeruginosa and S. aureus. The impact of coexistence on the establishment and maintenance of a chronic infection will also be presented, by considering the latest research on the subject.
Quercetin Attenuates Diabetic Peripheral Neuropathy by Correcting Mitochondrial Abnormality via Activation of AMPK/PGC-1α Pathway in vivo and in vitro
Authors: Zhang Qian , Song Wei , Zhao Bingjia , Xie Jun , Sun Qing , Shi Xiaohu , Yan Bin , Tian Guoqing , Liang Xiaochun
Published: March 2021

The AMPK/PGC-1α pathway-mediated mitochondrial dysfunction has been supposed to play a crucial role in pathogenesis of diabetic peripheral neuropathy (DPN). The present study investigated the neuroprotective potential of quercetin, a natural AMPK activator. Streptozotocin (STZ)-induced diabetic rats that developed DPN phenotype were orally administrated with quercetin (30 and 60 mg/kg per day) for 6 weeks. The morphologic changes in the sciatic nerves (SN), the pathological structure of neurons in dorsal root ganglion (DRG), and the expressions of myelin proteins were assessed. The ATP content and the mitochondrial ultrastructure were measured. Furthermore, key proteins in the AMPK/PGC-1α pathway were determined. As a result, quercetin administration at both doses improved the paw withdrawal threshold, nerve conduction velocity, and the pathologic changes in SN and DRG of DPN rats. The expressions of myelin basic protein and myelin protein zero were also increased by quercetin. The oxidative stress, decreased ATP generation, and morphological changes of mitochondria were corrected by quercetin. In vitro study found that quercetin treatment significantly decreased the high-glucose-induced generation of reactive oxygen species, as well as attenuated the mitochondrial morphologic injuries and oxidative DNA damages of RSC96 cells. Quercetin treatment promoted the expressions of phosphorylated AMPK, PGC-1α, SIRT1, NRF1, and TFAM under hyperglycemic state in vivo and in vitro. This study revealed that the neuroprotective effect of quercetin was mainly related to mitochondrial protection by activation of the AMPK/PGC-1α pathway for the first time and proved quercetin as a potential therapeutic agent in the management of diabetic neuropathy.
The Abundance and Structure of Deadwood: A Comparison of Mixed and Thinned Chinese Fir Plantations
Authors: Li Yuanfa , Li Muxuan , Li Xian , Liu Zhilong , Ming Angang , Lan Huangxu , Ye Shaoming
Published: March 2021

The sustainability of coniferous monoculture plantations is facing challenges with respect to yields, ecology, and biodiversity. Conversion of monocultural coniferous plantations into mixed stands using thinning or direct mixed planting is widely considered to be a key strategy for overcoming these challenges and transforming the characteristics of plantations on a regional scale. Substantial amounts of deadwood may be produced in mixed forests (MFs); this material is important for evaluating and modifying forest management methods, understanding the dynamics of forest stands, and achieving biodiversity conservation. We assessed the quantitative characters and diameter distributions of deadwood in mixed and thinned Chinese fir [Cunninghamia lanceolata (Lamb.) Hook.] forests over one rotation. We used the g(r) function and spatial parameters to analyze the spatial structure of deadwood, and used logistic regression and Hegyi’s competition index (HCI) to explore competition and mortality. Our results indicate that: (1) Chinese fir dominated in all groups of deadwood (snags, broken wood, and fallen wood), and the abundance, volume, and mortality rates of deadwood were much lower in the thinning forest compared to the MF. (2) Later coming populations (LCPs) comprised the majority of the small diameter classes in the thinning forest, but only accounted for a small proportion of the MF. (3) Broken wood in the thinning forest was randomly distributed, while the other types of deadwood were clustered at most spatial scales. In contrast, the spatial patterns in the MF were random at most spatial scales. (4) Total deadwood in both stands was in a status of intermediate and was randomly surrounded by its four nearest neighbors. All types of deadwood were highly mixed in the thinning forest and moderately mixed in the MF. Our case study suggests that thinning and mixing result in different stand development processes and thus influence the type, amount, and structure of deadwood. Thinning significantly reduces competition, which is the main driver of tree mortality. Converting pure Chinese fir plantations into mixed stands by thinning should be taken in future. Understanding tree mortality after conversion is essential to select appropriate silvicultural treatments and achieve ultimately sustainable forest management.
Towards a More Efficient Training Process in High-Level Female Volleyball From a Match Analysis Intervention Program Based on the Constraint-Led Approach: The Voice of the Players
Authors: Fernández-Echeverría Carmen , Mesquita Isabel , González-Silva Jara , Moreno M. Perla
Published: March 2021

The aim of the research was to know the perception of high-level volleyball players of the changes produced (in relation to the previous season) in the efficiency of the training process, after a match analysis intervention program based on the Constraint-led Approach (CLA). The sample consisted of 11 players from a women's volleyball team. The protocol of the intervention program consisted of providing objective, contextualised and systematic information to the coach (adapted to his needs) that would allow understanding the different real game contexts. We used semi-structured interviews to assess players' perceptions. The athletes perceived changes in training, both in their preparation and development, specifically in greater involvement and organisation in preparing the training; in an increase in the specificity and suitability of training tasks according to individual needs; in the representativeness of the restrictions of the game; in a more tactical approach; in the variability of task and in the accountability to achieve the objective proposed. In addition, in the preparation and development for competition, the players detected more game planning; a deeper analysis of the opponents; an objective selection of the most relevant data, an increase in the depth of match analysis and the inclusion of the weekly meeting with the use of video compared to the previous season. These results expose the benefits of coaches incorporate programmes to obtain objective information about the game in their training process.
Nyström Minimum Kernel Risk-Sensitive Loss Based Seamless Control of Grid-Tied PV-Hybrid Energy Storage System
Authors: Chankaya Mukul , Hussain Ikhlaq , Ahmad Aijaz , Khan Irfan , Muyeen S.M.
Published: March 2021

This paper presents Nyström minimum kernel risk-sensitive loss (NysMKRSL) based control of a three-phase four-wire grid-tied dual-stage PV-hybrid energy storage system, under varying conditions such as irradiation variation, unbalanced load, and abnormal grid voltage. The Voltage Source Converter (VSC) control enables the system to perform multifunctional operations such as reactive power compensation, load balancing, power balancing, and harmonics elimination while maintaining Unity Power Factor (UPF). The proposed VSC control delivers more accurate weights with fewer oscillations, hence reducing overall losses and providing better stability to the system. The seamless control with the Hybrid Energy Storage System (HESS) facilitates the system’s grid-tied and isolated operation. The HESS includes the battery, fuel cell, and ultra-capacitor to accomplish the peak shaving, managing the disturbances of sudden and prolonged nature occurring due to load unbalancing and abnormal grid voltage. The DC link voltage is regulated by tuning the PI controller gains utilizing the Salp Swarm Optimization (SSO) algorithm to stabilize the system with minimum deviation from the reference voltage, during various simulated dynamic conditions. The optimized DC bus control generates the accurate loss component of current, which further enhances the performance of the proposed VSC control. The presented system was simulated in the MATLAB 2016a environment and performed satisfactorily as per IEEE 519 standards.
Energy Consumption Structure and Its Improvement of Low-Lifting Capacity Scissor Lift
Authors: Stawinski Lukasz , Zaczynski Jakub , Morawiec Adrian , Skowronska Justyna , Kosucki Andrzej
Published: March 2021

The article presents the experimental investigation of low-lifting capacity hydraulic scissor lift energy consumption. The analysis is based on experimental tests of two individual drives of the scissor lift: the conventional one and the variable-speed electro-hydraulic one. The investigation focuses on the study of the total energy consumption for lifting and lowering the scissor lift with different masses of transported cargo and also power consumptions of each element supplying these systems. Particular attention was paid to the significant impact of power supply on each control component as the main factor of reduction in the energetic efficiency of the low-lifting capacity scissor lift. A comparison of both drives indicated that the mass of transported cargo has a significant influence on the choice of the drive used. Results of the research show that significant energetic savings are obtained, as the modernized propulsion system consumes 67% energy of the standard one. A decrease in the percentage of energy losses with the increase in the mass handled led to the conclusion that the enhancement of propulsion systems in scissor lifts should be especially considered in machines carrying big loads.
Assessing the Relation between Mud Components and Rheology for Loss Circulation Prevention Using Polymeric Gels: A Machine Learning Approach
Authors: Magzoub Musaab I. , Kiran Raj , Salehi Saeed , Hussein Ibnelwaleed A. , Nasser Mustafa S.
Published: March 2021

The traditional way to mitigate loss circulation in drilling operations is to use preventative and curative materials. However, it is difficult to quantify the amount of materials from every possible combination to produce customized rheological properties. In this study, machine learning (ML) is used to develop a framework to identify material composition for loss circulation applications based on the desired rheological characteristics. The relation between the rheological properties and the mud components for polyacrylamide/polyethyleneimine (PAM/PEI)-based mud is assessed experimentally. Four different ML algorithms were implemented to model the rheological data for various mud components at different concentrations and testing conditions. These four algorithms include (a) k-Nearest Neighbor, (b) Random Forest, (c) Gradient Boosting, and (d) AdaBoosting. The Gradient Boosting model showed the highest accuracy (91 and 74% for plastic and apparent viscosity, respectively), which can be further used for hydraulic calculations. Overall, the experimental study presented in this paper, together with the proposed ML-based framework, adds valuable information to the design of PAM/PEI-based mud. The ML models allowed a wide range of rheology assessments for various drilling fluid formulations with a mean accuracy of up to 91%. The case study has shown that with the appropriate combination of materials, reasonable rheological properties could be achieved to prevent loss circulation by managing the equivalent circulating density (ECD).
Demand Response Coupled with Dynamic Thermal Rating for Increased Transformer Reserve and Lifetime
Authors: Daminov Ildar , Rigo-Mariani Rémy , Caire Raphael , Prokhorov Anton , Alvarez-Hérault Marie-Cécile
Published: March 2021

(1) Background: This paper proposes a strategy coupling Demand Response Program with Dynamic Thermal Rating to ensure a transformer reserve for the load connection. This solution is an alternative to expensive grid reinforcements. (2) Methods: The proposed methodology firstly considers the N-1 mode under strict assumptions on load and ambient temperature and then identifies critical periods of the year when transformer constraints are violated. For each critical period, the integrated management/sizing problem is solved in YALMIP to find the minimal Demand Response needed to ensure a load connection. However, due to the nonlinear thermal model of transformers, the optimization problem becomes intractable at long periods. To overcome this problem, a validated piece-wise linearization is applied here. (3) Results: It is possible to increase reserve margins significantly compared to conventional approaches. These high reserve margins could be achieved for relatively small Demand Response volumes. For instance, a reserve margin of 75% (of transformer nominal rating) can be ensured if only 1% of the annual energy is curtailed. Moreover, the maximal amplitude of Demand Response (in kW) should be activated only 2–3 h during a year. (4) Conclusions: Improvements for combining Demand Response with Dynamic Thermal Rating are suggested. Results could be used to develop consumer connection agreements with variable network access.
The Tumor Proteolytic Landscape: A Challenging Frontier in Cancer Diagnosis and Therapy
Authors: Vizovisek Matej , Ristanovic Dragana , Menghini Stefano , Christiansen Michael G. , Schuerle Simone
Published: March 2021

In recent decades, dysregulation of proteases and atypical proteolysis have become increasingly recognized as important hallmarks of cancer, driving community-wide efforts to explore the proteolytic landscape of oncologic disease. With more than 100 proteases currently associated with different aspects of cancer development and progression, there is a clear impetus to harness their potential in the context of oncology. Advances in the protease field have yielded technologies enabling sensitive protease detection in various settings, paving the way towards diagnostic profiling of disease-related protease activity patterns. Methods including activity-based probes and substrates, antibodies, and various nanosystems that generate reporter signals, i.e., for PET or MRI, after interaction with the target protease have shown potential for clinical translation. Nevertheless, these technologies are costly, not easily multiplexed, and require advanced imaging technologies. While the current clinical applications of protease-responsive technologies in oncologic settings are still limited, emerging technologies and protease sensors are poised to enable comprehensive exploration of the tumor proteolytic landscape as a diagnostic and therapeutic frontier. This review aims to give an overview of the most relevant classes of proteases as indicators for tumor diagnosis, current approaches to detect and monitor their activity in vivo, and associated therapeutic applications.
Pharmacological Conditioning of the Heart: An Update on Experimental Developments and Clinical Implications
Authors: Roth Sebastian , Torregroza Carolin , Feige Katharina , Preckel Benedikt , Hollmann Markus W. , Weber Nina C. , Huhn Ragnar
Published: March 2021

The aim of pharmacological conditioning is to protect the heart against myocardial ischemia-reperfusion (I/R) injury and its consequences. There is extensive literature that reports a multitude of different cardioprotective signaling molecules and mechanisms in diverse experimental protocols. Several pharmacological agents have been evaluated in terms of myocardial I/R injury. While results from experimental studies are immensely encouraging, translation into the clinical setting remains unsatisfactory. This narrative review wants to focus on two aspects: (1) give a comprehensive update on new developments of pharmacological conditioning in the experimental setting concentrating on recent literature of the last two years and (2) briefly summarize clinical evidence of these cardioprotective substances in the perioperative setting highlighting their clinical implications. By directly opposing each pharmacological agent regarding its recent experimental knowledge and most important available clinical data, a clear overview is given demonstrating the remaining gap between basic research and clinical practice. Finally, future perspectives are given on how we might overcome the limited translatability in the field of pharmacological conditioning.
Melt-Spun Fibers from Bio-Based Polyester–Fiber Structure Development in High-Speed Melt Spinning of Poly(ethylene 2,5-furandicarboxylate) (PEF)
Authors: Takarada Wataru , Sugimoto Kenichi , Nakajima Hajime , Visser Hendrikus A. , Gruter Gert-Jan M. , Kikutani Takeshi
Published: March 2021

Poly(ethylene 2,5-furandicarboxylate) (PEF) is regarded as a bio-based alternative or complementary polyester for the widely used fossil resource-based polyester, poly(ethylene terephthalate) (PET). High-speed melt spinning of PEF of low and high molecular weight (L-PEF, H-PEF) was conducted, and the structure and properties of the resultant as-spun fibers were investigated. The occurrence of orientation-induced crystallization was confirmed for the H-PEF at the take-up velocity of 6.0 km/min, the highest speed for producing PET fibers in the industry. Molecular orientation and crystallinity of the as-spun fibers increased with the increase of take-up velocity, where the H-PEF fibers always showed a higher degree of structural development than the L-PEF fibers. The tensile modulus of the high-speed spun H-PEF fibers was relatively low at 5 GPa, whereas a sufficiently high tensile strength of approximately 500 MPa was measured. These values are adequately high for the application in the general semi-engineering fiber field.
Convolutional Neural Network for Drowsiness Detection Using EEG Signals
Authors: Chaabene Siwar , Bouaziz Bassem , Boudaya Amal , Hökelmann Anita , Ammar Achraf , Chaari Lotfi
Published: March 2021

Drowsiness detection (DD) has become a relevant area of active research in biomedical signal processing. Recently, various deep learning (DL) researches based on the EEG signals have been proposed to detect fatigue conditions. The research presented in this paper proposes an EEG classification system for DD based on DL networks. However, the proposed DD system is mainly realized into two procedures; (i) data acquisition and (ii) model analysis. For the data acquisition procedure, two key steps are considered, which are the signal collection using a wearable Emotiv EPOC+ headset to record 14 channels of EEG, and the signal annotation. Furthermore, a data augmentation (DA) step has been added to the proposed system to overcome the problem of over-fitting and to improve accuracy. As regards the model analysis, a comparative study is also introduced in this paper to argue the choice of DL architecture and frameworks used in our DD system. In this sense, The proposed DD protocol makes use of a convolutional neural network (CNN) architecture implemented using the Keras library. The results showed a high accuracy value (90.42%) in drowsy/awake discrimination and revealed the efficiency of the proposed DD system compared to other research works.