bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid Summarization of Medical Records for Predicting Length of Stay in the Intensive Care Unit
Authors: Rhazzafe Soukaina , Caraffini Fabio , Colreavy-Donnelly Simon , Dhassi Younes , Kuhn Stefan , Nikolov Nikola S.
Published: July 2024

Electronic health records (EHRs) are a critical tool in healthcare and capture a wide array of patient information that can inform clinical decision-making. However, the sheer volume and complexity of EHR data present challenges for healthcare providers, particularly in fast-paced environments such as intensive care units (ICUs). To address this problem, the automatic summarization of the main problems of patients from daily progress notes can be extremely helpful. Furthermore, by accurately predicting ICU patients’ lengths of stay (LOSs), resource allocation and management can be optimized, allowing for a more efficient flow of patients within the healthcare system. This work proposes a hybrid method to summarize EHR notes and studies the potential of these summaries together with structured data for the prediction of LOSs of ICU patients. Our investigation demonstrates the effectiveness of combining extractive and abstractive summarization techniques with a concept-based method combined with a text-to-text transfer transformer (T5), which shows the most promising results. By integrating the generated summaries and diagnoses with other features, our study contributes to the accurate prediction of LOSs, with a support vector machine emerging as our best-performing classifier with an accuracy of 77.5%, surpassing existing systems and highlighting the potential for optimal allocation of resources within ICUs.
Evaluating the Efficacy of a Passive Exoskeleton for Enhancing Ergonomics in Manufacturing
Authors: Davoudi Kakhki Fatemeh , Moghadam Armin , Nieto Arnold , Vora Hardik
Published: July 2024

Manual material handling (MMH) significantly impacts worker health and productivity, often leading to musculoskeletal disorders (MSDs) primarily in the lower back. As a novel assistive technology, exoskeletons may serve as ergonomic tools to mitigate these work-related MSDs. It is essential to examine exoskeletons from the users’ perspectives before their widespread implementation in occupational settings. This study investigates the effectiveness of a passive back-support exoskeleton (BExo) in reducing perceived physical exertion and improving ergonomic safety in a manufacturing context. Twenty-two college students were recruited to perform MMH tasks in a controlled lab environment, both with and without the BExo, followed by completing a survey questionnaire on various aspects of the BExo. Using ANOVA, the study analyzed biomechanical exertion across various body parts and tasks. The findings indicate that the BExo substantially alleviated discomfort and physical exertion in the low back, shoulders and knees, thereby enhancing an ergonomic posture and reducing fatigue. These results underscore the potential of passive exoskeletons to boost workers’ safety and efficiency, providing valuable insights for future ergonomic strategies in industrial settings.
Extending Product Lifecycles—An Initial Model with New and Emerging Existential Design Aspects Required for Long and Extendable Lifecycles
Authors: Lindström John , Kyösti Petter , Psarommatis Foivos , Andersson Karl , Starck Enman Kristiina
Published: July 2024

This paper introduces an evaluated initial model for how product lifecycles can be extended considering new and emerging existential design aspects concerning both general as well as digital/connected products. The initial model, which is cyclic, includes reverse logistics of components and raw materials, as well as information on how to manage data at the end of lifecycles. The aim is to improve long-term sustainability with a high degree of circularity while also achieving increased profitability and competitiveness. Further, we highlighted that product providers must start to evaluate and prepare for how to improve product durability, manage long and extendable lifespans, and achieve circularity with reverse logistics to close the loops. Additionally, updatability and upgradability are also required to stay current with time and create value while being cybersecure. Otherwise, customers’ expectations, various legal and regulatory aspects, as well as other existential design aspects can halt or even terminate a product’s lifecycle.
A Multi-Performance Reliability Evaluation Approach Based on the Surrogate Model with Cluster Mixing Weight
Authors: Fan Xiaoduo , Wang Jiantai , Zhang Jianguo , Ni Ziqi
Published: July 2024

Kriging surrogate model has extracted extensive attention in reliability evaluation, owing to its excellent applicability and operability nowadays, which confronts with difficulties in balancing the efficiency and accuracy for complicated mechanical assets with multiple failure modes. Consequently, this paper devises a multi-performance reliability analysis approach within the surrogate model framework, particularly innovative in its use of cluster mixing weight. Specifically, high-value test points are selected to fit the surrogate model after sorting the samples referring to the corresponding values; then, a cluster-based active learning strategy is employed to accomplish rapid convergence, and the particle swarm algorithm is utilized to optimize relevant parameters. Afterwards, the mixing weight for every performance referring to the contributions to the final reliability is determined, and the failure probability is subsequently predicted. Furthermore, the superiority of the proposed approach with the clustering surrogate model and mixing weight, compared with traditional sampling as well as other surrogate models, has been verified via case studies, contributing to overcoming the multi-performance reliability analysis oriented to complicated mechanical assets.
The Development of Novel Edible Films from Single-Cell Protein Produced by the Biotechnological Valorization of Cheese Whey
Authors: Koukoumaki Danai Ioanna , Papanikolaou Seraphim , Ioannou Zacharias , Gkatzionis Konstantinos , Sarris Dimitris
Published: July 2024

The production of value-added products from microorganisms, such as single-cell protein (SCP), through the valorization of agricultural byproducts enhances circular economy while offering alternative solutions for waste treatment. In this study, SCP was obtained through the biotechnological treatment and valorization of cheese whey, the main byproduct of the dairy industry, for the development of novel edible films. To the best of the authors’ knowledge, this is the first report examining SCP as a biopolymer for edible film production. Specifically, Kluyveromyces marxianus, which has gained QPS and GRAS status, strain EXF-5288 cultivated in deproteinized cheese whey (DCW) lactose (10.0 g/L) in a 3 L fed-batch bioreactor, resulting in a SCPmax of 2.63 g/L with a protein content of up to 49.1% w/w. The addition of increased glycerol concentrations (30, 40, and 50% w/w of dry cells) as plasticizers was examined to develop SCP-based edible films. Regarding physicochemical characterization, increased glycerol concentration significantly increased moisture content (MC%) and solubility (S%), but there was not a significant difference in other parameters. Regarding wettability, SCP-based films could be described as oleophilic surfaces since the degree of oil contact angle (OCA) ranged between 46.7° ± 1.3 and 54.0° ± 0.5. The proposed holistic approach could contribute to the development of sustainable packaging materials through waste treatment.
Susceptibility Modeling and Potential Risk Analysis of Thermokarst Hazard in Qinghai–Tibet Plateau Permafrost Landscapes Using a New Interpretable Ensemble Learning Method
Authors: Yang Yuting , Wang Jizhou , Mao Xi , Lu Wenjuan , Wang Rui , Zheng Hao
Published: July 2024

Climate change is causing permafrost in the Qinghai–Tibet Plateau to degrade, triggering thermokarst hazards and impacting the environment. Despite their ecological importance, the distribution and risks of thermokarst lakes are not well understood due to complex influencing factors. In this study, we introduced a new interpretable ensemble learning method designed to improve the global and local interpretation of susceptibility assessments for thermokarst lakes. Our primary aim was to offer scientific support for precisely evaluating areas prone to thermokarst lake formation. In the thermokarst lake susceptibility assessment, we identified ten conditioning factors related to the formation and distribution of thermokarst lakes. In this highly accurate stacking model, the primary learning units were the random forest (RF), extremely randomized trees (EXTs), extreme gradient boosting (XGBoost), and categorical boosting (CatBoost) algorithms. Meanwhile, gradient boosted decision trees (GBDTs) were employed as the secondary learning unit. Based on the stacking model, we assessed thermokarst lake susceptibility and validated accuracy through six evaluation indices. We examined the interpretability of the stacking model using three interpretation methods: accumulated local effects (ALE), local interpretable model-agnostic explanations (LIME), and Shapley additive explanations (SHAP). The results showed that the ensemble learning stacking model demonstrated superior performance and the highest prediction accuracy. Approximately 91.20% of the total thermokarst hazard points fell within the high and very high susceptible areas, encompassing 20.08% of the permafrost expanse in the QTP. The conclusive findings revealed that slope, elevation, the topographic wetness index (TWI), and precipitation were the primary factors influencing the assessment of thermokarst lake susceptibility. This comprehensive analysis extends to the broader impacts of thermokarst hazards, with the identified high and very high susceptibility zones affecting significant stretches of railway and highway infrastructure, substantial soil organic carbon reserves, and vast alpine grasslands. This interpretable ensemble learning model, which exhibits high accuracy, offers substantial practical significance for project route selection, construction, and operation in the QTP.
Driving Factors of NOx Emissions in China: Insights from Spatial Regression Analysis
Authors: Abdelwahab Mahmoud M. , Shalaby Ohood A. , Semary H. E. , Abonazel Mohamed R.
Published: July 2024

China’s rapid industrialization and urbanization have led to significant nitrogen oxide (NOx) emissions, contributing to severe atmospheric pollution. Understanding the driving factors behind these emissions is crucial for effective pollution control and environmental management. Therefore, this study is an attempt to provide insights into the influence of socioeconomic factors and explore spatial dependencies of NOx emissions in China in 2022 employing spatial regression models (SRMs). Among the SRMs considered, the spatial Durbin model (SDM) is identified as the most suitable for analyzing regional NOx emissions. The study highlights the importance of controlling electricity consumption and vehicle emissions for addressing air pollution in Chinese regions. Specifically, a one billion kilowatt-hour increase in electricity consumption leads to approximately 549.6 tons of NOx emissions, and an increase of 1000 vehicles in a region results in an average increase of 7113.4 tons of NOx emissions in the same region. Furthermore, per capita consumption expenditure (PCEXP) and research and development (R&D) expenditure exhibit negative direct and spillover impacts. Contrary to previous studies, this research finds that changes in urban population density do not have a significant direct or indirect effect on NOx emissions within the studied areas. Moreover, we conducted additional investigations to assess the effectiveness of government action plans in reducing NOx emissions. Specifically, we evaluated the impact of Phases 1 and 2 of the Clean Air Action Plan, launched in 2013 and 2018, respectively, on the socioeconomic drivers of NOx emissions. Therefore, the data were modeled for the years 2013 and 2017 and compared to the results obtained for 2022. The findings indicate that over the entire period (2013–2022), the emission controls mandated by the action plan resulted in significant reductions in the impact of many of the studied NOx drivers. In conclusion, based on the results, this study presents recommendations to mitigate NOx emissions.
Optimization and Validation of Analytical Methodology for Determination of Pesticides in Grape, Must and Wine Samples with QuEChERS Extraction and Gas Chromatography–Mass Spectrometry
Authors: Sykalia Dionysia L. , Trantopoulos Epameinondas P. , Tsoutsi Charoula S. , Albanis Triantafyllos A.
Published: July 2024

This study is focused on the optimization and application of an analytical methodology for the determination of 15 selected pesticides in three substrates during the vinification process. QuEChERS extraction was used followed by GC-MS to develop a simple and rapid method for the determination of these compounds. The optimized methodology was validated, providing for all selected pesticides excellent linearity, recoveries ranging between 60.9% and 95.0% and LOQs lower than 50 ng g−1 f for all substrates. The developed methodology was tested on real samples of grapes, must and wine obtained from a winery in the Epirus region. The results indicated the existence of some of the selected pesticides at comparatively low levels in contrast to the valid MRLs.
Phytoplankton Assemblage over a 14-Year Period in the Adriatic Sea: Patterns and Trends
Authors: Skejić Sanda , Milić Roje Blanka , Matić Frano , Arapov Jasna , Francé Janja , Bužančić Mia , Bakrač Ana , Straka Maja , Ninčević Gladan Živana
Published: July 2024

Considering the role of phytoplankton in the functioning and health of marine systems, it is important to characterize its responses to a changing environment. The central Adriatic Sea, as a generally oligotrophic area, is a suitable environment to distinguish between regular fluctuations in phytoplankton and those caused by anthropogenic or climatic influences. This study provides a long-term perspective of phytoplankton assemblage in the central eastern Adriatic Sea, with 14 years of continuous time series data collected at two coastal and two offshore stations. The predominant phytoplankton groups were diatoms and phytoflagellates, but their proportion varied depending on the vicinity of the coast, as evidenced also by the distribution of chlorophyll a. In the coastal environment, the phytoplankton biomass was substantially higher, with a higher proportion of microphytoplankton, while small phytoplankton accounted for the majority of biomass in the offshore area. In addition, a decreasing trend in diatom abundance was observed in the coastal waters, while such trend was not so evident in the offshore area. Using a neural gas algorithm, five clusters were defined based on the contribution of the major groups. The observed increase in diversity, especially in dinoflagellates, which outnumber diatom taxa, could be a possible adaptation of dinoflagellates to the increased natural solar radiation in summer and the increased sea surface temperature.
Skin Surface Sebum Analysis by ESI-MS
Authors: Isom Madeline , Desaire Heather
Published: July 2024

The skin surface is an important sample source that the metabolomics community has only just begun to explore. Alterations in sebum, the lipid-rich mixture coating the skin surface, correlate with age, sex, ethnicity, diet, exercise, and disease state, making the skin surface an ideal sample source for future noninvasive biomarker exploration, disease diagnosis, and forensic investigation. The potential of sebum sampling has been realized primarily via electrospray ionization mass spectrometry (ESI-MS), an ideal approach to assess the skin surface lipidome. However, a better understanding of sebum collection and subsequent ESI-MS analysis is required before skin surface sampling can be implemented in routine analyses. Challenges include ambiguity in definitive lipid identification, inherent biological variability in sebum production, and methodological, technical variability in analyses. To overcome these obstacles, avoid common pitfalls, and achieve reproducible, robust outcomes, every portion of the workflow—from sample collection to data analysis—should be carefully considered with the specific application in mind. This review details current practices in sebum sampling, sample preparation, ESI-MS data acquisition, and data analysis, and it provides important considerations in acquiring meaningful lipidomic datasets from the skin surface. Forensic researchers investigating sebum as a means for suspect elimination in lieu of adequate fingerprint ridge detail or database matches, as well as clinical researchers interested in noninvasive biomarker exploration, disease diagnosis, and treatment monitoring, can use this review as a guide for developing methods of best-practice.
CCZ1 Accelerates the Progression of Cervical Squamous Cell Carcinoma by Promoting MMP2/MMP17 Expression
Authors: Yu Jing , Yuan Zhenlong , Liu Jing , Deng Lu , Zhao Yuting , Wang Shengnan , Tang Enyu , Yang Xi , Li Ning , An Jusheng , Wu Lingying
Published: July 2024

Cervical squamous cell carcinoma (CSCC) represents a significant global health concern among females. Identifying new biomarkers and therapeutic targets is pivotal for improving the prognosis of CSCC. This study investigates the prognostic relevance of CCZ1 in CSCC and elucidates its downstream pathways and targets using a combination of bioinformatics analysis and experimental validation. Transcriptomic analysis of 239 CSCC and 3 normal cervical samples from The Cancer Genome Atlas database reveals a marked upregulation of CCZ1 mRNA levels in CSCC, and elevated CCZ1 mRNA levels were associated with poor prognosis. Immunohistochemical analysis of clinical samples also confirmed these findings. Furthermore, functional assays, including Cell Counting Kit-8, colony formation, Transwell, and flow cytometry, elucidated the influence of CCZ1 on CSCC cell proliferation, migration, invasion, and cell cycle progression. Remarkably, CCZ1 knockdown suppressed CSCC progression both in vitro and in vivo. Mechanistically, CCZ1 knockdown downregulated MMP2 and MMP17 expression. Restoring MMP2 or MMP17 expression rescued phenotypic alterations induced by CCZ1 knockdown. Hence, CCZ1 promotes CSCC progression by upregulating MMP2 and MMP17 expression, emerging as a novel biomarker in CSCC and presenting potential as a therapeutic target in CSCC.
Reduction in Xenogeneic Epitopes on Porcine Endothelial Cells by Periodate Oxidation
Authors: Thom Jonas , Roters Nathalie , Schuemann Slavica , Andrée Birgit , Buettner Falk F. R. , Hilfiker Andres , Goecke Tobias , Ramm Robert
Published: July 2024

Background: Patterns of humoral immune responses represent a major hurdle in terms of pig-to-human xenotransplantation approaches. The best-known xenogeneic glycan antigens present in pigs are the αGal (Galili antigen) and the non-human sialic acid Neu5Gc. As there are further differences between porcine and human cellular surface glycosylation, a much broader range of glycan epitopes with xeno-reactive relevance can be anticipated. Therefore, we set out to chemically modify porcine cellular surface glycans in a global approach by applying sodium periodate (NaIO4) oxidation. Methods: Porcine endothelial cells were exposed to oxidation with 1 to 5 mM NaIO4 for different time periods at 37 °C or 4 °C and under static or dynamic conditions. The impact on cellular survival was determined by applying live/dead assays. Oxidation of αGal-epitopes was assessed by fluorescence microscopy-based quantification of isolectin-B4 (IL-B4) staining. Overall immunogenicity of porcine cells was determined by human serum antibody binding. Results: Treatment of porcine endothelial cells and tissues with NaIO4 led to reduced binding of the αGal-specific IL-B4 and/or human serum antibodies. NaIO4 was revealed to be cytotoxic when performed at elevated temperatures and for a prolonged time. However, by applying 2 mM NaIO4 for 60 min at 4 °C, a high extent of cellular viability and a relevant reduction in detectable αGal epitope were observed. No differences were detected irrespectively on whether the cells were oxidized under static or flow conditions. Conclusions: Glycan epitopes on living cells can be oxidized with NaIO4 while maintaining their viability. Accordingly, this strategy holds promise to prevent immune reactions mediated by preformed anti-glycan antibodies.
Correction: Raman et al. Relationships between Affect Recognition, Empathy, Alexithymia, and Co-Occurring Conditions in Autism. Brain Sci. 2023, 13, 1161
Authors: Raman Nandita , Ringold Sofronia M. , Jayashankar Aditya , Butera Christiana D. , Kilroy Emily , Harrison Laura , Cermak Sharon A. , Aziz-Zadeh Lisa
Published: July 2024

In the original publication [...]
Prestress Force and General Excitation Identification for Plate-like Concrete Bridges
Authors: Wang Wensen , Xiang Ziru , Wang Yi , Shao Xuejun , Lu Jieyu
Published: July 2024

Prestress force dominates the carrying capacity of concrete girders, and is vital for bridge health monitoring. Many vibrational-based methods have been proposed to determine prestress using bridge responses induced by known excitations, which means that they can barely use the normal traffic of in-service bridges as excitation to achieve long-term monitoring. Moreover, most studies are based on beam theory, which may not be precise for plate-like bridges. Hence, this paper establishes a motion equation for a prestressed slab via Kirchhoff’s plate theory and proposes a two-step procedure to assess the prestress and general excitation simultaneously through only bridge responses. The excitation is determined in the first step via the Load Shape function method and used as input for the prestress identification via state-space formulation in the second step. A numerical study on a prestressed plate subjected to a moving load is conducted. Considering different levels of measurement noise and load speed, the proposed method can determine the prestress and moving load with 7.33% and 10.18% error, respectively. A laboratory test on a prestressed box girder subjected to a fixed cyclic load is performed, the prestress and cyclic load are both determined to have good stability, and the errors are under 11.32%.
Strength Prediction of Smart Cementitious Materials Using a Neural Network Optimized by Particle Swarm Algorithm
Authors: Zhang Pengfei , Kong Fan , Hai Lu
Published: July 2024

Because of the improved physical, mechanical and crack–resistant properties, smart cementitious materials have garnered significant attention in civil engineering. However, the method of predicting performance of smart cementitious materials remains a formidable task. To address this issue, this study develops a neural network optimized by particle swarm algorithm, specifically designed for predicting the strength of smart cementitious materials. Particle swarm optimization is used to determine the initial weights and biases of the neural network in this algorithm. Two types of smart cementitious materials, namely 3D printed fiber reinforced concrete and graphene nanoparticles–reinforced cementitious composites, are studied as examples. Utilizing the PSO–BPNN method and data gathered from the existing articles, the predictive models for the mechanical properties of these materials are developed. Five commonly used statistical metrics are applied to evaluate the predictive performance. The results indicate suggest the PSO–BPNN outperforms the traditional back propagation neural network. Thus, a reliable and robust performance predictive model can be built for smart cementitious materials using the proposed approach.
ALdamage-seg: A Lightweight Model for Instance Segmentation of Aluminum Profiles
Authors: Zhu Wenxuan , Su Bochao , Zhang Xinhe , Li Ly , Fang Siwen
Published: July 2024

Aluminum profiles are widely used in various manufacturing sectors due to their flexibility and chemical properties. However, these profiles are susceptible to defects during manufacturing and transportation. Detecting these defects is crucial, but existing object detection models like Mask R-CNN and YOLOv8-seg are not optimized for this task. These models are large and computationally intensive, making them unsuitable for edge devices used in industrial inspections. To address this issue, this study proposes a novel lightweight instance segmentation model called AL-damage-seg, inspired by the YOLOv8n-seg architecture. This model utilizes MobileNetV3 as the backbone. In YOLOv8n-seg, the role of C2f is to enhance the nonlinear representation of the model to capture complex image features more efficiently. We upgraded and improved it to form multilayer feature extraction module (MFEM) and integrates a large separable kernel attention (LSKA) mechanism in the C2f module, resulting in C2f_LSKA, to further optimize the performance of the model. Additionally, depth-wise separable convolutions are employed in the feature fusion process. The ALdamage-seg’s weight on the Alibaba Tian-chi aluminum profile dataset constitutes 43.9% of that of YOLOv8n-seg, with its GFLOPs reduced to 53% relative to YOLOv8-seg, all the while achieving an average precision (mAP) of 99% relative to YOLOv8-seg. With its compact size and lower computational requirements, this model is well-suited for deployment on edge devices with limited processing capabilities.
Theoretical Studies on the Dynamical Behavior of Atom/Ion Migration on the Surface of Pristine and BN-Doped Graphene
Authors: Zhang Tong-Kun , Zhou Li-Jun , Guo Jian-Gang
Published: July 2024

Using the potential function method, a theoretical model of the interaction was presented, and the interaction force between atoms/ions and (doped) graphene was obtained. Based on the interaction force, the dynamical control equation of atom/ion migration was derived. The dynamical behavior of atom/ion migrating on finite-size graphene surfaces along a specific direction and the regulation of boron nitride (BN) doping on the migration behavior were studied. The results show that the atoms/ions exhibit different migration mechanical behaviors due to different lateral forces inside and at the edges of the graphene surface. In addition, near the normal equilibrium height, atoms/ions are mainly affected by the lateral force, and their migration behavior is also influenced by the initial position, initial height, initial lateral velocity, etc. Furthermore, BN doping can affect the energy barrier of atom/ion migration on the graphene surface and effectively regulate the migration behavior of atoms/ions at the edge of the graphene surface. The research results can provide a theoretical reference for graphene surface localization modification and graphene-based atom/ion screening and detection.
Patterns of Formation of Binary Cobalt–Magnesium Oxide Combustion Catalysts of Various Composition
Authors: Khussain Bolatbek , Sass Alexandr , Brodskiy Alexandr , Rakhmetova Kenzhegul , Torlopov Ivan , Zhylkybek Magira , Baizhumanova Tolkyn , Tungatarova Svetlana , Khussain Atabek , Zhurinov Murat , Kenessary Abzal , Tyulebayeva Ranida , Logvinenko Alexandr , Narimanov Yernar
Published: July 2024

In order to establish the formation patterns of the Co–Mg oxide system, samples with different Co:Mg ratios and heat treatment temperatures were synthesized and studied. A study of the samples confirmed the phase transition of MgxCo2–xO4 spinels into the corresponding solid solutions at 800–900 °C. The similarity of the formation patterns for different compositions is shown. The rocksalt oxide in low-temperature samples is an anion-modified paracrystalline phase that forms a “true” solid solution only upon spinel decomposition. The TPR profiles of the decomposed Co3O4 spinel show surface Co3O4 peaks and a wide peak corresponding to the well-crystallized CoO, while partial Co3O4 TPR up to 380 °C results in dispersed and amorphous CoO. The high-temperature non-stoichiometric samples are poorly reduced, indicating their low oxygen reactivity. Spinel reoxidation after heat treatment to 1100 °C by calcination at 750 °C showed complete regeneration for MgCo2O4–Co3O4 samples and its absence in case of an excess of MgO relative to stoichiometry.
Neurodevelopmental Disorders Associated with Gut Microbiome Dysbiosis in Children
Authors: Borrego-Ruiz Alejandro , Borrego Juan J.
Published: July 2024

The formation of the human gut microbiome initiates in utero, and its maturation is established during the first 2–3 years of life. Numerous factors alter the composition of the gut microbiome and its functions, including mode of delivery, early onset of breastfeeding, exposure to antibiotics and chemicals, and maternal stress, among others. The gut microbiome–brain axis refers to the interconnection of biological networks that allow bidirectional communication between the gut microbiome and the brain, involving the nervous, endocrine, and immune systems. Evidence suggests that the gut microbiome and its metabolic byproducts are actively implicated in the regulation of the early brain development. Any disturbance during this stage may adversely affect brain functions, resulting in a variety of neurodevelopmental disorders (NDDs). In the present study, we reviewed recent evidence regarding the impact of the gut microbiome on early brain development, alongside its correlation with significant NDDs, such as autism spectrum disorder, attention-deficit/hyperactivity disorder, Tourette syndrome, cerebral palsy, fetal alcohol spectrum disorders, and genetic NDDs (Rett, Down, Angelman, and Turner syndromes). Understanding changes in the gut microbiome in NDDs may provide new chances for their treatment in the future.
A Systematic Review on Ketamine and Esketamine for Treatment-Resistant Depression and Suicidality in Adolescents: A New Hope?
Authors: Pardossi Simone , Fagiolini Andrea , Scheggi Simona , Cuomo Alessandro
Published: July 2024

Treating depression in adolescents is a significant challenge, and major depressive disorder (MDD) with suicidal ideation and treatment-resistant depression (TRD) are common and potentially devastating to optimal psychological and physical development in this age group. Suicide is among the leading causes of youth mortality, and TRD occurs in up to 40% of adolescents with MDD. TRD involves severe, persistent symptoms that are hard to treat, significantly reducing functioning and quality of life. We conducted a literature search focusing on key terms related to ketamine and esketamine for MDD with suicidal ideation and TRD in adolescents, aiming to review the potential utility of these molecules in adolescents for these conditions. Ketamine has shown efficacy in reducing depressive symptoms in adolescents with TRD. Esketamine has shown efficacy in reducing depressive symptoms and treating suicidal ideation in adolescents. Both ketamine and esketamine have demonstrated favorable safety and tolerability profiles. Using these drugs for serious conditions like adolescent MDD with suicidal thoughts and TRD can effectively treat symptoms, reduce self-harm and suicide risks, and provide a window for longer-term therapeutic interventions. The prompt and effective treatment of TRD could improve adolescents’ quality of life. However, more research is needed to optimize treatment protocols and evaluate long-term effects.
Self-Perception Profile, Body Image Perception and Satisfaction in Relation to Body Mass Index: An Investigation in a Sample of Adolescents from the Campania Region, Italy
Authors: Ballarin Giada , Gallè Francesca , Dinacci Lucia , Liberti Federica , Cunti Antonia , Valerio Giuliana
Published: July 2024

(1) Background: Body image dissatisfaction has been commonly reported in adolescents with overweight/obesity and has been related to a lack of motivation to change lifestyle behaviors. Plus, a better perception of physical fitness has been related to a higher self-perception in physical aspect and social items in youths. (2) Methods: A total of 120 (59.2% males, mean age of 12.3 ± 0.9 years) middle-school adolescents participated in the present study. Anthropometric measurements were assessed following the standard procedures. Body weight perception and body image satisfaction were assessed using the Silhouette Figure Body Images Test. Self-perception profile, perceived physical fitness, and perceived difficulties in conducting physical tasks were assessed by using structured questionnaires. (3) Results: Overweight was present in 27.5% adolescents and obesity in 32.5%. A total of 89.7% of adolescents with obesity did not have a real perception of his/her weight status and 84.6% of adolescents with obesity were not satisfied with his/her body image. The self-perception of physical appearance, perceived difficulties in running, perceived overall fitness, and perceived speed/agility were lower in adolescents who were unsatisfied with their body image. Body image satisfaction was positively associated with the self-perception of physical appearance and overall fitness and negatively associated with perceived difficulties in running, independently of sex, age, and BMI. (4) Conclusions: Adolescents with obesity did not have a real perception of their weight status and were unsatisfied with their body image. The positive association between body satisfaction, a better perception of overall fitness, and less difficulties in conducting physical tasks suggests the protective role of the components of physical activity and health-related fitness on body acceptance in a critical period of life.
Chronic Kidney Disease and Growth Failure in Children
Authors: Todisco Tommaso , Ubertini Grazia Maria , Bizzarri Carla , Loche Sandro , Cappa Marco
Published: July 2024

Chronic kidney disease (CKD) is a significant challenge for pediatric endocrinologists, as children with CKD may present a variety of endocrine complications. Growth failure is common in CKD, and its severity is correlated with the degree of renal insufficiency. Management strategies include addressing reversible comorbidities, optimizing nutrition, and ensuring metabolic control. Kidney replacement therapy, including transplantation, determines a significant improvement in growth. According to a recent Consensus Statement, children with CKD stage 3—or on dialysis older >6 months—are eligible for treatment with recombinant growth hormone (rGH) in the case of persistent growth failure. Treatment with rGH may be considered for those with height between the 3rd and 10th percentile and persistent growth deceleration. In children who received kidney transplantation but continue to experience growth failure, initiation of GH therapy is recommended one year post-transplantation if spontaneous catch-up growth does not occur and steroid-free immunosuppression is not an option. In children with CKD, due to nephropathic cystinosis and persistent growth failure, GH therapy should be considered at all stages of CKD. Potential adverse effects and benefits must be regularly assessed during therapy. Treatment with GH is safe in children with CKD. However, its general efficacy is still controversial. All possible problems with a negative impact on growth should be timely addressed and resolved, whenever possible with a personalized approach to the patient. GH therapy may be useful in promoting catch-up growth in children with residual growth potential. Future research should focus on refining effective therapeutic strategies and establishing consensus guidelines to optimize growth outcomes in this population.
Feasibility and Acceptability of Yoga for Adolescents with Juvenile Idiopathic Arthritis
Authors: Dawoud Adina , Blitz Jill , Moonaz Steffany , Grout Leah
Published: July 2024

Background/Objectives: Yoga is effective for adults with arthritis but unstudied in adolescents with juvenile idiopathic arthritis (JIA). Methods: A pilot study assessed the feasibility and acceptability of an 8-week group yoga intervention for adolescents ages 14–18 with JIA. Each 75-min session included breathing techniques, relaxation, mindfulness, and modified yoga postures, using yoga props and a rope wall. An online video was available for home practice. The outcome measures administered at the baseline and at 8 weeks were physician global assessment with joint count, visual assessment with a joint damage assessment index, the Pediatric Quality of Life Arthritis Module 3.0 (Peds QL), and the visual analog scale for pain. Results: Thirteen out of 25 participants attended ≥1 class with a mean of 5.7 ± 2.2 classes. Common reasons for non-enrollment included distance, schedule, and lack of interest. The average distance to classes was 29.0 ± 41.7 miles. There was a trend toward improvement for joint count (p = 0.07), global assessment (p = 0.10), and the Pain and Hurt domain of the Peds QL (p = 0.13), but no other outcomes approached significance. Satisfaction data from an anonymous survey (n = 8) were high in all areas. Conclusions: Adolescents with JIA who attended yoga reported enjoyment, pain reduction, and interest in continued practice with no adverse events. Future studies should consider stakeholder engagement to reduce barriers and larger sample sizes to test the effectiveness.
Muscle Mass as a Biomarker for Health Status and Function in Pediatric Individuals with Neuromuscular Disabilities: A Systematic Review
Authors: Ferrara Isabella R. , Sadowsky Cristina L.
Published: July 2024

This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in this analysis, articles must have had participants with an average age ≤21, focus on children with neuromuscular disabilities, and primarily examine relationships between muscle mass and any functional or health outcomes measure. Studies including typically developing children were used to contrast and enhance findings. Thirty-two studies were included, with 10,129 unique individuals represented: seventeen studies focused on healthy/typically developing children; seven on children with cerebral palsy; three on children with Duchenne muscular dystrophy; two on children with sarcopenia; and one study each on children with osteoporosis, congenital muscular dystrophy, and other various neurologic disorders. Thirteen studies assessed functional outcomes, ten assessed bone outcomes, and nine assessed other cardiovascular/metabolic outcomes. All of the included studies demonstrated relationships between muscle mass and respective outcomes in varying measures. The results of this review demonstrate that there is a consistently recognized relationship between muscle mass and important health outcomes in children, supporting clinically targeting muscle mass as a means to optimize desired outcomes.
Nutrient and Hormonal Effects on Long Bone Growth in Healthy and Obese Children: A Literature Review
Authors: Hasan Sazid , Naseer Shahrukh , Zamzam Mazen , Mohilldean Hashem , Van Wagoner Colin , Hasan Ahmad , Saleh Ehab S. , Uhley Virginia , Kamel-ElSayed Suzan
Published: July 2024

Longitudinal bone growth is mediated through several mechanisms including macro- and micronutrients, and endocrine and paracrine hormones. These mechanisms can be affected by childhood obesity as excess adiposity may affect signaling pathways, place undue stress on the body, and affect normal physiology. This review describes the physiology of the epiphyseal growth plate, its regulation under healthy weight and obesity parameters, and bone pathology following obesity. A literature review was performed utilizing PubMed, PMC, NIH, and the Cochrane Database of Systematic Reviews pertinent to hormonal and nutritional effects on bone development, child obesity, and pathologic bone development related to weight. The review indicates a complex network of nutrients, hormones, and multi-system interactions mediates long bone growth. As growth of long bones occurs during childhood and the pubertal growth spurt, pediatric bones require adequate levels of minerals, vitamins, amino acids, and a base caloric supply for energy. Recommendations should focus on a nutrient-dense dietary approach rather than restrictive caloric diets to maintain optimal health. In conclusion, childhood obesity has profound multifaceted effects on the developing musculoskeletal system, ultimately causing poor nutritional status during development. Weight loss, under medical supervision, with proper nutritional guidelines, can help counteract the ill effects of childhood obesity.
Reciprocal Interactions of Human Monocytes and Cancer Cells in Co-Cultures In Vitro
Authors: Paduch Roman , Klatka Maria , Pieniądz Paulina , Wertel Iwona , Pawłowska Anna , Klatka Janusz
Published: July 2024

The tumor microenvironment (TME) includes immune and stromal cells and noncellular extracellular matrix (ECM) components. Tumor-associated macrophages (TAMs) are the most important immune cells in TME and are crucial for carcinomas’ progression. The purpose was to analyze direct and indirect interactions in co-culture of tumor cells with monocytes/macrophages and, additionally, to indicate which interactions are more important for cancer development. Cytokines, reactive oxygen species, nitric oxide level, tumor cell cycle and changes in tumor cell morphology after human tumor cells (Hep-2 and RK33 cell lines) with human monocyte/macrophage (THP-1 cell line) interactions were tested. Morphology and cytoskeleton organization of tumor cells did not change after co-culture with macrophages. In co-culture of tumor cells with human monocyte, changes in the percentage of tumor cells in cell cycle phases was observed. No significant changes in reactive oxygen species (ROS) were found in the co-culture as compared to the tumor cell mono-culture. Monocytes produced about three times higher ROS than tumor cells. In co-cultures, a lower nitric oxide (NOx) level was found as compared to the sum of the production by both mono-cultures. Co-culture conditions limited the production of cytokines (IL-4, IL-10 and IL-13) as compared to the sum of their level in mono-cultures. In conclusion, macrophages influence tumor cell growth and functions. Mutual (direct and paracrine) interactions between tumor cells and macrophages changed cytokine production and tumor cell cycle profile. The data obtained may allow us to initially indicate which kind of interactions may have a greater impact on cancer development processes.
The Impact of Thyroidectomy and Lobectomy on Patients’ Health-Related Quality of Life, Eastern Region, Saudi Arabia
Authors: AlOsaif Zainab Ali , Al Bisher Hassan Mohammed , Elshnawie Hend Abdelmonem , Al-Hariri Mohammed Taha
Published: July 2024

Introduction: The thyroid gland is a crucial endocrine organ that can be susceptible to various pathological conditions, often necessitating total thyroidectomy or lobectomy. It is a common surgical procedure in Saudi Arabia. Thus, it is essential to recognize the impact of thyroid surgery on patients’ health-related quality of life (HRQoL). Aim: The aim of this study was to evaluate HRQoL among patients with benign and malignant thyroid diseases who underwent thyroidectomy in the eastern region of Saudi Arabia. Methods: This cross-sectional study was conducted at King Fahad Hospital of University in Khobar, Kingdom of Saudi Arabia from January 2018 to May 2018. The data collection method used was divided into two parts. Part I included the patients’ socio-demographic characteristics and the clinical characteristics of their thyroid surgery. Part II was a HRQoL questionnaire (SF-36, version 1.0). Results: The sample included 100 thyroidectomy patients ≥18 years. The study findings revealed that the overall scores for post-thyroidectomy patients showed a significant improvement in HRQoL, and HRQoL was not significantly associated with benign or malignant thyroid diseases. Conclusion: Especially when the surgery is performed by a high-volume endocrine surgeon, thyroidectomy may lead to significant improvements in HRQoL among patients, including the elderly and younger adults, with benign and malignant thyroid disorders. There was no difference in HRQoL between patients who underwent total thyroidectomy or thyroid lobectomy. Also, HRQol among thyroidectomy patients is associated with their educational and occupational statuses.
Contrast Role of Third Body Layer and Hard Abrasives in the Wear Process of a TiAlSiN Hardness-Modulated Multilayer Coating: A Case Study on the Effect of Normal Load and Velocity
Authors: Zhao Fan , Zhu Zhou , Yu Jiaxin , Luo Zhiquan , Qi Huimin
Published: July 2024

Working conditions exert an important influence on the tribological properties of protective coatings, thus affecting the wear resistance of workpieces. In this work, a TiAlSiN hardness-modulated multilayer coating with a good match of strength and toughness was deposited on WC-Co substrates. The adhesive wear played a predominant role under the condition of a larger normal load and lower velocity, leading to the formation of a third body layer composed of compressed and lubricating oxides. As a result, the wear rate of the coating tested at 20 N reduced by 23% of that tested at 5 N. Instead, abrasive wear was more manifest, leading to the formation of big-size abrasives, and thus the wear rate increased by 2.8 times while the velocity elevated from 4 mm/s to 16 mm/s. A full factorial analysis of the wear behaviors, including the nanohardness and roughness of the wear track, and the friction coefficient and wear rate of the coating, offered good guidance for the comprehension of the wear form of the TiAlSiN multilayer coating. The results demonstrated the optimization of multilayer structures for TiAlSiN coatings to attain better wear resistance under coupling conditions of normal load and velocity: harder or more lubricated sublayers.