bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Learning for Plastic Waste Classification System
Authors: Bobulski Janusz , Kubanek Mariusz
Published: May 2021

Plastic waste management is a challenge for the whole world. Manual sorting of garbage is a difficult and expensive process, which is why scientists create and study automated sorting methods that increase the efficiency of the recycling process. The plastic waste may be automatically chosen on a transmission belt for waste removal by using methods of image processing and artificial intelligence, especially deep learning, to improve the recycling process. Waste segregation techniques and procedures are applied to major groups of materials such as paper, plastic, metal, and glass. Though, the biggest challenge is separating different materials types in a group, for example, sorting different colours of glass or plastics types. The issue of plastic garbage is important due to the possibility of recycling only certain types of plastic (PET can be converted into polyester material). Therefore, we should look for ways to separate this waste. One of the opportunities is the use of deep learning and convolutional neural network. In household waste, the most problematic are plastic components, and the main types are polyethylene, polypropylene, and polystyrene. The main problem considered in this article is creating an automatic plastic waste segregation method, which can separate garbage into four mentioned categories, PS, PP, PE-HD, and PET, and could be applicable on a sorting plant or home by citizens. We proposed a technique that can apply in portable devices for waste recognizing which would be helpful in solving urban waste problems.
SIMSCAPE Electrical Modelling of the IGBT with Parameter Optimization Using Genetic Algorithm
Authors: Baghdadi Mohamed , Elwarraki Elmostafa , Mijlad Naoual , Ait Ayad Imane
Published: May 2021

The concept introduced by MathWorks in the Simscape product is the link representation between the SIMSCAPE library components that correspond to physical connections transmitting power. In this paper, a power insulated-gate bipolar transistor (IGBT) model using MATLAB graphical software is reproduced. An electrical IGBT behavior model using the Simscape Electronics library components is developed and analyzed. This model is parameterized using the constructor datasheet to ensure a good representation of the dynamic and static IGBT behaviors. An extraction and optimization studies of the IGBT model parameters using a stochastic algorithm implemented in Matlab are presented. The proposed method is based on the Genetic Algorithm (GA) to perfectly extract and optimize the model parameters using the mathematical model circuit equations and the provided datasheet characteristics. A simulation in the Matlab/Simulink environment and a comparison with the experimental results for an IGBT device example are carried out to demonstrate the proposed model accuracy.
Sauchinone Blocks Ethanol Withdrawal-Induced Anxiety but Spares Locomotor Sensitization: Involvement of Nitric Oxide in the Bed Nucleus of the Stria Terminalis
Authors: Jiao Yu , Kim Sang Chan , Wang Yuhua , Wu Tong , Jin Haifeng , Lee Chul Won , Park Sook Jahr , Lee Bong Hyo , Kim Hee Young , Yang Chae Ha , Zhao Zhenglin , Zhao Rongjie
Published: May 2021

Both the positive (manifested by locomotor sensitization) and negative (withdrawal symptoms) reinforcing effects of ethanol (EtOH) involve central nitric oxide (NO) signaling. Sauchinone (a bioactive lignan in Saururus chinensis) has been shown to improve methamphetamine-induced behavioral and neurochemical changes via the NO signaling pathway. Thus, this study evaluated the effects of sauchinone on locomotor sensitization and anxiety during EtOH withdrawal (EtOHW). Male adult Sprague-Dawley rats were treated with 1.5 g/kg/day of EtOH (20%, vol/vol) via intraperitoneal injection for 28 days, followed by a 3-day withdrawal. During withdrawal, the rats were given intragastric sauchinone (2.5, 7.5, or 25 mg/kg/day) once a day. EtOH locomotor sensitization was determined by challenging EtOHW rats with 0.75 g/kg EtOH, while EtOHW-induced anxiety was assessed using the elevated plus maze (EPM). None of the three doses of sauchinone affected EtOH locomotor sensitization. However, in the EPM, treatment of EtOHW rats with sauchinone at 7.5 or 25 mg/kg/day increased both the number of entries into and the time spent in the open arms. Moreover, the two doses of sauchinone inhibited the oversecretion of plasma corticosterone during EtOHW. In the bed nucleus of the stria terminalis (BNST), EtOHW increased NO production, enhanced gene and protein expression of both inducible nitric oxide synthase (iNOS) and neuronal NOS (nNOS), and also elevated protein levels of corticotropin-releasing factor, which were all inhibited by 25 mg/kg/day sauchinone. In an in vitro experiment, sauchinone (3, 10, and 30 μM) inhibited H2O2-stimulated nNOS protein expression in neuronal PC12 cells. Finally, intra-BNST infusion of sodium nitroprusside, a NO donor, after sauchinone (25 mg/kg/day) administration, abolished its expected anxiolytic effect. Taken together, these results indicate that sauchinone attenuates anxiety-like behavior in rats during EtOHW but spares EtOH locomotor sensitization, and the anxiolytic effect is mediated via the NO signaling pathway in the BNST.
The Study on Credit Risk Warning of Regional Listed Companies in China Based on Logistic Model
Authors: Zhou Qingping , Wang Long , Juan Li , Zhou Shugong , Li Lingli
Published: May 2021

The paper aims to propose a new method to state the credit risk characteristics of the regional listed companies in China and makes the listed companies avoid involving in credit crisis. The paper selects fifty-four listed companies of Hebei Province as the research sample and establishes the index system of listed company’s credit risk evaluation from four financial index categories which included profitability, operating capacity, solvency, and growth capability. The paper first filtrates fifteen indexes by using the gray clustering method from the four financial categories and finds out the effective variables of the prediction model. Then the paper predicates the credit risk probability of the listed companies by using the logistic regression model. Finally, by analyzing the financial data of annual reports of fifty-four listed companies in Hebei Province from 2012 to 2017 as sample data, the simulation experiment empirical test is carried out by using SPSS software. The results show that the logistic regression model with gray clustering analysis has high predictive accuracy and has a strong predictive ability to evaluate the credit risk of listed companies. The gray logistics evaluation plays a very good role in financial early warning for regional listed companies in China.
Differences in the Expression of KIR, ILT Inhibitory Receptors, and VEGF Production in the Induced Decidual NK Cell Cultures of Fertile and RPL Women
Authors: Kniotek Monika , Roszczyk Aleksander , Zych Michał , Szafarowska Monika , Jerzak Małgorzata
Published: May 2021

Problem. Natural killer (NK) cells are the most abundant leukocyte population in the uterus. The interactions of the maternal NK expression of killer cell immunoglobulin‐like receptors (KIRs) and human inhibitory receptor Ig‐like transcript (ILT) with fetal HLA determine the activation of NK cells and pregnancy outcomes. Moreover, dNK cells release numerous angiogenic factors including VEGF. Our previous study showed that sildenafil citrate (SC) significantly decreased peripheral blood NK (pbNK) cell activity and improved intrauterine blood flow, which correlated with a successful pregnancy outcome. Thus, in this study, we investigated whether SC influenced the expression of KIR or ILT receptors on induced decidual NK (idNK), the apoptosis of cells, and VEGF‐A production in the culture supernatants of idNK cells. Method of Study. pbNK cells from 24 healthy women and 23 women with RPL were converted to idNK cells under hypoxia, IL‐15, and TGF‐β conditions. The cultures were prepared with or without SC. Changes in KIR2DL1 (CD158a), NKG2A (CD159a), ILT‐2 (CD85j), and ILT‐4 (CD85d) expression on CD56+CD16- cells and their apoptosis were determined via flow cytometry. VEGF‐A level was established in culture supernatants with the ELISA method. Results. KIR2DL1 and ILT‐2 expression on idNK cells was higher in healthy women than in RPL patients. Sildenafil enhanced NKG2A expression in RPL patients. VEGF concentration was higher in fertile woman idNK cell cultures. idNK cells were more sensitive for necrosis in RPL than in fertile women. SC did not influence VEGF production or idNK cell apoptosis. Conclusions. A combination of hypoxia, IL‐15, and AZA promotes the conversion of pbNK into idNK cells CD56+CD16-‐expressing KIR receptors and produces VEGF. Alterations in KIR2DL1 and ILT‐2 expression as well as impaired VEGF production were associated with RPL. SC affects NKG2A expression on RPL idNK cells. SC had no effect on VEGF release or idNK cell apoptosis.
Effect of the Location of Dental Mini-Implants on Strain Distribution under Mandibular Kennedy Class I Implant-Retained Removable Partial Dentures
Authors: Rungsiyakull Pimduen , Kujarearntaworn Kallaya , Khongkhunthian Pathawee , Swain Michael , Rungsiyakull Chaiy
Published: May 2021

Purpose. To investigate the effect of minidental implant location on strain distributions transmitted to tooth abutments and dental minidental implants under mandibular distal extension removable partial denture. Materials and Methods. A mandibular Kennedy Class I distal extension model missing teeth 35–37 and 45–47 was constructed. Six dental mini-implants were placed at positions A, B, and C, where position A was 6.5 mm distal to the abutment teeth with 5 mm between each position. Fourteen uniaxial strain gauges were bonded on the model at the region of dental mini-implant and abutment (first premolar). Four groups were designated according to the location of the mini-implants. A load of 150 N and 200 N was applied using an Instron testing machine. Loadings consisted of bilateral and unilateral loading. Comparisons of the mean microstrains among all strain gauges in all situations were analyzed. Results. Variation in mini-implant locations induced local strains in different areas. Strains at the tooth abutment were significantly decreased in the group in which implants were placed mesially. Strains around the mini-implants showed different patterns when loaded with different loading conditions. The group in which implants were placed distally showed the lowest strains compared to other groups. Conclusion. Mesially placed mini-implants showed the lowest strain around abutment teeth, while a distally-placed mini-implants presented the lowest strain around mini-implants themselves. Under favorable biting force, mini-implant is an option to assist mandibular distal extension removable partial denture. Mesially placed mini-implants are recommended when the abutment has periodontally compromised conditions and a distally placed mini-implant when periodontal conditions are stable.
Physicochemical Characterization of Regional Clay: Application to Phenol Adsorption
Authors: Amar Abdelouahed , Loulidi Ilyasse , Kali Abderrahim , Boukhlifi Fatima , Hadey Chaimaa , Jabri Maria
Published: May 2021

Phenol is one of the most toxic pollutants found in industrial waste. This work focuses on the removal of phenol using clay from the Sale region. Adsorbent was characterized by X-ray fluorescence spectroscopy, X-ray diffraction, infrared spectroscopy, and scanning electron microscopy. The chemical analysis of this clay shows that the percentage of silicon and aluminium is quite high, and the percentage of calcium and iron is relatively high, so this material is rich in muscovite, quartz, and calcite. In addition to the presence of titanium dioxide (TiO2), which can give it a property of degradation of organic compounds under ultraviolet light, the pHPZC zero point of our material is 7.4. The results showed that the adsorption of phenol was well fitted by the pseudo-second-order kinetic model and the Langmuir and Freundlich isotherms and that the best retention is obtained at a pH between 3 and 8.
Green Tea (Camellia sinensis) Extract Increased Topoisomerase IIβ, Improved Antioxidant Defense, and Attenuated Cardiac Remodeling in an Acute Doxorubicin Toxicity Model
Authors: Modesto Pamela N. , Polegato Bertha F. , dos Santos Priscila P. , Grassi Leticia D. V. , Molina Leticia C. C. , Bazan Silmeia G. Z. , Pereira Elenize J. , Fernandes Ana Angelica H. , Fabro Alexandre T. , Androcioli Vickeline N. , Roscani Meliza G. , de Paiva Sergio A. R. , Zornoff Leonardo A. M. , Minicucci Marcos F. , Azevedo Paula S.
Published: May 2021

Experimental studies have shown the action of green tea in modulating cardiac remodeling. However, the effects of green tea on the cardiac remodeling process induced by doxorubicin (DOX) are not known. Therefore, this study is aimed at evaluating whether green tea extract could attenuate DOX‐induced cardiac remodeling, assessed by cardiac morphological and functional changes and associated with the evaluation of different modulators of cardiac remodeling. The animals were divided into four groups: the control group (C), the green tea group (GT), the DOX group (D), and the DOX and green tea group (DGT). Groups C and GT received intraperitoneal sterile saline injections, D and DGT received intraperitoneal injections of DOX, and GT and DGT were fed chow supplemented with green tea extract for 35 days prior to DOX injection. After forty‐eight hours, we performed an echocardiogram and euthanasia and collected the materials for analysis. Green tea attenuated DOX‐induced cardiotoxicity by increasing cardiac function and decreasing the concentric remodeling. Treatment with DOX increased oxidative stress in the heart, marked by a higher level of lipid hydroperoxide (LH) and lower levels of antioxidant enzymes. Treatment with green tea increased the antioxidant enzymes’ activity and decreased the production of LH. Green tea extract increased the expression of Top2‐β independent of DOX treatment. The activity of ATP synthase, citrate synthase, and complexes I and II decreased with DOX, without the effects of green tea. Both groups that received DOX presented with a lower ratio of P‐akt/T‐akt and a higher expression of CD45, TNFα, and intermediate MMP‐2, without the effects of green tea. In conclusion, green tea attenuated cardiac remodeling induced by DOX and was associated with increasing the expression of Top2‐β and lowering oxidative stress. However, energy metabolism and inflammation probably do not receive the benefits induced by green tea in this model.
Stimulated Raman Scattering of X-Mode Laser in a Plasma Channel
Authors: Babu Sanjay , Kumar Asheel , Jeet Ram , Kumar Arvind , Varma Ashish
Published: May 2021

Stimulated Raman forward scattering (SRFS) of an intense X-mode laser pump in a preformed parabolic plasma density profile is investigated. The laser pump excites a plasma wave and one/two electromagnetic sideband waves. In Raman forward scattering, the growth rate of the parametric instability scales as two-third powers of the pump amplitude and increases linearly with cyclotron frequency.
An Aptamer-Based Antagonist against the Receptor for Advanced Glycation End-Products (RAGE) Blocks Development of Colorectal Cancer
Authors: Zheng Jihui , Zhu Wenjing , He Fang , Li Zhu , Cai Na , Wang Hong-Hui
Published: May 2021

Tumor angiogenesis plays a crucial role in colorectal cancer development. Dysregulation of the receptor for the advanced glycation end-products (RAGE) transmembrane signaling mediates inflammation, resulting in various cancers. However, the mechanism of the RAGE signaling pathway in modulating development of colorectal cancer has not been explored. In this study, an aptamer-based RAGE antagonist (Apt-RAGE) was used to inhibit interaction between RAGE and S100B, thus blocking downstream NFκB-mediated signal transduction. In vitro results showed that Apt-RAGE effectively inhibited S100B-dependent and S100B-independent RAGE/NFκB activation in colorectal HCT116 cancer cells, thus decreasing proliferation and migration of cells. Notably, expression and secretion of VEGF-A were inhibited, implying that Apt-RAGE can be used as an antiangiogenesis agent in tumor therapy. Moreover, Apt-RAGE inhibited tumor growth and microvasculature formation in colorectal tumor-bearing mice. Inhibition of angiogenesis by Apt-RAGE was positively correlated with suppression of the RAGE/NFκB/VEGF-A signaling. The findings of this study show that Apt-RAGE antagonist is a potential therapeutic agent for treatment of colorectal cancer.
A Single Intramedullary K-Wire Is Sufficient for the Management of Nonthumb Metacarpal Shaft Fractures
Authors: Abulsoud Mohamed I. , Elmarghany Mohammed , Abdelghany Tharwat , Abdelaal Mohamed , Elhalawany Mohamed F. , Zakaria Ahmed R.
Published: May 2021

Objective. This study aims to evaluate the outcome after the internal fixation of diaphyseal metacarpal fractures by a single intramedullary K-wire. Methods. In this prospective case series study, conducted from July 2017 to June 2019 in 23 adult patients with a single, unstable, diaphyseal metacarpal fracture, outcomes after internal surgical fixation using a single antegrade intramedullary K-wire were evaluated. The outcomes were evaluated by union rate, time to union, handgrip measurements at 6 and 12 months, and the modified Disabilities of the Arm, Shoulder, and Hand (DASH) score at 12 months. Results. The study population consisted of 17 males and 6 females, with a mean patient age of 28.4 ± 8.5 years (range, 16–45 years). The median time to final follow-up was 14 ± 1.8 months (range: 12–24 months). The mean duration of the union was 7.3 ± 1.6 weeks (range: 5–11 weeks), with a union rate of 95.7% (22 cases). The mean handgrip strength was 68% ± 12.8% of the strength of the uninjured hand after 6 months and 92.7% ± 6.9% after 12 months. The mean modified DASH score was 2.6 ± 0.26 after 12 months (range: 0–5.8). There were no cases of malrotation or infection. In conclusion, using a single 1.8–2.0 mm K-wire gives excellent functional outcomes and union rate without significant complications when used to treat an unstable metacarpal shaft fracture.
Deep Multiple Kernel Learning for Prediction of MicroRNA Precursors
Authors: Shi Hengyue , Wang Dong , Wu Peng , Cao Yi , Chen Yuehui
Published: May 2021

MicroRNAs are a group of noncoding RNAs that are about 20–24 nucleotides in length. They are involved in the physiological processes of many diseases and regulate transcriptional and post-transcriptional gene expression. Therefore, the prediction of microRNAs is of great significance for basic biological research and disease treatment. MicroRNA precursors are the necessary stage of microRNA formation. RBF kernel support vector machines (RBF-SVMs) and shallow multiple kernel support vector machines (MK-SVMs) are often used in microRNA precursors prediction. However, the RBF-SVMs could not represent the richer sample features, and the MK-SVMs just use a simply convex combination of few base kernels. This paper proposed a localized multiple kernel learning model with a nonlinear synthetic kernel (LMKL-D). The nonlinear synthetic kernel was trained by a three-layer deep multiple kernel learning model. The LMKL-D model was tested on 2241 pre-microRNAs and 8494 pseudo hairpin sequences. The experiments showed that the LMKL-D model achieved 93.06% sensitivity, 99.27% specificity, and 98.03% accuracy on the test set. The results showed that the LMKL-D model can increase the complexity of kernels and better predict microRNA precursors. Our LMKL-D model can better predict microRNA precursors compared with the existing methods in specificity and accuracy. The LMKL-D model provides a reference for further validation of potential microRNA precursors.
Adaptive Evolution: How Bacteria and Cancer Cells Survive Stressful Conditions and Drug Treatment
Authors: Russo Mariangela , Sogari Alberto , Bardelli Alberto
Published: May 2021

Cancer is characterized by loss of the regulatory mechanisms that preserve homeostasis in multicellular organisms, such as controlled proliferation, cell–cell adhesion, and tissue differentiation. The breakdown of multicellularity rules is accompanied by activation of “selfish,” unicellular-like life features, which are linked to the increased adaptability to environmental changes displayed by cancer cells. Mechanisms of stress response, resembling those observed in unicellular organisms, are actively exploited by mammalian cancer cells to boost genetic diversity and increase chances of survival under unfavorable conditions, such as lack of oxygen/nutrients or exposure to drugs. Unicellular organisms under stressful conditions (e.g., antibiotic treatment) stop replicating or slowly divide and transiently increase their mutation rates to foster diversity, a process known as adaptive mutability. Analogously, tumor cells exposed to drugs enter a persister phenotype and can reduce DNA replication fidelity, which in turn fosters genetic diversity. The implications of adaptive evolution are of relevance to understand resistance to anticancer therapies.
MHC Class II Antigen Presentation by Lymphatic Endothelial Cells in Tumors Promotes Intratumoral Regulatory T cell–Suppressive Functions
Authors: Gkountidi Anastasia O. , Garnier Laure , Dubrot Juan , Angelillo Julien , Harlé Guillaume , Brighouse Dale , Wrobel Ludovic J. , Pick Robert , Scheiermann Christoph , Swartz Melody A. , Hugues Stéphanie
Published: May 2021

Several solid malignancies trigger lymphangiogenesis, facilitating metastasis. Tumor-associated lymphatic vessels significantly contribute to the generation of an immunosuppressive tumor microenvironment (TME). Here, we have investigated the ability of tumoral lymphatic endothelial cells (LEC) to function as MHC class II–restricted antigen-presenting cells in the regulation of antitumor immunity. Using murine models of lymphangiogenic tumors engrafted under the skin, we have shown that tumoral LECs upregulate MHC class II and the MHC class II antigen-processing machinery, and that they promote regulatory T-cell (Treg) expansion ex vivo. In mice with LEC-restricted lack of MHC class II expression, tumor growth was severely impaired, whereas tumor-infiltrating effector T cells were increased. Reduction of tumor growth and reinvigoration of tumor-specific T-cell responses both resulted from alterations of the tumor-infiltrating Treg transcriptome and phenotype. Treg-suppressive functions were profoundly altered in tumors lacking MHC class II in LECs. No difference in effector T-cell responses or Treg phenotype and functions was observed in tumor-draining lymph nodes, indicating that MHC class II–restricted antigen presentation by LECs was required locally in the TME to confer potent suppressive functions to Tregs. Altogether, our study suggests that MHC class II–restricted antigen-presenting tumoral LECs function as a local brake, dampening T cell–mediated antitumor immunity and promoting intratumoral Treg-suppressive functions.
Interoceptive Sensibility, Alexithymia, and Emotion Regulation in Individuals Suffering from Fibromyalgia
Authors: Schmitz Natalie , Napieralski Jessica , Schroeder Dorothee , Loeser Johannes , Gerlach Alexander L. , Pohl Anna
Published: May 2021

Introduction: People suffering from fibromyalgia syndrome report various difficulties in emotional processing, possibly resulting from changes in bodily perception (interoception). In our study, we investigated the relationships between interoceptive sensibility (IS) and two disease-relevant emotional components (alexithymia and emotion regulation) in fibromyalgia sufferers compared to healthy individuals. Methods: Fifty-five fibromyalgia sufferers and 55 healthy individuals, matched with regard to age and gender, participated in our cross-sectional study. All participants completed the following self-report measures: the Multidimensional Assessment of Interoceptive Awareness, the Toronto Alexithymia Scale, and the Emotion Regulation Skills Questionnaire. Depression and anxiety scores served as confounding variables. Results: Fibromyalgia sufferers reported a stronger tendency to note as well as to avoid (unpleasant) body sensations. IS and psychopathology each explained about thirty percent of the variance in emotion regulation in fibromyalgia sufferers. Alexithymia was related to IS and emotion regulation in controls but not in fibromyalgia sufferers. Conclusion: Disturbances in interoception could be seen as the starting point of emotional difficulties in people with fibromyalgia. Following the fear-avoidance-model, experiential avoidance may restrict patients’ ability to adaptively regulate emotional states, possibly initiating a vicious cycle of psychological distress and pain.
Prevalence of Metabolic Syndrome and Impaired Glucose Metabolism among 10- to 17-Year-Old Overweight and Obese Lithuanian Children and Adolescents
Authors: Smetanina Natalija , Valickas Raimondas , Vitkauskiene Astra , Albertsson-Wikland Kerstin , Verkauskienė Rasa
Published: May 2021

Background: Overweight (Ow) and obesity among adults and children increases the risk of metabolic consequences. Metabolic syndrome (MS) and impaired glucose metabolism are well-known risk factors for cardiovascular diseases and type 2 diabetes. The aim of this study was to evaluate the prevalence of MS and impaired glucose metabolism among Ow and obese (Ob) children and adolescents (aged 10–17 years) in Lithuania, and to evaluate the associations between insulin resistance (IR) indices and anthropometric parameters as well as metabolic disturbances. Methods: The study population consisted of 344 OwOb children and adolescents of all pubertal stages. Oral glucose tolerance tests (OGTTs), IR and β cell function indices, lipid profile, and anthropometric parameters of all subjects were analyzed. MS was defined according to the International Diabetes Federation consensus guidelines. Results: MS was found in 21.3% of the OwOb children and adolescents, and 12.1% had impaired glucose metabolism (6.9% with impaired fasting glucose, 4.5% with impaired glucose tolerance, and 0.6% with type 2 diabetes). IR was directly related to body mass index and waist circumference, waist-to-height and waist-to-hip ratios, and sum of skin-fold thicknesses. Children with MS were more insulin-resistant, had higher odds ratio for prediabetes and had a more disturbed lipid profile than subjects without MS. Moreover, total cholesterol and low-density lipoprotein cholesterol levels were significantly lower in the more mature OwOb adolescents. Conclusion: MS and lipid profile disturbances are common in OwOb children and adolescents. MS is directly associated with IR. Therefore, OwOb children and adolescents should be carefully followed up for metabolic abnormalities during late childhood as these can persist into adulthood.
Influence of Gestational Age and Mode of Delivery on Neonatal Outcomes in Prenatally Diagnosed Isolated Congenital Diaphragmatic Hernia
Authors: Soni Shelly , Moldenhauer Julie S. , Kallan Michael J. , Rintoul Natalie , Adzick N. Scott , Hedrick Holly L. , Khalek Nahla
Published: May 2021

Aim: The optimal gestational age (GA) at delivery and mode of delivery (MoD) for pregnancies with fetal congenital diaphragmatic hernia (CDH) is undetermined. The impact of early term (37–38 weeks 6 days) versus full term (39–40 weeks 6 days) and MoD on immediate neonatal outcomes in prenatally diagnosed isolated CDH cases was evaluated. Material and Methods: A retrospective chart review of pregnancies evaluated and delivered with the prenatal diagnosis of CDH between July 1, 2008, and December 31, 2018. The primary outcome was survival to hospital discharge. Secondary outcomes included neonatal intensive care unit (NICU) length of stay (LOS), extracorporeal membrane oxygenation (ECMO) requirement and need for supplemental oxygen at day 30 of life. Results: A total of 296 patients were prenatally evaluated for CDH and delivered in a single center during the study period. After applying exclusion criteria, data were available on 113 women who delivered early term and 72 women who delivered full term. Survival to hospital discharge was comparable between the 2 groups – 83.2% in the early term versus 93.1% in the full term (p = 0.07; 95% CI of 0.13–1.04). No difference was observed in any other secondary outcomes. MoD was stratified into spontaneous vaginal, induced vaginal, unplanned cesarean and scheduled cesarean delivery with associated neonatal survival rates of 74.2, 90.6, 89.7 and 88.2%, respectively, p = 0.13. The 5-min Apgar score was higher in the elective cesarean group (7.94) followed by the induced vaginal delivery group (7.8) compared to 7.17 and 7.18 in the spontaneous vaginal and unplanned cesarean groups, respectively (p = 0.03). The GA and MoD did not influence survival to hospital discharge nor NICU LOS in multivariate analysis. Conclusions: Though there were no significant differences in neonatal outcomes for early term compared to full term deliveries of CDH neonates, a trend toward improved survival rates and lower ECMO requirements in the full term group may suggest an underlying importance GA at delivery. Further studies are warranted to validate these findings.
Unusual and Unexpected Allergic Reactions Can Be Unraveled by Molecular Allergy Diagnostics
Authors: Konradsen Jon R. , Borres Magnus P. , Nilsson Caroline
Published: May 2021

The fifth class of immunoglobulin, immunoglobulin E (IgE) was discovered in 1967 and has had immense importance for the understanding, diagnosis, and treatment of allergic disease. More than 50 years have passed and efforts to characterize, standardize, and refine allergens with the aim to improve clinical diagnosis and allergen-specific immunotherapy are still ongoing. Another important breakthrough was made in 1999 with the introduction of component-resolved diagnostics (CRD), making it possible to quantify IgE antibodies against individual allergen proteins for diagnostic purposes at a molecular level. The progress and developments made in allergy diagnosis often originate from clinical observations and case studies. Observant physicians and health-care personnel have reported their findings in the medical literature, which in turn has inspired researchers to become involved in clinical research. Allergists continuously encounter new allergies and are often asked by their patients how to prevent new reactions. In the current article, we focus on recent clinical observations that can now be explained by CRD. The examples taken concern allergic reactions toward peanuts, tree nuts, lemon kernels, health drinks, meat, insects, dog dander, cannabis, and semen. We now have an improved understanding of why patients may react in a serious or unexpected way, as illustrated by these examples, yet many other clinical observations remain unexplained. The aim of this review is to highlight the importance of clinical observations among allergic patients, focusing on systemic, or unusual and unexpected allergic reactions, where component-testing has further refined the diagnosis of IgE-mediated allergy.
Neoadjuvant Systemic Chemotherapy in Sebaceous Gland Carcinoma of the Eyelid: A Retrospective Study
Authors: Verma Saurav , Kumar Nipun , Meel Rachna , Sen Seema , Kashyap Seema , Sharma Sanjay , Pushker Neelam , Pushpam Deepam , Bakhshi Sameer
Published: May 2021

There are sparse data on neoadjuvant systemic chemotherapy (NACT) in eyelid sebaceous gland carcinoma (SGC). The aim of this study was to evaluate efficacy and outcomes with NACT in eyelid SGC. We retrospectively analyzed 8 patients who received platinum-based NACT. The median number of cycles per patient was 4 (range, 3–5). The mean percentage reduction of tumor diameter after NACT was 71% (range, 30–100%). Two patients had a radiological complete response (CR). After NACT, surgical treatment for residual tumor was performed in 5 cases. One patient had a pathological CR and is recurrence free for 11 years. After a mean follow-up period of 44.5 months (range, 9–109), tumor recurrence occurred in 4 cases. Among these 4 cases, 3 were rechallenged with the same regimen and all responded. Systemic NACT has a role in eyelid SGC, downstages the tumor, and allows less aggressive and organ-sparing surgeries, warranting a prospective study.
Adapter Protein RapGEF1 Is Required for ERK1/2 Signaling in Response to Elevated Phosphate in Vascular Smooth Muscle Cells
Authors: Chavkin Nicholas W. , Leaf Elizabeth M. , Brooks Kadin E. , Wallingford Mary C. , Lund Susan M. , Giachelli Cecilia M.
Published: May 2021

The sodium-dependent phosphate transporter, SLC20A1, is required for elevated inorganic phosphate (Pi) induced vascular smooth muscle cell (VSMC) matrix mineralization and phenotype transdifferentiation. Recently, elevated Pi was shown to induce ERK1/2 phosphorylation through SLC20A1 by Pi uptake-independent functions in VSMCs, suggesting a cell signaling response to elevated Pi. Previous studies identified Rap1 guanine nucleotide exchange factor (RapGEF1) as an SLC20A1-interacting protein and RapGEF1 promotes ERK1/2 phosphorylation through Rap1 activation. In this study, we tested the hypothesis that RapGEF1 is a critical component of the SLC20A1-mediated Pi-induced ERK1/2 phosphorylation pathway. Co-localization of SLC20A1 and RapGEF1, knockdown of RapGEF1 with siRNA, and small molecule inhibitors of Rap1, B-Raf, and Mek1/2 were investigated. SLC20A1 and RapGEF1 were co-localized in peri-membranous structures in VSMCs. Knockdown of RapGEF1 and small molecule inhibitors against Rap1, B-Raf, and Mek1/2 eliminated elevated Pi-induced ERK1/2 phosphorylation. Knockdown of RapGEF1 inhibited SM22α mRNA expression and blocked elevated Pi-induced downregulation of SM22α mRNA. Together, these data suggest that RapGEF1 is required for SLC20A1-mediated elevated Pi signaling through a Rap1/B-Raf/Mek1/2 cell signaling pathway, thereby promoting ERK1/2 phosphorylation and inhibiting SM22α gene expression in VSMCs.
Pulmonary Hypertension: The Hidden Danger for Newborns
Authors: Abman Steven H.
Published: May 2021

Despite growing awareness of the clinical importance of pulmonary hypertension (PH) in preterm infants, uncertainty persists regarding the different clinical settings in which abnormalities of pulmonary vascular growth, function, and structure contribute to high morbidity and mortality, and potential interventions to improve outcomes are uncertain. A major gap for improving outcomes of preterm infants with PH has been the limited characterization of the distinct settings of PH and related disease-specific mechanisms in preterm infants that represent diverse pulmonary vascular phenotypes of prematurity. In comparison with term newborns, preterm infants have a higher risk for developing hypoxemia due to suprasystemic levels of PH in preterm infants shortly after birth or persistent pulmonary hypertension of the newborn (PPHN). Variable and milder levels of PH have also been demonstrated in preterm infants without evidence of severe hypoxemic respiratory failure, suggesting delayed vascular transition of the lung which is associated with higher risks of mortality and developing bronchopulmonary dysplasia (BPD). In addition, early echocardiographic signs of PH at day 7 are strongly associated with the subsequent diagnosis of BPD, late PH, and respiratory disease throughout early childhood. In infants with evolving or established BPD, PH that persists beyond the first few months of life in preterm infants is associated with high mortality. Recent data further show that PVD can persist and cause PH in prematurely born adults. Overall, more precise characterization and studies of diverse pulmonary vascular phenotypes in preterm infants will be likely to improve the development of therapeutic strategies to optimize care of preterm infants with PH.
Das Kataraktrisiko für junge Typ-1-Diabetiker: Ergebnisse einer nationalen Kohortenstudie in Taiwan
Authors: Dingerkus Vita , Becker Matthias D.
Published: May 2021

Background: Chronic hyperglycemia in type 1 diabetes (T1D) patients results in ocular problems over time, but only a few studies emphasized on cataracts. Aim: To evaluate the epidemiology of cataracts in the T1D population. Method: A two-part study was conducted using data from the National Health Insurance Research Database in Taiwan. Information from the Longitudinal Health Insurance Database (LHID) was served as a template of the general population. In the first part, a total of 3,622 T1D cases registered between 1998 and 2007 were enrolled and compared with a matched group from the LHID. For identifying risk factors of cataracts in the T1D population in the second part, a total of 9032 T1D cases registered between 1998 and 2013 were included. Results: Compared to the LHID, the hazard ratio (HR) of cataracts in the T1D group was 5.81 (95% CI 4.60–7.33), and the HR was higher in females (6.29, 95% CI 4.63–8.55). The peak incidence of cataracts occurred between age 20 and 29 in the T1D group, while in the LHID, it was after 60. The overall incidence of cataracts in the T1D group was 9.1%. In T1D patients with cataracts, they were found with higher rates of associated diabetic complications. Conclusion: Compared to the nondiabetic population, cataracts seemed more rampant and premature in T1D patients, especially those of female gender. Early ophthalmologic examination should be considered in T1D patients.
Framework to Classify Reverse Cardiac Remodeling With Mechanical Circulatory Support: The Utah-Inova Stages
Authors: Shah Palak , Psotka Mitchell , Taleb Iosif , Alharethi Rami , Shams Mortada A. , Wever-Pinzon Omar , Yin Michael , Latta Federica , Stehlik Josef , Fang James C. , Diao Guoqing , Singh Ramesh , Ijaz Naila , Kyriakopoulos Christos P. , Zhu Wei , May Christopher W. , Cooper Lauren B. , Desai Shashank S. , Selzman Craig H. , Kfoury Abdallah G. , Drakos Stavros G.
Published: May 2021

Background:

Variable definitions and an incomplete understanding of the gradient of reverse cardiac remodeling following continuous flow left ventricular assist device (LVAD) implantation has limited the field of myocardial plasticity. We evaluated the continuum of LV remodeling by serial echocardiographic imaging to define 3 stages of reverse cardiac remodeling following LVAD.

Methods:

The study enrolled consecutive LVAD patients across 4 study sites. A blinded echocardiographer evaluated the degree of structural (LV internal dimension at end-diastole [LVIDd]) and functional (LV ejection fraction [LVEF]) change after LVAD. Patients experiencing an improvement in LVEF ≥40% and LVIDd ≤6.0 cm were termed responders, absolute change in LVEF of ≥5% and LVEF <40% were termed partial responders, and the remaining patients with no significant improvement in LVEF were termed nonresponders.

Results:

Among 358 LVAD patients, 34 (10%) were responders, 112 (31%) partial responders, and the remaining 212 (59%) were nonresponders. The use of guideline-directed medical therapy for heart failure was higher in partial responders and responders. Structural changes (LVIDd) followed a different pattern with significant improvements even in patients who had minimal LVEF improvement. With mechanical unloading, the median reduction in LVIDd was −0.6 cm (interquartile range [IQR], −1.1 to −0.1 cm; nonresponders), −1.1 cm (IQR, −1.8 to −0.4 cm; partial responders), and −1.9 cm (IQR, −2.9 to −1.1 cm; responders). Similarly, the median change in LVEF was −2% (IQR, −6% to 1%), 9% (IQR, 6%–14%), and 27% (IQR, 23%–33%), respectively.

Conclusions:

Reverse cardiac remodeling associated with durable LVAD support is not an all-or-none phenomenon and manifests in a continuous spectrum. Defining 3 stages across this continuum can inform clinical management, facilitate the field of myocardial plasticity, and improve the design of future investigations.
Computed Tomography Perfusion Deficit Volumes Predict Functional Outcome in Patients With Basilar Artery Occlusion
Authors: Fabritius Matthias P. , Tiedt Steffen , Puhr-Westerheide Daniel , Grosu Sergio , Maurus Stefan , Schwarze Vincent , Rübenthaler Johannes , Stueckelschweiger Lena , Ricke Jens , Liebig Thomas , Kellert Lars , Feil Katharina , Dimitriadis Konstantinos , Kunz Wolfgang G. , Reidler Paul
Published: May 2021

Background and Purpose:

Basilar artery occlusion is associated with high morbidity and mortality. Optimal imaging and treatment strategy are still controversial and prognosis estimation challenging. We, therefore, aimed to determine the predictive value of computed tomography perfusion (CTP) parameters for functional outcome in patients with basilar artery occlusion in the context of endovascular treatment.

Methods:

Patients with basilar artery occlusion who underwent endovascular treatment were selected from a prospectively acquired cohort. Ischemic changes were assessed with the posterior-circulation Acute Stroke Prognosis Early Computed Tomography Score on noncontrast computed tomography, computed tomography angiography (CTA) source images, and CTP maps. Basilar artery on CTA score, posterior-circulation CTA score, and posterior-circulation collateral score were evaluated on CTA. Perfusion deficit volumes were quantified on CTP maps. Good functional outcome was defined as modified Rankin Scale score ≤3 at 90 days. Statistical analysis included binary logistic regressions and receiver operating characteristics analyses.

Results:

Among 49 patients who matched the inclusion criteria, 24 (49.0%) achieved a good outcome. In univariate analysis, age, National Institutes of Health Stroke Scale score on admission, posterior cerebral artery involvement, absence of or hypoplastic posterior communicating arteries, basilar artery on CTA score, posterior-circulation Acute Stroke Prognosis Early Computed Tomography Score, and perfusion deficit volumes on all CTP parameter maps presented significant association with functional outcome (
P
<0.05). In multivariate analyses, Basilar artery on CTA score, posterior-circulation Acute Stroke Prognosis Early Computed Tomography Score (odds ratio range, 1.31–2.10 [95% CI, 1.00–7.24]), and perfusion deficit volumes on all CTP maps (odds ratio range, 0.77–0.98 [95% CI, 0.63–1.00]) remained as independent outcome predictors. Cerebral blood flow deficit volume yielded the best performance for the classification of good clinical outcome with an area under the curve of 0.92 (95% CI, 0.84–0.99). Age and admission National Institutes of Health Stroke Scale had lower discriminatory power (area under the curve, <0.7).

Conclusions:

CTP imaging parameters contain prognostic information for functional outcome in patients with stroke due to basilar artery occlusion and may identify patients with higher risk of disability at an early stage of hospitalization.
Comparison of the effect of red light exposure and eyestalk ablation for inducing sexual maturation and improving egg quality in the cleaner shrimp Lysmata amboinensis
Authors: Song Jin Ah , Kho Kang Hee , Park Young-Su , Choi Ji Yong , Choi Cheol Young
Published: May 2021

Female cleaner shrimps Lysmata amboinensis either underwent eyestalk ablations (EA), or were treated with two different wavelength intensities of red light (peak at 630 nm), and then their sex maturation and the effects on their egg quality parameters were compared. Vitellogenesis-inhibiting hormone (VIH), vitellogenin (VTG), VTG-receptor (VTG-R), and crustacean hyperglycemic hormone (CHH) expressions in the hepatopancreas were analysed. VTG-R expression (in situ) levels that caused the EA and red irradiation to induce the synthesis of VTG-R were assessed, and the triglycerides (TG) and glucose levels in the eggs were analysed. VIH expression was decreased in all experimental groups, but VTG and VTG-R expressions were increased. CHH expression and TG and glucose concentrations were higher in the red irradiation group, compared to the EA group. These results confirmed that the red light not only had a positive effect on the promotion of sex maturation, but it also improved the quality of the eggs, when compared to the EA method.
The Use of Data as Evidence in Dutch Criminal Courts
Authors: Custers Bart , Stevens Lonneke
Published: May 2021

Digital traces that people leave behind in our digitalized society can be useful evidence in criminal courts. The central question of this article (how is the use of data as evidence in Dutch criminal courts regulated and, considering how these courts deal with such data as evidence in practice, what is needed?) is answered by analyzing the relevant legal frameworks for processing data in Dutch criminal courts: criminal law and data protection law. Next, current court practices are examined, by looking at typical case law and current developments in society and technology. Comparing the legal framework and actual practices, we conclude that the existing legal framework in the Netherlands does not obstruct the collection of data for evidence, but that regulation on collection (in criminal law) and regulation on processing and analysis (in data protection law) are not integrated. Remarkable is the almost complete absence of regulation of automated data analysis – in contrast with the many rules for data collection.
The Implementation of the European Prison Rules Regarding Education in Belgium and Ireland
Authors: Spolverato Giorgia
Published: May 2021

Reintegration of prisoners into community life is more than one of the desired outcomes of detention; it is a right. A long-standing tradition of international standards has been developed over time to regulate individualised reintegration plans, based on learning and working activities, relations with the outside world and assistance post-release. The European Prison Rules – adopted by the Committee of Ministers of the Council of Europe – are an outstanding result of this normative production. The purpose of this study is to evaluate and compare the implementation of international standards on prison education in Belgium and Ireland. The analysis of law, practices and domestic data points out the features of the prison education services in the two countries. Eventually, interviewing experts in the field allowed illustrating the initiatives that Belgium and Ireland are undertaking to respond to some current obstacles that the delivery of educational activities is facing. This research shows that despite the efforts of the two countries to comply with international standards on prison education, inadequate detention conditions – characterised by scarcity of resources and lack of specialised staff – hamper the reintegration of prisoners.
Patronage and Productions of Paintings and Albums in 18th-Century Awadh
Authors: Imbert Isabelle
Published: May 2021

During the 18th century, Faizābād and Lucknow became strategic centres of painting production in Northern India. Encouraged by the patronage of European collectors, but most probably by unnamed Indian patrons as well, the region experienced an intense period marked by the large number of albums and paintings in circulation. Based on the in-depth analysis of a selection of albums, paintings, and manuscripts, this article aims to highlight the evolution of compilation practices and painting productions. Full-page flower paintings, in particular, became increasingly popular in muraqqaʿ, to the point where calligraphic panels were completely replaced by colourful plants. Floral designs also appear in the margins, and the repetition of motives and patterns on several pages of different dimensions revealed an extensive commercialization based on a standardized production. In addition, the collections of European collectors such as Antoine-Louis Polier and Jean-Baptiste-Joseph Gentil bear the traces of commercial transactions between European and Indian collectors, as well as prices and possession marks. Together with their writings, correspondences, and memoirs, they bring new information on previously unknown Indian collectors, and more generally on the dynamism of the 18th-century book market.