bluuebunny/crossref_metadata_2025 huggingface dataset:
Foot and Ankle Trauma: Epidemiology Before, During, and Post COVID-19 Pandemic in a Level I Trauma Center: A 5-Year Experience and Data Analysis
Authors: Mascio Antonio , Greco Tommaso , Comisi Chiara , Cinelli Virginia , De Gasperis Nicola , Candelli Marcello , Franceschi Francesco , Covino Marcello , Maccauro Giulio , Perisano Carlo
Published: December 2024

Background: Foot and ankle injuries are one of the leading orthopedic causes of emergency department (ED) admissions. The purpose of this study was to analyze, through 5 years of data collection, differences in number and type of admissions, as well as the severity of foot and ankle trauma to the ED in the pre-pandemic period, during the COVID-19 emergency, and in the post-pandemic period. This study aims to assess epidemiological and clinical data. Methods: Five years of data were collected on admissions to the ED at the Fondazione Policlinico Universitario A. Gemelli using an electronic database. The system allowed the use of a numeric code assessed at triage ranging from 1 to 5, where 1 indicated a patient with compromised vital functions, and it continued in decreasing criticality. Data were extensively analyzed and extrapolated to obtain epidemiological and clinical evaluation. Results: Data from 3787 patients, including 1945 males with a mean age of 41.4 years, were collected. Data were evaluated in the three different periods. In the pre-pandemic period, 2228 ED admissions were recorded, including 1138 males with a mean age of 37.4 years and a mean of 2.79 admissions per day. Codes 3 and 4 reported in the ED triage were 4.8% and 90.1%, respectively; the average surgical treatment was 5.6%. During the COVID period, the total number of admissions was 981, with 501 males with an average age of 43.8 years and a mean of 1.30 admissions per day. Codes 3 and 4 were 22.5% and 72.7%, respectively; the average surgical treatment was 10.4%. In the post-COVID period, 578 admissions were, including 306 males with a mean age of 43.2 years, and a daily access rate of 1.58 patients. Codes 3 and 4 reported in the ED triage were 25.4% and 70.8%, respectively; the average surgical treatment was 8.6%. Conclusions: During the pandemic period due to COVID-19 a substantial decrease in total admissions per day in the ED was noted, but an increase in more complex codes occurred, as evidenced by the percentage increase in surgical admissions compared to total admissions during the pandemic; the mean age of users gradually increased. Total hospitalization data remained stable in the post-pandemic period, likely due to the global impact of the pandemic. COVID-19 radically and concretely changed people’s living habits and priorities for accessing the ED.
Admixture of Liposomal Bupivacaine and Bupivacaine Hydrochloride for Peripheral Nerve Blocks in Adolescents Undergoing Orthopedic Surgery: An Observational Cohort Study
Authors: Fiorillo Benjamin P. , Melton M. Stephen , Nelsen Derek , Einhorn Lisa M.
Published: December 2024

Background/Objectives: In 2021, the Food and Drug Administration approved liposomal bupivacaine injectable suspension for single-dose infiltration in patients ≥ 6 years of age. Liposomal bupivacaine and bupivacaine hydrochloride admixtures may also be administered off-label for pediatric regional anesthesia including peripheral nerve blocks (PNBs). This single-injection, long-acting technique is not well described in pediatrics but may have benefits over traditional continuous catheter-based systems. The purpose of this investigation was to examine an adolescent cohort who received liposomal bupivacaine/bupivacaine hydrochloride PNBs for orthopedic surgery. Methods: Patient, surgical, anesthetic, block characteristics, and post-anesthesia care unit (PACU) outcomes were retrospectively reviewed from February 2020 to June 2024. From February to December 2022, a short follow-up survey was conducted to assess post-discharge patient-reported outcomes. Results: There were 524 liposomal bupivacaine/bupivacaine hydrochloride PNBs (106 upper-extremity and 418 lower-extremity) performed in 374 patients with a mean (standard deviation, range) age of 16 (1.2, 11–17) years. Two unilateral PNBs were performed in 150 (40%) patients to ensure an adequate sensory neural blockade. The interscalene (n = 81, 15%) and adductor canal (n = 140, 27%) blocks were the most common upper- and lower-extremity PNBs, respectively. Intraoperatively, the majority of the cohort (n = 258, 69%) underwent monitored anesthesia care (MAC). No patient required conversion from MAC to general anesthesia due to pain. In PACU, 288 (77%) patients reported no pain. Mild and moderate pain were reported by 56 (15%) and 30 (8%) patients, respectively. No patients developed local anesthetic toxicity. The survey results (n = 66) indicate that the majority of patients (96%) were satisfied with block analgesia postoperatively. Conclusion: Liposomal bupivacaine/bupivacaine hydrochloride PNBs were used successfully in adolescents undergoing a variety of orthopedic surgeries.
Prognostic Impact of Hospital Discharge After Heart Failure Admission Without Structured Heart Failure Follow-Up
Authors: Báez-Ferrer Néstor , Rodríguez-Cabrera Carmen Montserrat , Parra-Esquivel Patricia Corina , Burillo-Putze Guillermo , Domínguez-Rodríguez Alberto
Published: December 2024

(1) Objective. The aim was to evaluate the risk of new exacerbations of heart failure (HF) in patients discharged from hospital emergency departments (EDs) without a structured HF follow-up. (2) Methods. This prospective, single-center cohort study included patients discharged from the ED following hospital admission for acute HF. The study analyzed the profile of patients seen in the ED and assessed their risk of new ED visits or HF-related hospitalizations within 12 months of discharge. (3) Results. A total of 779 patients were included, with a mean age of 82 ± 8 years; 471 were women (60.4%), and 674 (86.7%) had a history of prior HF episodes. Of these, 591 patients (76.1%) were referred to an unstructured HF follow-up in primary care (PC). Patients who experienced HF exacerbations within 12 months of ED discharge had a higher incidence of chronic kidney disease, elevated natriuretic peptide levels, and a higher number of prior HF exacerbations and were more likely to receive unstructured HF follow-up in PC. The presence of the last two factors was associated with the highest risk of HF exacerbation within 12 months of discharge (HR: 2.83; 95% CI: 1.60–5.03; p < 0.001). (4) Conclusions. Patients discharged from the ED after an HF episode and referred to PC without a structured HF follow-up have a high risk of ED revisits or rehospitalization for HF.
Sesamoid Bone Reduction in Hallux Valgus: Comparing Radiological Outcomes of Hallux Valgus Following Distal Chevron Osteotomy and Modified McBride Procedure
Authors: Su Po-Han , Lin Chung-Wei , Chiang Cheng-Hung , Wang Wei-Chih , Yeh Chen-Wei , Chen Hsien-Te , Fong Yi-Chin , Kuo Chien-Chung
Published: December 2024

Background: Hallux valgus is a common forefoot disorder with hundreds of proposed management techniques. Distal chevron osteotomy with a modified McBride procedure has been traditionally recommended for mild hallux valgus because of its simple and less invasive nature with fewer complications, faster recovery, and reliable outcomes. In recent years, the indications for this procedure have expanded to include hallux valgus with severe deformities. This study aims to compare the radiographic outcomes of the surgical treatment for moderate versus severe hallux valgus patients from the perspective of sesamoid bone reduction. Materials and Methods: A retrospective review of medical records identified 99 feet from 94 patients that were treated with distal chevron osteotomy with a modified McBride procedure. These feet were divided by the preoperative hallux valgus angle and intermetatarsal angle into the moderate and severe groups. Results: Postoperative radiographic parameters significantly improved in both groups after treatment, indicating adequate deformity correction. Improvement in the sesamoid position was better in the moderate group compared to that in the severe group. The recurrence rate in the severe group was higher than that in the moderate group without statistical significance. Conclusions: Based on the radiographic results of the postoperative position following sesamoid reduction, the distal chevron osteotomy with a modified McBride procedure is effective for treating moderate hallux valgus deformities. However, this treatment strategy may be associated with a higher recurrence rate in cases of severe hallux valgus deformity. A complete reduction in the sesamoids should be emphasized during the management of severe hallux valgus deformity.
Methodological Variation Among Studies Evaluating Pain Processing in Tendinopathy: A Scoping Review
Authors: Jayaseelan Dhinu , Post Andrew , Sault Josiah , Mischke John
Published: December 2024

Background/Objectives: Tendinopathy is a condition associated with pain and limited function. While upper and lower extremity tendinopathies may have different functional implications, there have been a number of reports supporting different patterns of dysfunction in pain processing and inhibition. The purpose of this scoping review was to examine the methods across studies examining pain processing in patients with upper and lower extremity tendinopathy. Methods: Five electronic databases (PubMed, Scopus, CINAHL, the Cochrane Library, and SPORTDiscus) and gray literature sources were searched from inception through 15 April 2024, using appropriate keywords and relevant synonyms. Results: In total, 3219 titles were retrieved from the searches, with 43 studies retained for final inclusion. Of the 43 studies, 22 were specific to upper extremity tendinopathies, 19 were specific to lower extremity tendinopathies, and 2 studies included mixed samples. Physical testing to detect nervous system sensitization was most commonly performed using pressure pain thresholds. Although infrequent, questionnaire instruments were used mostly to include the central sensitization inventory. Substantial variation was noted across studies in mode of testing and instruments used, while patient demographics and inclusion criteria were not clearly reported in many instances. Thirty-one studies (72%) reported nervous system sensitization or dysfunction in tendinopathy, while 13 (28%) did not. Conclusions: While the difference between pain processing in tendinopathy is likely multifactorial, the results of this review identified substantial variability in methodology used and reporting in tendon pain research. As inconsistency in evidence can limit clinical guidance, efforts to standardize tendinopathy pain research appear warranted.
The Long-Term Cardiovascular Risks of Duloxetine Use in Older Adults: A Retrospective Medical Record-Based Adverse Drug Reaction Assessment
Authors: Cui Yuqi , Abdi Sayed Aliul Hasan , Wei Jeanne , Azhar Gohar
Published: December 2024

Background: Duloxetine, a Serotonin–Norepinephrine Reuptake Inhibitor (SNRI), is frequently used to treat diabetic peripheral neuropathy, depression, and fibromyalgia. However, its long-term cardiovascular implications in older individuals remain underexplored, particularly in those with pre-existing cardiovascular diseases. This medical record assessment aimed to evaluate the potential cardiovascular risks of duloxetine use in older persons after prolonged use. Methods: We evaluated adverse drug reactions (ADRs) using six medical records from elderly individuals (aged 70–79) with cardiovascular comorbidities who received duloxetine (≥60 mg daily) for anxiety, depression, and chronic pain. ADRs were assessed using the Naranjo ADR Probability Scale, the Modified Hartwig and Siegel Severity Scale, and the Karch and Lasagna Algorithm. Clinical outcomes were assessed before and after duloxetine dose reduction or withdrawal. Results: All the patients had cardiovascular-related ADRs, such as peripheral cyanosis, vasoconstriction, atrial fibrillation, and hypertensive episodes. Five of the six patients experienced mild cognitive impairment [Montreal Cognitive Assessment (MoCA) scores of 11–24/30]. A positive dechallenge (symptom resolution) was observed in all medical records after decreasing or discontinuing duloxetine. It is interesting to note that four medical records demonstrated significant improvement in cyanosis, blood pressure, and anxiety after decreasing or discontinuing duloxetine use. There was no rechallenge in this study. The causality was considered probable (Naranjo Scale), and ADRs were categorized as moderately severe (Hartwig and Siegel Scale) in all the medical records. However, with adequate monitoring, the ADRs were considered preventable (Schumock and Thornton Scale). Conclusions: Long-term duloxetine use could cause significant cardiovascular problems in older individuals, particularly those who already have cardiovascular difficulties. Regular monitoring of cardiovascular function and early steps such as dose adjustment or drug withdrawal of duloxetine may reduce the prognosis of ADRs. More studies are required to create safer treatment strategies for managing depression and anxiety in older people with cardiovascular issues.
Peripheral Circulating Blood Cells Deviation Based on Tumor Inflammatory Microenvironment Activity in Resected Upstaged Lung Adenocarcinomas
Authors: Bonis Alessandro , Lunardi Francesca , Pagliarini Giulia , Verzeletti Vincenzo , Lione Luigi , Busetto Alberto , Cannone Giorgio , Comacchio Giovanni Maria , Mammana Marco , Faccioli Eleonora , Rebusso Alessandro , Schiavon Marco , Nicotra Samuele , Dell’Amore Andrea , Rea Federico
Published: December 2024

Background: The tumour inflammatory microenvironment (TIME) reflects a selective activation of the central immune system (IS), particularly T-cells expansion, which leads to immune cells migrating to the target, such as lung cancer, via the bloodstream and lymphatic vessels. In this study, the aim is to investigate whether the distribution of peripheral blood cells varies based on the immune status of patients with lung adenocarcinoma. Methods: This is a single-center retrospective study conducted in the Thoracic Surgery Unit of the University of Padua (Italy) between 1 January 2016 and 1 April 2024. It included patients (>18 years old) with lung adenocarcinoma deemed resectable (cT2bN0M0 or lower) who experienced pathological upstaging (IIB or higher). Patients were classified as TIME-active (with tumour-infiltrating lymphocytes—TILs and/or PD-L1 expression) or TIME-silent (without TILs or PD-L1). According to the TIME status, peripheral blood cell counts with clinical and pathological data were compared between groups using the Fisher’s, Pearson’s or Wilcoxon’s test when appropriate. A Kaplan–Meier estimator investigated overall survival (OS) and recurrence-free survival (RFS) adopting the log-rank test. Results: Preoperatively, the TIME-a group demonstrated a significantly higher lymphocyte count (p = 0.02) and a lower absolute neutrophil rate (p = 0.01) than TIME-s. These differences persisted after resection (p = 0.06 and p = 0.02) while they became similar one month after surgery (p = 1 and p = 0.32). The neutrophil-to-lymphocyte ratio—NLR showed similar trends (p = 0.01 and p = 1). Better OS and RFS were shown in the TIME-a group (p = 0.02 and 0.03, respectively). Conclusions: Resected upstaged lung adenocarcinomas show distinct peripheral blood cell profiles based on immune status. TIME-active patients had a significantly lower NLR, which normalized post-surgery. Surgical resection may help restore native immune surveillance.
A Machine Learning-Based Decision Support System for the Prognostication of Neurological Outcomes in Successfully Resuscitated Out-of-Hospital Cardiac Arrest Patients
Authors: Lee Sijin , Lee Kwang-Sig , Park Sang-Hyun , Lee Sung Woo , Kim Su Jin
Published: December 2024

Background/Objectives: This study uses machine learning and multicenter registry data for analyzing the determinants of a favorable neurological outcome in patients with out-of-hospital cardiac arrest (OHCA) and developing decision support systems for various subgroups. Methods: The data came from the Korean Cardiac Arrest Research Consortium registry, with 2679 patients who underwent OHCA aged 18 or above with the return of spontaneous circulation (ROSC). The dependent variable was a favorable neurological outcome (Cerebral Performance Category score 1–2), and 68 independent variables were included, e.g., first monitored rhythm, in-hospital cardiopulmonary resuscitation (CPR) duration and post-ROSC pH. A random forest was used for identifying the major determinants of the favorable neurological outcome and developing decision support systems for the various subgroups stratified by the major variables. Results: Based on the random forest variable importance, the major determinants of the OHCA patient outcomes were the in-hospital CPR duration (0.0824), in-hospital electrocardiogram on emergency room arrival (0.0692), post-ROSC pH (0.0579), prehospital ROSC before emergency room arrival (0.0565), coronary angiography (0.0527), age (0.0415), first monitored rhythm (EMS) (0.0402), first monitored rhythm (community) (0.0401), early coronary angiography within 24 h (0.0304) and time from scene arrival to CPR stop (0.0301). It was also found that the patients could be divided into six subgroups in terms of their prehospital ROSC and first monitored rhythm (EMS), and that a decision tree could be developed as a decision support system for each subgroup to find the effective cut-off points regarding the in-hospital CPR duration, post-ROSC pH, age and hemoglobin. Conclusions: We identified the major determinants of favorable neurological outcomes in successfully resuscitated patients who underwent OHCA using machine learning. This study demonstrates the strengths of a random forest as an effective decision support system for each stratified subgroup (prehospital ROSC and first monitored rhythm by EMS) to find its own optimal cut-off points for the major in-hospital variables (in-hospital CPR duration, post-ROSC pH, age and hemoglobin).
Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management
Authors: Nezhat Camran , Amirlatifi Nikki , Najmi Zahra , Tsuei Angie
Published: December 2024

Background: Endometriosis is a systemic, inflammatory, estrogen-dependent condition characterized by endometrial stroma and gland-like lesions outside of the uterus. It causes a range of symptoms, notably chronic pelvic pain, infertility and organ dysfunction. Thoracic endometriosis syndrome (TES) has been described as endometriosis that is found in the lung parenchyma, pleura and diaphragm. It may be asymptomatic or present with symptoms of catamenial pneumothorax, hemothorax, hemoptysis, isolated chest pain, shoulder pain or findings of lung nodules. Aim: The aim of this review is to provide a comprehensive overview of thoracic endometriosis syndrome (TES), including its clinical presentation, diagnostic challenges, and current management strategies. This review aims to highlight the importance of a multidisciplinary approach in the treatment of TES, emphasizing conservative management and the role of minimally invasive surgical techniques for refractory cases. Conclusions: Thoracic endometriosis syndrome appears to be a marker of severe endometriosis. As much as possible, the patient with TES is managed conservatively, with surgery reserved for refractory cases. When surgery is recommended, the procedure is conducted through a multidisciplinary minimally invasive approach, with video-assisted thoracoscopic surgery (VATS) and video-assisted laparoscopy. Meticulous intraoperative survey, the removal of endometriosis implants with and without robotic assistance and post-operative hormonal therapy may be recommended to prevent recurrence.
Prevention and Management of Recurrent Laryngeal Nerve Palsy in Minimally Invasive Esophagectomy: Current Status and Future Perspectives
Authors: Taniyama Yusuke , Okamoto Hiroshi , Sato Chiaki , Ozawa Yohei , Ishida Hirotaka , Unno Michiaki , Kamei Takashi
Published: December 2024

Recurrent laryngeal nerve palsy remains a significant complication following minimally invasive esophagectomy for esophageal cancer. Despite advancements in surgical techniques and lymphadenectomy precision, the incidence of recurrent laryngeal nerve palsy has not been improved. Recurrent laryngeal nerve palsy predominantly affects the left side and may lead to unilateral or bilateral vocal cord paralysis, resulting in hoarseness, dysphagia, and an increased risk of aspiration pneumonia. While most cases of recurrent laryngeal nerve palsy are temporary and resolve within 6 to 12 months, some patients may experience permanent nerve dysfunction, severely impacting their quality of life. Prevention strategies, such as nerve integrity monitoring, robotic-assisted minimally invasive esophagectomy, and advanced dissection techniques, aim to minimize nerve injury, though their effectiveness varies. The management of recurrent laryngeal nerve palsy includes voice and swallowing rehabilitation, reinnervation techniques, and, in severe cases, surgical interventions such as thyroplasty and intracordal injection. As recurrent laryngeal nerve palsy can lead to significant postoperative respiratory complications, a multidisciplinary approach involving surgical precision, early detection, and comprehensive rehabilitation is crucial to improving patient outcomes and minimizing long-term morbidity in minimally invasive esophagectomy. This review article aims to inform esophageal surgeons and other clinicians about strategies for the prevention and management of recurrent laryngeal nerve palsy in esophagectomy.
The Diagnostic Accuracy of an Electrocardiogram in Pulmonary Hypertension and the Role of “R V1, V2 + S I, aVL − S V1”
Authors: Ley Lukas , Wiedenroth Christoph B. , Guth Stefan , Gold Christian , Yogeswaran Athiththan , Ghofrani Hossein Ardeschir , Bandorski Dirk
Published: December 2024

Background: Pulmonary hypertension (PH) can cause characteristic electrocardiographic (ECG) changes due to right ventricular hypertrophy and/or strain. The aims of the present study were to explore the diagnostic accuracy of ECG parameters for the diagnosis of PH, applying the recently adjusted mean pulmonary artery pressure (mPAP) threshold of >20 mmHg, and to determine the role of “R V1, V2 + S I, aVL − S V1”. Methods: Between July 2012 and November 2023, 100 patients without PH, with pulmonary arterial hypertension, or with chronic thromboembolic pulmonary hypertension were retrospectively enrolled. Results: The sensitivity and specificity of the ECG parameters for the diagnosis of PH varied from 3 to 98% and from 3 to 100% (means: 39% and 87%). After optimising the parameters’ cut-offs, the mean sensitivity (39% to 66%) increased significantly but the mean specificity (87% to 74%) slightly decreased. “R V1, V2 + S I, aVL − S V1” was able to predict an mPAP >20 mmHg (OR: 34.33; p < 0.001) and a pulmonary vascular resistance >5 WU (OR: 17.14, p < 0.001) but could not predict all-cause mortality. Conclusions: Even with improved cut-offs, ECG parameters alone are not able to reliably diagnose or exclude PH because of their low sensitivity. However, they still might be helpful to reveal a suspicion of PH, especially in early diagnostic stages, e.g., in primary care with general practitioners or non-specialised cardiologists and pulmonologists. “R V1, V2 + S I, aVL − S V1” was able to predict the diagnosis of (severe) PH but could not predict all-cause mortality. Nevertheless, it can still be useful in risk stratification.
Associations Between Fundamental Movement Skills, Muscular Fitness, Self-Perception and Physical Activity in Primary School Students
Authors: Sortwell Andrew , Ramirez-Campillo Rodrigo , Murphy Aron , Newton Michael , Hine Gregory , Piggott Ben
Published: December 2024

Background/Objectives: Positive self-perception, physical activity and fundamental movement skill (FMS) proficiency are important aspects of a child’s healthy development. The objective of this research was twofold: first, to explore associations between FMS, muscular fitness, self-perception and physical activity in school children; and second, to identify key predictors of FMS proficiency, athletic self-perception, physical activity levels in these participants and the differences between biological sexes. Methods: Primary school-aged children (n = 104; 53.85% female) from 8 to 10 years old (M = 9.04, SD = 0.69) engaged in two days of testing. All students were measured on FMS, standing long jump (SLJ), countermovement jump (CMJ), seated medicine ball chest throw and self-perception, followed by correlation and stepwise multiple linear regression analyses. Results: The findings revealed significant positive correlations between FMS proficiency, lower body muscular fitness (CMJ, SLJ), and athletic self-perception for the entire cohort, with varying results between male and female subgroups. Additionally, athletic self-perception showed strong relationships with other self-perception domains. Notably, forward stepwise regression analysis identified FMS proficiency as a significant predictor of physical activity levels, explaining 12.8% of the variance. SLJ, scholastic perception, and physical activity explained 45.5% of FMS variance for females. In males, FMS proficiency significantly predicted physical activity, accounting for 13.3% of the variance. SLJ and athletic competence self-perception explained 42.1% of FMS variance in males. Conclusions: The study indicates that FMS, self-perception, muscular fitness, and physical activity levels may mutually enhance each other, and that there is a need for biological sex-specific strategies to be considered in physical education programs.
Cycling Isokinetic Peak Force Explains Maximal Aerobic Power and Physiological Thresholds but Not Cycling Economy in Trained Triathletes
Authors: Giancáspero-Inostroza Felipe , Burgos-Jara Carlos , Sepúlveda Carlos , Haichelis Danni , Meneses-Valdés Roberto , Orizola-Cáceres Ignacio , Cerda-Kohler Hugo
Published: December 2024

Background: Assessments of muscle strength help prescribe and monitor training loads in cyclists (e.g., triathletes). Some methods include repetition maximum, joint isokinetic tests, and indirect estimates. However, their specificity for cycling’s dynamic force application and competitive cadences is lacking. This study aims to determine the influence of the cycling isokinetic peak force (cIPF) at different cadences on aerobic performance-related variables in trained triathletes. Methods: Eleven trained male athletes (33 ± 9.8 years, 173.1 ± 5.0 cm height, 73.9 ± 6.8 kg body mass, and ≥5 years of triathlon experience) were recruited. Maximal oxygen consumption (VO2 max), ventilatory thresholds (i.e., VT1 and VT2), and cIPF were assessed. cIPF testing involved 10 s sprints at varied cadences with 4 min rest intervals. Pedaling cadences were set at low (60 rpm), moderate (80 and 100 rpm), and high (120 and 140 rpm) cadences. A regression model approach identified cIPF related to aerobic performance. Results: IPF at 80 and 120 rpm explained 49% of the variability in power output at VT1, 55% of the variability in power output at VT2, 65% of the variability in power output at maximal aerobic power (MAP), and 39% of the variability in VO2 max. The cycling economy was not explained by cIPF. Conclusions: This study highlights the significance of cIPF, particularly at moderate to high cadences, as a determinant of aerobic-related variables in trained triathletes. Cycling cIPF should be tested to understand an athlete’s profile during crank cycling, informing better practice for training specificity and ultimately supporting athletes in achieving optimal performance outcomes in competitive cycling events.
MediScan: A Framework of U-Health and Prognostic AI Assessment on Medical Imaging
Authors: Syed Sibtain , Ahmed Rehan , Iqbal Arshad , Ahmad Naveed , Alshara Mohammed Ali
Published: December 2024

With technological advancements, remarkable progress has been made with the convergence of health sciences and Artificial Intelligence (AI). Modern health systems are proposed to ease patient diagnostics. However, the challenge is to provide AI-based precautions to patients and doctors for more accurate risk assessment. The proposed healthcare system aims to integrate patients, doctors, laboratories, pharmacies, and administrative personnel use cases and their primary functions onto a single platform. The proposed framework can also process microscopic images, CT scans, X-rays, and MRI to classify malignancy and give doctors a set of AI precautions for patient risk assessment. The proposed framework incorporates various DCNN models for identifying different forms of tumors and fractures in the human body i.e., brain, bones, lungs, kidneys, and skin, and generating precautions with the help of the Fined-Tuned Large Language Model (LLM) i.e., Generative Pretrained Transformer 4 (GPT-4). With enough training data, DCNN can learn highly representative, data-driven, hierarchical image features. The GPT-4 model is selected for generating precautions due to its explanation, reasoning, memory, and accuracy on prior medical assessments and research studies. Classification models are evaluated by classification report (i.e., Recall, Precision, F1 Score, Support, Accuracy, and Macro and Weighted Average) and confusion matrix and have shown robust performance compared to the conventional schemes.
Numerical Simulation and Experimental Study of a Small-Scale Vacuum Fish Pump
Authors: Tian Changfeng , Qu Zhi , Che Xuan , Han Mengxia , Zhou Yin , Wu Fan
Published: December 2024

The existing vacuum fish pump is too large and difficult to move, which is difficult to apply to small fishing vessels. However, the development of a small vacuum fish pump is not a single scaling of the existing vacuum fish pump but requires the support of relevant experiments and simulation theories. In this study, a vacuum fish pump suitable for small fishing vessels was developed. Firstly, a numerical model of the internal flow field during the vacuum fish pump’s working process was established using computational fluid dynamics (CFDs) and verified its effectiveness by physical experiments. It is found that the VOF model can well predict the variation of the volume fraction of the liquid phase in the whole calculation area with time during the suction or drainage process of the vacuum fish pump. Then, the internal flow field characteristics of the fish pump under different working conditions were simulated, and the rationality of the design of the fish pump was evaluated according to the numerical results. Finally, a separate physical experiment was carried out on grass carp, carp, crucian carp, silver carp, and bighead carp, respectively, and the capture efficiency and corresponding fish damage rate for different fish were analyzed. The experimental and numerical results show that the vacuum suction fish pump can achieve efficient and automatic suction and transport of live fish.
Spectral Analysis of Dissolved Organic Carbon in Seawater by Combined Absorption and Fluorescence Technology
Authors: Cao Xuan , Xiong Feng , Wang Yang , Ma Haikuan , Zhang Yanmin , Liu Yan , Kong Xiangfeng , Wang Jingru , Shi Qian , Fan Pingping , Li Yunzhou , Wu Ning
Published: December 2024

Dissolved organic carbon refers to soluble carbon substances in water bodies and can be used as an important indicator for water pollution. Spectroscopic detection is commonly used to detect dissolved organic carbon in seawater. However, independent spectral methods are susceptible to interference, and insufficient extraction of the data features can occur. Accordingly, this study introduces a multisource spectral fusion method that relies on a combination of principal component analysis and convolutional neural networks to construct the detection model. The Bayesian correction method is used for calibration, and the dissolved organic carbon content of 10 groups of unfiltered seawater samples is analyzed. Correcting the spectral data acquired from samples containing impurities significantly improved the linear correlation coefficient R2 of dissolved organic carbon from 0.8891 to 0.9838. Similarly, the mean absolute error was significantly reduced from 15.33% to 3.24%, while the individual absolute error was effectively controlled, remaining within 9%. The obtained results show that the developed method effectively integrates the ultraviolet absorption and fluorescence spectral data and overcomes interference from other substances using the Bayesian correction method. Overall, this provides a highly accurate detection system with potential applications in monitoring the marine environment.
High-Resolution Dynamic Monitoring of Rocky Desertification of Agricultural Land Based on Spatio-Temporal Fusion
Authors: Zhao Xin , Zhou Zhongfa , Wu Guijie , Long Yangyang , Luo Jiancheng , Huang Xingxin , Chen Jing , Wu Tianjun
Published: December 2024

The current research on rocky desertification primarily prioritizes large-scale surveillance, with minimal attention given to internal agricultural areas. This study offers a comprehensive framework for bedrock extraction in agricultural areas, employing spatial constraints and spatio-temporal fusion methodologies. Utilizing the high resolution and capabilities of Gaofen-2 imagery, we first delineate agricultural land, use these boundaries as spatial constraints to compute the agricultural land bedrock response Index (ABRI), and apply the spatial and temporal adaptive reflectance fusion model (STARFM) to achieve spatio-temporal fusion of Gaofen-2 imagery and Sentinel-2 imagery from multiple time periods, resulting in a high-spatio-temporal-resolution bedrock discrimination index (ABRI*) for analysis. This work demonstrates the pronounced rocky desertification phenomenon in the agricultural land in the study area. The ABRI* effectively captures this phenomenon, with the classification accuracy for the bedrock, based on the ABRI* derived from Gaofen-2 imagery, reaching 0.86. The bedrock exposure area in the farmland showed a decreasing trend from 2019 to 2021, a significant increase from 2021 to 2022, and a gradual decline from 2022 to 2024. Cultivation activities have a significant impact on rocky desertification within agricultural land. The ABRI significantly enhances the capabilities for the dynamic monitoring of rocky desertification in agricultural areas, providing data support for the management of specialized farmland. For vulnerable areas, timely adjustments to planting schemes and the prioritization of intervention measures such as soil conservation, vegetation restoration, and water resource management could help to improve the resilience and stability of agriculture, particularly in karst regions.
Green Urban Public Spaces Accessibility: A Spatial Analysis for the Urban Area of the 14 Italian Metropolitan Cities Based on SDG Methodology
Authors: Cimini Angela , De Fioravante Paolo , Marinosci Ines , Congedo Luca , Cipriano Piergiorgio , Dazzi Leonardo , Marchetti Marco , Scarascia Mugnozza Giuseppe , Munafò Michele
Published: December 2024

Among the most significant impacts related to the spread of settlements and the densification of urban areas, the reduction in the availability of public green spaces plays a central role in the definition of livable cities, in terms of the environment and social cohesion, interaction, and equality. In the framework of target 11.7 of the Sustainable Development Goals (SDG) 11, the United Nations has established the objective of ensuring universal, safe, and inclusive access to public spaces by 2030, for women, children, the elderly, and people with disabilities. This study proposes the evaluation of this objective for the urban area of the 14 Italian metropolitan cities, as defined by EUROSTAT and adopted by the United Nations and the Nature Restoration Law (NRL). A methodology based on open-source data and network analysis tools is tested for the provision of an unprecedented mapping of the availability and accessibility to green urban public spaces, which shows that less than 30% of metropolitan city residents have access to a green space within 300 m on foot, according to OpenStreetMap data (less than one in five for the Urban Atlas data). Furthermore, a critical analysis on the geometric and semantic definition of green urban public spaces adopted by the main European and international tools is carried out, which underlines the strategic role of crowdsourcing but also the need for mapping rules that make the data more consistent with the monitoring objectives set at the institutional level.
Practice and Prospect of Regulating Personal Data Protection in China
Authors: Yang Liping , Lin Yiling , Chen Bing
Published: December 2024

Privacy protection is a fundamental guarantee for secure data flows and the basic requirement for data security. A reasonable privacy protection system acts as a catalyst for unlocking the financial value of data. The current legislative framework for personal data protection in China, adhering to the principle of proportionality, establishes critical measures such as informed consent for data collection and processing, data classification and grading management, and remedies for data leakage and other risks. In addition, in judicial practice, typical disputes regarding personal information protection and privacy rights have been promoted to clarify the scope for collecting users’ personal information and biometric data. Although further improvements are needed in legislative, judicial, and technical approaches, China’s commitment and practice in personal data protection are noteworthy. The existing legislation, law enforcement, and technical practices play an increasingly vital role in realizing the financial value of data and are essential for international cooperation on privacy protection. Furthermore, it is crucial to actively explore cooperation mechanisms for cross-border data flows under the principle of data sovereignty, participate in developing international rules for cross-border data flows, and formulate different management norms for cross-border data flows across different industries.
Effects of Marigold Extract and Carophyll Red on Growth, Body Color Development, Antioxidant Properties, and Innate Immunity in the Ornamental Fish Golden Severum (Heros efasciatus)
Authors: Park Jung-Jin , Bae Jun-Sung , Lee Chae-Won , Yang Chan-Young , Jeong Eun-Ha , Park Kwan-Ha , Seo Jung-Soo , Kwon Mun-Gyeong , Lee Ji-Hoon
Published: December 2024

The body color state is an important determinant of the value of golden severum (Heros efasciatus)—a popular ornamental fish. The use of dietary supplements to improve the color development and health of this species is unexplored. Herein, the effects of marigold extract (MG) and carophyll red (CR) are examined on the growth, body color development, antioxidant properties, and innate immunity in golden severum. Fish were maintained under controlled water quality conditions (pH, temperature, and dissolved oxygen) and fed six experimental diets containing either 0% MG and CR, 1% MG, 2% MG, 5% MG, 0.5% CR, or 2% CR for five weeks. Both MG and CR significantly decreased lipid peroxide levels in hepatic tissues. In contrast, only MG enhanced the activities of reactive oxygen species (ROS)-scavenging enzymes (superoxide dismutase and catalase). Although MG and CR decreased the respiratory burst activity of splenic leukocytes, other innate immune parameters remained unchanged. Additionally, MG and CR stimulated body color development patterns in golden severum that reflect their unique coloring principles. The ROS-scavenging abilities of MG and CR appear to be related to their antioxidant activity. Hence, MG and CR at the optimal levels of 1.0% and 0.5%, respectively, can improve the body color of golden severum and protect against oxidative stress.
Three-Dimensionally Printed Bionic Hydroxyapatite (HAp) Ceramic Scaffolds with Different Structures and Porosities: Strength, Biocompatibility, and Biomedical Application Potential
Authors: Zhang Peng , Zhou Qing , He Rujie
Published: December 2024

Bionic bioceramic scaffolds are essential for achieving excellent implant properties and biocompatible behavior. In this study, inspired by the microstructure of natural bone, bionic hydroxyapatite (HAp) ceramic scaffolds with different structures (body-centered cubic (BCC), face-centered cubic (FCC), and gyroid Triply Periodic Minimal Surfaces (TPMSs)) and porosities (80 vol.%, 60 vol.%, and 40 vol.%) were designed, 3D-printed, and characterized. The effects of structure and porosity on the morphology, mechanical properties, and in vitro biocompatibility properties of the HAp scaffolds were studied and compared with each other. Interestingly, the HAp scaffold with a porosity of 80 vol.% and a TPMS structure had the best combination of compressive strength and in vitro biocompatibility, and demonstrated a great biomedical application potential for bone repair. We hope this study can provide a reference for the application and development of HAp scaffolds in the field of bone repair engineering.
The Effect of Post Heat Treatment on the Microstructure and Mechanical Properties of Cold-Sprayed Zn-6Cu Deposits
Authors: Hu Xiao-Zhen , Tan Xiao-Bo , Xie Bin , Yao Hai-Long , Yang Chao , Zhou Tao
Published: December 2024

To explore the feasibility of preparing Zn alloy bulk, Zn-6Cu deposit was prepared by cold-spraying additive manufacturing. Microstructure, tensile and wear behavior were investigated before and after heat treatment. Cold-sprayed Zn-6Cu deposit was constituted by irregular flattening particles and pores after heat treatment. Zn-6Cu deposits were composed of Zn and CuZn5 phases in addition to ZnO phase regardless of heat treatment, but the full width at half maximum of both the CuZn5 and the Zn phase were varied. The yield strength and ultimate tensile strength of Zn-6Cu deposits after post heat treatment were, respectively, increased from 83.8 ± 28.7 MPa and 159.6 ± 44.5 MPa to 89.4 ± 24.4 MPa and 223.8 ± 37.1 MPa. Fracture morphology after tensile testing exhibited main features of dimples, pores and cleaving particles. The friction coefficient and wear rate of Zn-6Cu deposits were increased after heat treatment, and the corrosive wear exhibited a lower friction coefficient and wear rate than the dry wear due to the lubricant of simulated body fluid. Grooves and localized delamination were the main wear features of Zn-6Cu deposits regardless of both the heat treatment and wear condition. This result indicates a potential application of cold-sprayed Zn-6Cu deposits comparable to the casting ones.
Effect of Load-Bearing Wall Material on Building Dynamic Properties
Authors: Zajac Maciej , Kuzniar Krystyna , Tatara Tadeusz
Published: December 2024

Nowadays, more and more buildings are being constructed from various types of modern materials. Many works have been written about these materials, which primarily focus on the influence of their properties on the thermal and acoustic insulation of, for example, building walls. However, there are very few publications analyzing the influence of construction materials on the dynamic properties of building structures and their vibration behavior. Yet, vibrations are dangerous for building structures. In the analysis of dynamic issues, the dynamic properties of objects should primarily be taken into account because the dynamic response of a building depends on the values of these parameters. This article focuses on numerically determining and analyzing the impact of load-bearing wall construction material on building dynamic properties—natural vibration frequencies and mode shapes. Seven building construction materials were considered, and then nine variants of building load-bearing walls made from these materials were analyzed. The analyses were carried out on the example of a low-rise administrative building structure. The building was modeled using the finite element method (FEM) with three-dimensional (3D) model analysis. Three variants of 3D FEM models were proposed, validated, and compared. A notable impact of load-bearing wall material properties on the natural frequencies and mode shapes of building structures was found. Two issues could be mentioned as the main new contributions of this paper: numerical analysis and comparing the effect of various building construction materials on dynamic building properties and the proposition and validation of various approaches to 3D FEM building load-bearing wall modeling. The findings of this research are of important significance and should be taken into account when constructing buildings subjected to dynamic loading or analyzing the possible harmful effects of various types of vibrations on buildings.
Experimental Validation of Hydrogen Affinity as a Design Criterion for Alloys
Authors: Nigutová Katarína , Oroszová Lenka , Molčanová Zuzana , Csík Dávid , Gáborová Katarína , Möllmer Jens , Lange Marcus , Saksl Karel
Published: December 2024

This study introduces an innovative approach to alloy design by experimentally validating the semi-empirical concept of Griessen and Driessen, which predicts the hydrogen affinity of solid solutions. The work focuses on designing and synthesizing four equiatomic high-entropy alloys (HEAs) with compositions tailored to exhibit highly endothermic enthalpies of solution and formation, resulting in resistance to hydrogen absorption. Unlike conventional studies that prioritize hydrogen storage capacity, this research uniquely targets alloys optimized for minimal hydrogen interaction, addressing critical needs in hydrogen storage and transportation technologies prone to hydrogen embrittlement. Experimental results confirm the negligible hydrogen absorption of these alloys, with a maximum of 0.23 wt.% (H/M = 0.13) at 2 MPa and 175 °C. This study not only demonstrates the applicability of a theoretical model to guide alloy design but also highlights the potential of these materials for low-pressure hydrogen storage systems, where mechanical integrity and resistance to hydrogen degradation are paramount. The findings bridge the gap between theoretical predictions and practical applications, offering a novel perspective on alloy development for hydrogen-related technologies.
Assessing the Conformity of Mycelium Biocomposites for Ecological Insulation Solutions
Authors: Irbe Ilze , Kirpluks Mikelis , Kampuss Mikus , Andze Laura , Milbreta Ulla , Filipova Inese
Published: December 2024

In this study, different combinations of mycelium biocomposites (MBs) were developed using primary substrates sourced from the local agricultural, wood processing, and paper industries. The physicomechanical properties, thermal conductivity, and fire behavior were evaluated. The highest bending strength was achieved in composites containing waste fibers and birch sanding dust, with a strength competitive with that of synthetic polymers like EPS and XPS, as well as some commercial building materials. The lowest thermal conductivity was observed in hemp-based MB, with a lambda coefficient of 40 m·W·m−1·K−1, making these composites competitive with non-mycelium insulation materials, including synthetic polymers such as EPS and XPS. Additionally, MB exhibited superior fire resistance compared to various synthetic foams and composite materials. They showed lower peak heat release rates (134–243 k·W·m−2) and total smoke release (7–281 m2·m−2) than synthetic polymers, and lower total heat release (6–62 k·W·m−2) compared to certain wood composites. Overall, the mechanical and thermal properties, along with the fire performance of MB, support their potential as a sustainable alternative to petroleum-based and traditional composite materials in the building industry.
Theory and Applications on Machines, Mechanisms and Robots, and the Figure of Ettore Pennestrì
Authors: Di Gregorio Raffaele
Published: December 2024

This editorial presents a book that marks the beginning of the MMR-T&A series, which compiles articles from the collection Machines, Mechanisms, and Robots: Theory and Applications (MMR-T&A), published in MDPI’s journal Machines [...]