bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening significant properties of macro-fiber composite laminate substrate anisotropy with viscoelastic and thermal considerations at the quasi-static level
Authors: Tran Brandon , Ifju Peter G 
Published: November 2023

Abstract
A macro-fiber composite (MFC) is a class of smart material actuator that employs piezoceramic fibers to extend or contract under an applied electric field. When embedded on a thin substrate, actuated MFCs induce surface pressure, resulting in out-of-plane motion. Design characteristics of the substrate, such as anisotropy, give rise to unique bend/twist behavior. Previous studies on MFC applications have focused on optimizing patch location in relation to the local design to achieve optimal bend/twist motion. However, the resolution to these approaches is restricted to the design space of the application, presenting an absence in piezoelectric laminate design intuition. This research aims to streamline the initial optimization process by analyzing the significant material properties associated with substrate design. To accomplish this, a viscoelastic piezoelectric plate theory model is developed to accurately capture the displacement behavior of the MFC laminate for any given substrate design. Experimental data is used to validate and refine the model, ensuring it closely represents real-world physics. A 2k fractional factorial design of experiments approach is used to identify significant substrate properties per MFC laminate configuration, assigning each material property a two-level coding system. Three configurations are observed, with each exhibiting distinct significant properties and effects compared to others. Furthermore, the study explores the impact of thermal factors on substrate behavior for these MFC laminates, highlighting how significant properties can be temperature dependent. The contributions to the kinematic response due to substrate property perturbation varies uniquely per material property and MFC laminate configuration. Statistical evidence supports the notion that the hysteretic behavior of a material is unaffected by thermal influences and is solely determined by the elastic constants of the substrate. The maximum remanent hysteretic response is shown to be proportional to the maximum actuation response at near room temperature.
Multi-taper-based automatic correction of non-anechoic antenna measurements
Authors: Dzwonkowski Mariusz , Waladi Vorya , Bekasiewicz Adrian 
Published: November 2023

Abstract
Prototype measurements belong to the key steps in the development of antenna structures. Although accurate validation of their far-field performance can be realized in dedicated facilities, such as anechoic chambers, the high cost of their construction and maintenance might not be justified if the main goal of measurements is to support teaching or low-budget research. Instead, they can be performed in non-anechoic conditions and then refined using appropriate correction algorithms. Unfortunately, the existing post-processing methods suffer from multiple challenges that include manual setup of parameters as well as validation of performance in idealized conditions. In this communication, a multi-taper-based framework for correction of antenna characteristics obtained in non-anechoic environments has been proposed. The algorithm augments one-shot measurements of the structure under test in order to extract the line-of-sight responses while attenuating the interferences pertinent to multi-path propagation and noise from external sources of radiation. The performance of the proposed correction routine has been demonstrated in two test sites using a geometrically small Vivaldi radiator and validated against state-of-the-art techniques from the literature. The uncertainty budget for the measurements performed using the approach amounts to 0.26 dB, which is low given challenging propagation conditions considered for experiments.
Pupil-linked arousal correlates with neural activity prior to sensorimotor decisions
Authors: Koorathota Sharath , Ma Jia Li , Faller Josef , Hong Linbi , Lapborisuth Pawan , Sajda Paul 
Published: November 2023

Abstract

Objective. Sensorimotor decisions require the brain to process external information and combine it with relevant knowledge prior to actions. In this study, we explore the neural predictors of motor actions in a novel, realistic driving task designed to study decisions while driving. Approach. Through a spatiospectral assessment of functional connectivity during the premotor period, we identified the organization of visual cortex regions of interest into a distinct scene processing network. Additionally, we identified a motor action selection network characterized by coherence between the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC). Main results. We show that steering behavior can be predicted from oscillatory power in the visual cortex, DLPFC, and ACC. Power during the premotor periods (specific to the theta and beta bands) correlates with pupil-linked arousal and saccade duration. Significance. We interpret our findings in the context of network-level correlations with saccade-related behavior and show that the DLPFC is a key node in arousal circuitry and in sensorimotor decisions.
Giant cell tumor of the clivus misdiagnosed as calcifying fibrous tumor
Authors: Lack M , Usman A , Hamza A , Meyer A R , Stevens T 
Published: November 2023

Abstract

Introduction/Objective
Giant cell tumors of bone (GCTs) are generally benign, locally aggressive lesions accounting for approximately 4% of primary bone tumors. GCTs of the skull are rare and constitute &lt;1% of all reported GCTs as they typically occur in the epiphysis of long bones. Specifically, in the clivus location, these tumors are exceedingly rare with fewer than 10 articles in English literature. The purpose of this report is to describe a case of GCT in this unusual location that was misdiagnosed as giant cell reparative granuloma on biopsy and subsequently calcifying fibrous tumor on resection.

Methods/Case Report
A 34-year-old male presented with history of headache, visual disturbance, epistaxis, and nausea. MRI demonstrated a large soft tissue mass eroding the clivus. A biopsy was interpreted at an outside institution as giant cell reparative granuloma. The patient was treated with denosumab and subsequently underwent resection of the mass due to worsening symptoms. Post-treatment pathology was interpreted as calcifying fibrous tumor. The patient presented to our institution for further management and outside pathology was reviewed.
Histologically, the initial tumor was composed of a bland spindle cell proliferation with admixed osteoclast-type giant cells. In this location, the differential diagnosis includes Brown tumor, giant cell reparative granuloma, and, rarely, GCT. HG34W immunostain was positive in the tumor cells confirming the diagnosis of GCT. The post-therapy specimen showed abundant woven bone formation and a lack of giant cells. Post-denosumab GCT are known to show these features. Follow up imaging showed a slow growing moderately enhancing mass at the resection site. Patient is alive with disease 36 months after initial diagnosis.

Results (if a Case Study enter NA)
NA

Conclusion
With rare exceptions, bone tumors frequently follow generalized patterns of involvement. Pathologists need to be aware of these exceptions. Appropriate panel of immunohistochemical stains help clinching the right diagnosis, especially in unusual clinical settings.
Impact of HER2 assay sensitivity on the ability to detect tumors with low to ultra-low HER2 expression: A TMA study on more than 10,000 tumors from more than 100 tumor entities
Authors: Lennartz M , Blessin N C , Dum D , Höflmayer D , Weidemann S , Sauter G , Clauditz T S , Simon R , Steurer S , Burandt E , Marx A H 
Published: November 2023

Abstract

Introduction/Objective
Detection of low level HER2 expression is important for therapy with new HER2 inhibitors in breast cancer. HER2 assays with high sensitivity are therefore needed. These may identify low level HER2 expression in various types other than breast cancer.

Methods/Case Report
A tissue microarray containing &gt;10,000 tissue samples from more than 100 different tumor types and subtypes was analyzed for immunohistochemical expression of HER2 using different immunohistochemistry protocols and anti-HER2 antibodies, including the HercepTest and laboratory developed tests designed for high sensitivity. HER2 IHC evaluation included the recording of HER2 low (1+), ultralow (any staining, less than 1+), and 0 (negative).

Results (if a Case Study enter NA)
Irrespective of the assay sensitivity all assays showed the expected/tolerable association with HER2 FISH data in 308 breast cancers. In non-breast cancers, the use of different assays yielded variable rates of low or ultra-low HER2 expression in different tumor entities. For example, low (1+) and ultra-low (+) expression was observed in 7-24% (1+) and 11-28% (+) of serous ovarian cancers, 6.2-24% (1+) and 3.4-19% (+) of endometrioid endometrial cancers, 5.5-14% (1+) and 7.7-13% (+) of intestinal gastric cancers, 1.8-9.2% (1+) and 4.5- 11% (+) of ductal adenocarcinomas of the pancreas, 19-33% (1+) and 5.5-11% (+) of muscle invasive urinary bladder cancers, 2.9-16% (1+) and 4.3-12% (+) of adenocarcinomas of the colon.

Conclusion
Low level HER2 expression occurs commonly in many cancer types. The rate of identifiable tumors with HER2 low or HER2 ultra-low expression varies depending on assay parameters that can easily be modified.
Irrespective of assay sensitivity, our data identify various tumor entities with significant fractions of “HER2-low” cases that might benefit from therapy with new antibody drug conjugates.
Interpace, Affirma, and Thyroseq Performance Characteristics in 341 Bethesda Category III/IV Thyroid Nodules
Authors: Connelly C F , Cimic A , Baskota S 
Published: November 2023

Abstract

Introduction/Objective
Multiple FDA-approved molecular testing platforms are used by our institution for evaluating genomic characteristics of thyroid nodules. We aim to correlate molecular results and final histopathology (HPE) of thyroid nodules with cytologic diagnosis of The Bethesda System (TBS) Category III or IV.

Methods/Case Report
We included 341 cases of thyroid nodules diagnosed as TBS-III or TBS-IV with subsequent molecular analysis performed on 1 of 5 platforms (Interpace ThyraMIR Thyroid miRNA Classifier, Afirma Genomic Sequencing Classifier, Thyroseq Genomic Classifier, Next-Generation Sequencing (NGS) Fusion Panel, or RosettaGX Reveal Thyroid miRNA Classifier). All findings reported on molecular analysis and all benign or malignant neoplasms diagnosed on final HPE were considered “significant findings.” Performance characteristics of all 5 molecular platforms were analyzed.

Results (if a Case Study enter NA)
Of 341 cases, 80.1% (n=273) were classified as TBS-III and 19.9% (n=68) were classified as TBS-IV. The overall concordance of molecular and final HPE when available was 60.9% (n=28).
Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) are respectively 75.0%, 60.0%, 75.0%, and 60.0% for Interpace; 65.0%, 60.0%, 85.0%, and 33.0% for Afirma; and 75.0%, 50.0%, 75.0%, and 50.0% for Thyroseq platforms.
Of TBS-III cases, 66.3% (n=181), 25.6% (n=70), 4.8% (n=13), 1.5% (n=4), and 1.8% (n=5) underwent molecular testing via Interpace, Afirma, Thyroseq, NGS, and Rosetta platforms, respectively. Only 9.2% (n=25) of TBS-III cases had subsequent HPE. Concordance of molecular and final HPE for TBS-III cases was 52.0% (n=13) with a PPV of 75.0% and NPV of 40.0%. Concordances of molecular and final HPE according to molecular platform are: 57.1% (n=4) on Interpace, 53.3% (n=8) on Afirma, and 50.0% (n=1) on Thyroseq.
Of TBS-IV cases, 52.9% (n=36), 36.8% (n=25), 5.9% (n=4), 2.9% (n=2), and 1.5% (n=1) underwent molecular testing via Interpace, Afirma, Thyroseq, NGS, and Rosetta platforms, respectively. Only 30.9% (n=21) of TBS-IV cases had subsequent HPE. Concordance of molecular and final HPE for TBS-IV cases was 71.4% (n=15) with a PPV of 86.0% and NPV of 43.0% Concordances of molecular and final HPE according to molecular platform are: 71.4% (n=5), 66.7% (n=6), and 75.0% (n=3) on Interpace, Afirma, and Thyroseq respectively.

Conclusion
Our study reports similar performance characteristics of 3 commonly used molecular platforms (Interpace, Afirma, and Thyroseq) for genomic evaluation of thyroid nodules.
Diffusely Invasive Mucormycosis of the Small Bowel in a Patient with Microbiologic Cultures and Tissue Biopsies Negative for Fungal Organisms
Authors: Chiu R , Lee J , Salahi W 
Published: November 2023

Abstract

Introduction/Objective
Invasive mucormycosis can be a swiftly fatal medical emergency occurring in patients with uncontrolled diabetes. This angioinvasive fungus causes tissue necrosis, hemorrhage, and thrombosis and often develops in the sinonasal cavities where it can extend directly to the CNS or spread systemically to visceral sites like the GI tract. Here, we describe a patient whose small bowel resection shortly before death, revealed diffusely invasive mucormycosis despite that blood and body fluid cultures and tissue biopsies were negative for fungal organisms.

Methods/Case Report
Our patient is a 39 year old male with a history of uncontrolled diabetes, brought to our hospital in cardiac arrest and found to have fentanyl in his system. His labs showed severe metabolic and electrolyte derangements including diabetic ketoacidosis. His blood cultures revealed bacteremia but no fungal growth, and he was placed on antibiotics for sepsis. The patient developed compartment syndrome of his bilateral forearms, which were amputated and showed necrotic skeletal muscle but no fungal infection. The patient also developed facial necrosis concerning for mucormycosis, but nasal endoscopic and facial skin biopsies were negative for mucor.
However, his abdominal CT showed diffuse mural thickening of his small bowel concerning for bowel ischemia, which prompted an exploratory laparotomy that revealed large segments of necrotic jejunum and ileum. While peritoneal fluids collected during the surgery yielded no fungal growth on culture, resected segments of necrotic small bowel showed massive presence of mucor with broad, pauci-septate, ribbon-like hyphae branching at right angles. Small bowel and mesenteric vessels showed angioinvasion by mucor with vasculitis and fibrin thrombi causing ischemic enteritis. Mucor was also noted diffusely invading small bowel muscularis propria, adventitia, and mesenteric fat, and small bowel also showed ulceration, hemorrhage, and transmural and mesenteric fat necrosis. Unfortunately, a few days after his surgery, the patient expired from multi-organ failure and septic shock before he could receive anti-fungal therapy for mucormycosis.

Results (if a Case Study enter NA)
NA

Conclusion
Mucormycosis is a rapidly growing, angioinvasive, and potentially lethal fungal infection that must be promptly recognized. This report documents an unusual case of invasive mucormycosis of the small bowel that went undetected in a severely ill patient whose blood and peritoneal cultures and tissue biopsies were all negative for fungal organisms.
Intraepithelial CD8+ cytotoxic T-cells are the main component of the immune tumor microenvironment that drive prognosis in muscle-invasive bladder cancer
Authors: Debatin N F , Bady E , Mandelkow T , Sauter G , Blessin N C , Samtleben H , Horst D , Marx A H , Fisch M , Slojewski M , Ecke T , Koch S , Zecha H , Schlomm T , Adamini N 
Published: November 2023

Abstract

Introduction/Objective
Quantity and the spatial relationship of individual immune cell (sub)types can provide prognostic information in muscle-invasive bladder cancer.

Methods/Case Report
To study the prognostic role of different immune cell subpopulations in muscle-invasive bladder cancer, we stained 521 muscle-invasive urothelial bladder carcinomas with 21 antibodies using BLEACH&STAIN multiplex fluorescence immunohistochemistry (mfIHC) in a tissue microarray format. A framework of neuronal networks was trained and used for image analysis.

Results (if a Case Study enter NA)
The identification of more than 300 different immune cell subpopulations and the characterization of their spatial relationship resulted in numerous spatial interaction patterns. 40 immune parameters
showed prognostic significance in univariate analyses of which 15 were independent from pT, pN, and histologic grade. The strongest association to clinical outcome was identified for intraepithelial CD8+cytotoxic T-cells (tAUC:
0.70) compared to all other 15 independent prognosis parameters (AUC: ≤0.68, p=0.039). Deeper spatial analysis revealed an increased expression levels of TIM3, CTLA-4 and PD-1 on CD8+ T cells that were located in the intraepithelial compartment. Furthermore, the cell-to-cell interaction profile of intraepithelial CD8+ T-cells was dominated by intraepithelial dendritic cells as well as intraepithelial M1-macrophages.

Conclusion
The intraepithelial CD8+T-cells that showed the highest expression level of TIM-3, PD-1 and CTLA-4 and were strongly interacting with M1-macrophages as well as dendritic cells and represented the strongest prognostic parameter in muscle-invasive bladder cancer. This can be explained by the fact that tumor cell destruction by CD8+ cytotoxic T-lymphocytes through direct cell-to-cell-contacts represents the “terminal-end-route” of anti-tumor immunity. The strongest prognostic immune-factor – intraepithelial CD8+T-cells – can be measured straightaway in routine pathology as the CD8-labelling index using conventional bright field immunohistochemistry.
Neurovascular Structure-adjacent Frozen-section Examination (NeuroSAFE) increases Nerve-sparing Frequency and reduces Positive Surgical Margins in open and Robot-assisted Laparoscopic Radical Prostatectomy: Experience After 486 Consecutive Patients
Authors: Soeder S J , Kaltenhaeuser S , Fuhrich N , Marx A H , Rossner L M , Jeziorowski A , Blana A , Samtleben H 
Published: November 2023

Abstract

Introduction/Objective: Introduction
Intraoperative frozen-section analysis allows real-time histologic assessment of surgical margins (SMs) and identification of candidates for nerve-sparing (NS) procedures in radical prostatectomy (RP).
Objective: To examine the efficacy of a systematic neurovascular structure-adjacent frozen-section examination (NeuroSAFE) during open and robotic assisted radical prostatectomy (RARP).

Methods/Case Report
From January 2019 to December 2020, 486 consecutive RPs were performed at the academic hospital Fuerth. Of these, 289 (59 %) were conducted with NeuroSAFE.
Surgical procedure: NeuroSAFE included the whole laterorectal circumference of the prostate corresponding to the neurovascular bundle to determine the SM status.
Outcome measurements and statistical analysis: The impact of NeuroSAFE on NS frequency and SM status was analyzed by chi-square test in matched cohorts. Data obtained from 289 RPs performed with NeuroSAFE were compaired to those from 197 RP without NeuroSAFE.

Results (if a Case Study enter NA)
In NeuroSAFE RPs, frequency of NS was significantly higher in lower pT stages (pT2 and pT3a: 78 % vs 68%, 58% vs 51%, p &lt; 0.0001, p = 0.047, respectively), whereas in stage ≥ pT3b, there was no significant difference in NS rate (53% vs 34%; p = 0.14). PSM rates were significantly lower only in pT2 tumors (all stages: 35% vs 24%, p=0.06; pT2: 12% vs 15%; p=0.02; pT3a: 36% vs 35%; p=0.6 and ≥pT3b: 39% vs 52%, p=0.3) compared with the matched non-NeuroSAFE RPs. Positive SMs (PSMs) were leading to a secondary resection of the ipsilateral neurovascular tissue. Secondary wide resection resulted in conversion to a definitive negative SM (NSM) status in 85 % of the patients.

Conclusion
NeuroSAFE enables real-time histologic monitoring and oncologic safety of a NS procedure. Systematic NeuroSAFE significantly increases NS frequencies and reduces PSMs in stage pT2 tumors. Patients with a NeuroSAFE-detected PSM could be converted to a prognostically more favorable NSM status by secondary wide resection.
Therapy-Related Acute Myeloid Leukemia After Chemotherapy For Osteosarcoma: Report of 2 Cases and Review of The Literature
Authors: Hwang C , Medeiros D , Kyono W , Thompson K 
Published: November 2023

Abstract

Introduction/Objective
Therapy-related acute myeloid leukemia (t-AML) and myelodysplastic syndrome (t-MDS) are rare but well-established late complications of chemotherapeutic agents or radiation therapy used to treat various malignancies. Many cases of t-AML/t-MDS have been described secondary to Hodgkin, non-Hodgkin lymphoma, and other solid tumors. However, only a few cases of t-AML and t-MDS have been reported following osteosarcoma treatment. We describe two patients diagnosed with osteosarcoma who developed t-AML after receiving multiple chemotherapeutic agents.

Methods/Case Report
A 12-year-old male with Li-Fraumeni syndrome was diagnosed with osteosarcoma of the left ilium and sacrum with pulmonary metastases. Despite multiple lines of chemoradiation therapy including doxorubicin and ifosfamide, tumor progressed at the primary tumor site. The patient subsequently presented with altered mental status and pancytopenia. Bone marrow biopsy demonstrated AML. He died despite supportive care.
A 14-year-old female was diagnosed with left tibial osteosarcoma with bony and pulmonary metastases. She was treated on standard osteosarcoma chemotherapy including doxorubicin, cisplatin, methotrexate, ifosfamide and etoposide, surgery, and radiation. 1 year following therapy, she had local recurrence of osteosarcoma without progression despite not starting chemotherapy. However, 3 years later, she developed pancytopenia, and immature white blood cells were identified on peripheral smear. Bone marrow biopsy revealed AML-M7. Despite supportive care and zoledronic acid, she ultimately died from sepsis and disseminated intravascular coagulation.

Results (if a Case Study enter NA)
NA

Conclusion
With improved therapy and survival for osteosarcoma patients, these patients should be monitored for secondary malignancies. T-AML is rare following osteosarcoma treatment, but outcome remains poor, despite treatment. Underlying Li-Fraumeni syndrome may influence the risk of development of secondary malignant neoplasms. Literature review of types and prognosis of t-AML following osteosarcoma will be reviewed and compared to our cases, including related genetic predisposing factors and chemotherapeutic agents. Our second patient is the first reported case of AML-M7 secondary to osteosarcoma treatment.