bluuebunny/crossref_metadata_2025 huggingface dataset:
AI-Enhanced Dyscalculia Screening: A Survey of Methods and Applications for Children
Authors: Bhushan Shashi , Arunkumar Sharmila , Eisa Taiseer Abdalla Elfadil , Nasser Maged , Singh Anuj Kumar , Kumar Pramod
Published: July 2024

New forms of interaction made possible by developments in special educational technologies can now help students with dyscalculia. Artificial intelligence (AI) has emerged as a promising tool in recent decades, particularly between 2001 and 2010, offering avenues to enhance the quality of education for individuals with dyscalculia. Therefore, the implementation of AI becomes crucial in addressing the needs of students with dyscalculia. Content analysis techniques were used to examine the literature covering the influence of AI on dyscalculia and its potential to assist instructors in promoting education for individuals with dyscalculia. The study sought to create a foundation for a more inclusive dyscalculia education in the future through in-depth studies. AI integration has had a big impact on educational institutions as well as people who struggle with dyscalculia. This paper highlights the importance of AI in improving the educational outcomes of students affected by dyscalculia.
Stochastic Debt Sustainability Analysis in Romania in the Context of the War in Ukraine
Authors: Dobrotă Gabriela , Voda Alina Daniela
Published: July 2024

Public debt is determined by borrowings undertaken by a government to finance its short- or long-term financial needs and to ensure that macroeconomic objectives are met within budgetary constraints. In Romania, public debt has been on an upward trajectory, a trend that has been further exacerbated in recent years by the COVID-19 pandemic. Additionally, a significant non-economic event influencing Romania’s public debt is the war in Ukraine. To analyze this, a stochastic debt sustainability analysis was conducted, incorporating the unique characteristics of Romania’s emerging market into the research methodology. The projections focused on achieving satisfactory results by following two lines of research. The first direction involved developing four scenarios to assess the risks presented by macroeconomic shocks. Particular emphasis was placed on an unusual negative shock, specifically the war in Ukraine, with forecasts indicating that the debt-to-GDP ratio could reach 102% by 2026. However, if policymakers implement discretionary measures, this level could be contained below 88%. The second direction of research aimed to establish the maximum safe limit of public debt for Romania, which was determined to be 70%. This threshold would allow the emerging economy to manage a reasonable level of risk without requiring excessive fiscal efforts to maintain long-term stability.
Improved Implementation of Chua’s Circuit on an Active Inductor and Non-Autonomous System
Authors: Zhang Ziqi , Wen Yiming , Ning Yafei , Zhang Zirui , Li Hu , Xia Yuhan
Published: July 2024

Chua’s circuit is a well-established model for studying chaotic phenomena and is extensively implemented in fields like encrypted communication. However, a traditional Chua’s circuit has large volume, high component precision requirements and limited adjustable parameter range, which are not conducive to application. In order to solve these problems, we propose an improved implementation of Chua’s circuit on an active inductor and non-autonomous system. First, we adopt the strategy of using active inductors instead of traditional passive inductors, achieving the miniaturization of the circuit and improving the accuracy of inductance. In addition, we present the theory of substituting non-autonomous systems for classical autonomous systems to reduce the requirements for the accuracy of components and improve the robustness of the circuit. Lastly, we connect the extension resistor in parallel with Chua’s diode to optimize circuit structure, thereby increasing the range of the adjustable parameter. Based on the three improvements above, experiments have shown that the average maximum error tolerance of components of our improved design has been increased from 1.88% to 7.38% when generating a single vortex, and from 4.73% to 12.61% when generating a double vortex, compared with the traditional Chua’s circuit. The range of the adjustable parameter has been increased by 195.83% and 36.98%, respectively, when generating a single vortex and double vortex. In summary, our improved circuit is more practical than the traditional Chua’s circuit and has good application value.
Frequency-Auxiliary One-Shot Domain Adaptation of Generative Adversarial Networks
Authors: Cheng Kan , Liu Haidong , Liu Jiayu , Xu Bo , Liu Xinyue
Published: July 2024

Generative domain adaptation in a one-shot scenario involves transferring a pretrained generator from one domain to another using only a single reference image. To address the issue of extremely scarce data, existing methods resort to complex parameter constraints and leverage additional semantic knowledge from CLIP models to mitigate it. However, these methods still suffer from overfitting and underfitting issues due to the lack of prior knowledge about the domain adaptation task. In this paper, we firstly introduce the perspective of the frequency domain into the generative domain adaptation task to support the model in understanding the adaptation goals in a one-shot scenario and propose a method called frequency-auxiliary GAN (FAGAN). The FAGAN contains two core modules: a low-frequency fusion module (LFF-Module) and high-frequency guide module (HFG-Module). Specifically, the LFF-Module aims to inherit the domain-sharing information of the source module by fusing the low-frequency features of the source model. In addition, the HFG-Module is designed to select the domain-specific information of the reference image and guide the model to fit them by utilizing high-frequency guidance. These two modules are dedicated to alleviating overfitting and underfitting issues, thereby enchancing the diversity and fidelity of generated images. Extensive experimental results showed that our method leads to better quantitative and qualitative results than the existing methods under a wide range of task settings.
An Improved Collaborative Estimation Method for Determining The SOC and SOH of Lithium-Ion Power Batteries for Electric Vehicles
Authors: Liu Yixin , Lei Ao , Yu Chunyang , Huang Tengfei , Yu Yuanbin
Published: July 2024

With the increase in the amount of actual operating data on electric vehicles, how to analyze and process useful information from existing battery charging and discharging data and apply it to subsequent state estimation is worthy of in-depth thinking and practice by researchers. This article proposes a collaborative estimation architecture for SOC and SOH based on the 1RC equivalent circuit model, recursive least squares, and adaptive extended Kalman filtering algorithms (AEKF), which combine offline data processing with online applications. By applying offline data processing, OCV–SOC polynomial fitting and average polarization resistance were determined, which reduced the time required for basic data measurement and improved the accuracy of model parameter identification, while a recursive estimation combining micro- and macro-time-scales of AEKF was used for the online real-time estimation of the SOC and actual available capacity of batteries, in order to eliminate interference from measurement and process noise. The results of the simulated and experimental data validation indicate that the proposed algorithm is applicable to the lithium-ion batteries studied in this paper, the average SOC deviation is less than 1.5%, the maximum deviation is less than 2.02%, and the SOH estimation deviation is less than 1% under different driving conditions in the multi-temperature range. This study lays the foundation for further utilizing offline data and improving SOC and SOH collaborative estimation algorithms.
Wellbore Integrity Analysis of a Deviated Well Section of a CO2 Sequestration Well under Anisotropic Geostress
Authors: Wang Xiabin , Jia Shanpo , Gao Shaobo , Zhao Long , Qi Xianyin , He Haijun
Published: July 2024

On the basis of “Carbon Peak and Carbon Neutral” goals, carbon sequestration projects are increasing in China. The integrity of cement sheaths, as an important factor affecting carbon sequestration projects, has also received more attention and research. When CO2 is injected into the subsurface from sequestration wells, the cement sheath may mechanically fail due to the pressure accumulated inside the casing, which leads to the sealing of the cement sheath failing. The elasticity and strength parameters of the cement sheath are considered in this paper. The critical bottom-hole injection pressures of inclined well sections under anisotropic formation stresses at different depths were calculated for actual carbon-sealing wells in the X block—the CO2 sequestration target block. The sensitivity factors of the critical bottom-hole injection pressure were also analyzed. It was found that the cement sheath damage criterion was tensile damage. The Young’s modulus and tensile strength of the cement sheath are the main factors affecting the mechanical failure of the cement sheath, with Poisson’s ratio having the second highest influence. An increase in the Young’s modulus, Poisson’s ratio, and tensile strength of the cement sheath can help to improve the mechanical stability of cement sheaths in CO2 sequestration wells. This model can be used for the design and evaluation of cement in carbon sequestration wells.
Mass Balance-Based Quality Control of PVT Results of Reservoir Oil DL Studies
Authors: Papanikolaou Panagiotis , Kanakaki Eirini Maria , Lempesis Stefanos , Gaganis Vassilis
Published: July 2024

Fluid properties live at the heart of hydrocarbon reservoir engineering as it is related to the behavior of fluids under reservoir pressure depletion. To obtain their values, PVT experimental work needs to be performed. Although the experimental workflow is strictly defined, the accuracy of the measurements often suffers from significant errors which in turn affect severely all the following engineering calculations as well as the following equation of state (EoS) tuning step. In this work, a systematic methodology is developed to apply quality control (QC) on the PVT values reported in a typical lab report. Firstly, the equations expressing mass balance are developed to calculate the missing closing data, such as the residual oil density and the composition of oil collected at each stage of the depletion study. Subsequently, computational tools are developed to evaluate the physical soundness of the received results and provide insight as to whether the quality of the experimental data is sufficient. To demonstrate the proposed workflow, it is applied to a selection of representative reservoir fluids of varying volatility. We demonstrate that depending on the reservoir fluid properties, calculations may yield highly unrealistic results, which engineers should avoid using unless corrected. Specifically, differential liberation (DL) test properties reported for low-volatility oils are generally reliable. However, for high-volatility oils, particularly during the final depletion stages, the test outcomes often become unrealistic. Finally, instructions to fluid and reservoir engineers on how to handle those issues and protect the reliability of their calculations are provided.
Simulation and Comparison of the Photovoltaic Performance of Conventional and Inverted Organic Solar Cells with SnO2 as Electron Transport Layers
Authors: Boudia Mohamed El Amine , Wang Qiuwang , Zhao Cunlu
Published: July 2024

Extensive research on organic solar cells (OSCs) over the past decade has led to efficiency improvements exceeding 18%. Enhancing the efficacy of binary organic solar cells involves multiple factors, including the strategic selection of materials. The choice of donor and acceptor materials, which must exhibit complementary absorption spectra, is crucial. Additionally, optimizing the solar cell structure, such as adjusting the thickness of layers and incorporating hole-transporting layers, can further increase efficiency. In this study, we simulated three different novels within the use of the inorganic SnO2 on the OSCs within this specific arrangement of structures using a drift-diffusion model: direct and inverted binary; direct ternary configurations of OSCs, specifically ITO/PEDOT: PSS/PM6:L8-BO/SnO2/Ag, ITO/SnO2/PM6:L8-BO/PEDOT: PSS/Ag; and FTO/PEDOT: PSS/PM6:D18:L8-BO/SnO2/Ag. These structures achieved power conversion efficiencies (PCE) of 18.34%, 18.37%, and 19.52%, respectively. The direct ternary device achieved an important Voc of 0.89 V and an FF of 82.3%, which is high in comparison with other simulated results in the literature. Our research focused on the role of SnO2 as an inorganic electron transport layer in enhancing efficiency in all three configurations. We also evaluated the properties of these structures by simulating external quantum efficiency (EQE), which results in a broadened absorption spectrum from 380 nm to 900 nm for both binary and ternary devices. Furthermore, we measured the spectral distribution of absorbed photons, and photo-charge extraction by linearly increasing voltage (photo-CELIV) to assess charge extraction and generation rates as well as charge mobility. These measurements help establish a robust model for practical application.
Simulation of the Static Sealing Performance of Rubber Packer Cylinders in a Supercritical–CO2 Environment
Authors: Zhu Zhenkun , Cai Meng , Cui Lining , Song Xingliang , Xu Xiaoyu , Cong Chuanbo , Li Haicheng , Gao Qiming
Published: July 2024

The aim of this study was to solve the problems associated with the sealing and tearing failure of rubber packer cylinders during CO2 downhole injection. Using Comsol Multiphysics 6.0 software, a rubber cylinder model in a supercritical CO2 (SC–CO2) environment was established. The thermal analogy method was used to simulate the CO2 diffusion and rubber cylinder swelling process. We analyzed the deformation and stress of the rubber cylinder that was caused by temperature and pressure, with CO2 as the swelling agent. The results show that in the SC–CO2 environment, under the influence of CO2 diffusion and the consequent swelling, the rubber cylinder body is prone to large deformations, and the maximum shear stress is significantly increased, leading to the shear failure of the rubber cylinder. Reducing the initial seating pressure can alleviate the impact of deformation, whereas reducing the maximum contact pressure can cause the rubber cylinder to lose its seal. We also analyzed the influence of various factors on the maximum contact stress of the rubber cylinder, providing a theoretical basis and technical support for improving the sealing performance of rubber packer cylinders in an SC–CO2 environment.
Small Decentralized Technologies for High-Strength Wastewater Treatment and Reuse in Arid and Semi-Arid Regions
Authors: Rahman Khaja Zillur , Al Saadi Shamsa , Al Rawahi Mohamed , van Afferden Manfred , Bernhard Katy , Friesen Jan , Müller Roland A.
Published: July 2024

Rural and semi-urban areas in arid/semi-arid regions are facing severe water scarcity and a series of environmental challenges nowadays, specifically due to rapid urbanization and economic development, climate change, population growth, increasing water demand, influxes of refugees caused by war and regional political conflict, etc. To solve the emerging problems, the safe reuse of treated wastewater in agriculture can provide an additional water resource for countries with high water scarcity. The aim of this study was to investigate the treatment performance and effectiveness of small decentralized wastewater treatment (DWWT) technologies treating high-strength wastewater with concentrations far beyond the European Union testing ranges of parameters such as five-day biochemical oxygen demand (BOD5 > 500 mg/L), chemical oxygen demand (COD > 1000 mg/L), or total suspended solids (TSS > 700 mg/L). Four (4) commercially available DWWT technologies with a design capacity of 4–8 PE (population equivalent) were selected and operated with various wastewater compositions in Leipzig, Germany. The technologies were (i) the moving bed biofilm reactor (MBBR), (ii) the sequencing batch reactor (SBR), (iii) the membrane bioreactor (MBR) and (iv) the aerated vertical-flow constructed wetland (AVFCW). This study results clearly demonstrated that the EU-certified small DWWT technologies are quite capable of treating high-strength wastewater and can provide high-quality treated water for safe reuse in rural communities of arid and semi-arid regions. During operation with high-strength wastewater with a mean inflow BOD5, COD and TSS concentrations of 1532 ± 478, 2547 ± 830 and 546 ± 176 mg/L, a low mean BOD5 (<10 mg/L), COD (<70 mg/L) and TSS (<15 mg/L) in the outflow of the four systems showed removal efficiency of BOD5 (>99%), COD (>97%) and TSS (>97%), and met the maximum allowable limit value of water quality class A for reuse in agriculture according to Jordanian and Omani standard. The MBR showed almost a complete removal of Escherichia coli (E. coli) in a range of 6.1–6.9-log removal in the outflow during all three experimental phases and performed best for BOD5, COD, TSS and pathogen removal when treating high-strength wastewater if properly maintained to prevent potential fouling and clogging of the membrane. Before the final permitting process, long-term monitoring under local temperature and climatic conditions as well as guidelines based on local needs (e.g., in Jordan, Oman, etc.) should be developed to guarantee a minimum level of performance standards of such small DWWT technologies and requirements for operation and maintenance (O&M).
The Effects of Wild Boar Rooting on Epigeic Arthropods in Oak Forests
Authors: Špoula Jakub , Stočes Dominik , Drimaj Jakub , Mikulka Ondřej
Published: July 2024

The distribution of wild boar (Sus scrofa L.) on almost all continents brings with it a number of negative impacts, the intensity of which depend on the local population density. One of these impacts is the rooting of the soil surface as part of their foraging behavior, which represents an ecologically valuable disturbance to the forest ecosystem. In this study, conducted in 2022 and 2023, we placed 50 pitfall traps across 10 plots at 10 model sites to compare epigeic arthropod communities in areas affected by wild boar rooting with those unaffected by rooting activity. Our findings demonstrate the presence or absence of rooting is a highly significant factor in shaping arthropod epigeic community assemblies. Rooted plots predominantly hosted species from the taxons Araneae, Carabidae, Elateridae, and Diplopoda, whereas plots without rooting were significantly associated with the taxons Tenebrionidae, Opiliones, Gryllidae, and Geotrupidae. Diptera, and Staphylinidae were not affected by wild boar rooting activity. Throughout the study, a decreasing trend in species diversity was observed. Wild boar rooting notably impacted the composition of epigeic assemblages.
The Impact Mechanism of Urban Built Environment on Urban Greenways Based on Computer Vision
Authors: Wang Lei , Zhang Longhao , Zhang Tianlin , Hu Yike , He Jie
Published: July 2024

With the development and widespread adoption of smart machines, researchers across various disciplines and fields are exploring the contributions of computers and intelligent machines to human science and society through interdisciplinary collaboration. In this study, we investigated the potential applications of artificial intelligence and multi-source big data in the selection and design of urban greenways, using the city of Nanjing as a case study. Utilizing computer vision technology and the DeepLabV3+ neural network model, we analyzed over 320,000 street view images and 530,000 fine-grained urban data points from Nanjing. We also trained the place space material quantification model using the Street Space Greening Structure (S.S.G.S) dataset. This dataset not only achieved high-precision semantic segmentation but also surpassed previous datasets in predicting greenery at the street level. The performance metrics for this model are as follows: MIoU is 0.6344, Recall is 0.7287, and Precision is 0.8074. Through Robust regression, we identified several micro and macro-level factors influencing the Panoramic View Green View Index (PVGVI). The results indicate that multiple factors have significant positive or negative effects on PVGVI. This research not only provides new decision-making tools for landscape architecture and urban planning but also opens new avenues for applying artificial intelligence in urban environmental studies.
“Not Even Hell Must Look like This”—Print Media Narratives about the October 2017 Wildfires in Portuguese Public-Managed Forests
Authors: Figueiredo Elisabete , Ribeiro Cristina , Fernandes Maria Eduarda
Published: July 2024

The unprecedented wildfires of 2017 in Portugal, particularly affecting the Centre Region, resulted in more than 100 deaths and numerous other dramatic socioeconomic and environmental impacts. Due to the unparalleled magnitude of these events, the extent of the burned area, and the catastrophic consequences, forest and fire management were placed at the center stage of public and political concerns, receiving wide mass media attention and amplification likely to shape public opinion and influence policy decisions. Through a quasi-qualitative content analysis approach, this article focuses on the media narratives conveyed by the news issued over two years (N = 1056) by eight newspapers of different periodicities and geographical scopes regarding the wildfires of October 2017 in the Matas do Litoral—coastal public-managed forest areas located in the Centre Region of Portugal. The analysis focuses on three main dimensions: the agents and actors mentioned and their power-related positions, the geographical coverage of the newspapers, and the relevance ascribed to emotions and feelings in the media narratives about the wildfires. The results demonstrate the relevance attributed in media narratives to the views of institutional agents and the negligence of local people’s voices. When particularly highlighting the material impacts of the wildfires, media narratives tended to focus less on people’s emotions and other non-tangible issues. The variation in these narratives according to the geographical scope of the newspapers and the publication time of the news strongly points out the need to address the heterogeneous character of the media coverage of wildfires.
Correction: Tappi et al. Multi-Analytical Approach to Study Fresh-Cut Apples Vacuum Impregnated with Different Solutions. Foods 2022, 11, 488
Authors: Tappi Silvia , Velickova Elena , Mannozzi Cinzia , Tylewicz Urszula , Laghi Luca , Rocculi Pietro
Published: July 2024

In the original publication [...]
Nutrition-Related Knowledge Graph Neural Network for Food Recommendation
Authors: Ma Wenming , Li Mingqi , Dai Jian , Ding Jianguo , Chu Zihao , Chen Hao
Published: July 2024

Food recommendation systems are becoming increasingly vital in modern society, given the fast-paced lifestyle and diverse dietary habits. Existing research and implemented solutions often rely on user preferences and past behaviors for recommendations, which poses significant issues. Firstly, this approach inadequately considers the nutritional content of foods, potentially leading to recommendations that are overly homogeneous and lacking in diversity. Secondly, it may result in repetitive suggestions of the same types of foods, thereby encouraging users to develop unhealthy dietary habits that could adversely affect their overall health. To address this issue, we introduce a novel nutrition-related knowledge graph (NRKG) method based on graph convolutional networks (GCNs). This method not only enhances users’ ability to select appropriate foods but also encourages the development of healthy eating habits, thereby contributing to overall public health. The NRKG method comprises two key components: user nutrition-related food preferences and recipe nutrition components. The first component gathers nutritional information from recipes that users show interest in and synthesizes these data for user reference. The second component connects recipes with similar nutritional profiles, forming a complex heterogeneous graph structure. By learning from this graph, the NRKG method integrates user preferences with nutritional data, resulting in more accurate and personalized food recommendations. We evaluated the NRKG method against six baseline methods using real-world food datasets. In the 100% dataset, the five metrics exceeded the performance of the best baseline method by 2.8%, 5.9%, 1.5%, 9.7%, and 6.0%, respectively. The results indicate that our NRKG method significantly outperforms the baseline methods, including FeaStNet, DeepGCN, GraphSAGE, GAT, UniMP, and GATv2, demonstrating its superiority and effectiveness in promoting healthier and more diverse eating habits. Unlike these baseline methods, which primarily focus on hierarchical information propagation, our NRKG method offers a more comprehensive approach by integrating the nutritional information of recipes with user preferences.
Total Polyphenol Contents and Mineral Profiles in Commercial Wellness Herbal Infusions: Evaluation of the Differences between Two Preparation Methods
Authors: Lo Turco Vincenzo , Nava Vincenzo , Potortì Angela Giorgia , Sgrò Benedetta , Arrigo Maria Aurora , Di Bella Giuseppa
Published: July 2024

The popularity of the consumption of wellness herbal teas is due to the many health-promoting properties they seem to possess. Modern preparation methods using coffee machines are also popular today. Therefore, the purpose of this research was to evaluate differences in infusions obtained by the traditional method using filters and by espresso coffee machines using pods. In this regard, different herbal materials were selected and purchased in two different types of herbal containers, and the corresponding infusions were analyzed for the contents of total polyphenols and mineral elements. Results showed that filter infusions had higher polyphenol and mineral contents than pod infusions, excluding Cd and Pb. For each of the plant materials used, differences due to the method of infusion preparation are highlighted. From a qualitative point of view, both methods of infusion preparation are valid, but the filter infusion method allows a higher transfer of minerals and polyphenols into the infusion, improving quality. The analyzed infusions can be safely consumed with respect to As, Cd, Pb, and Hg contents. Good amounts of polyphenols and Mn can be obtained by drinking a cup of any of the infusions analyzed, especially the mate infusion obtained by the filter technique, with amounts of 429 mg for polyphenols and 69.27% of the RDA for manganese.
Integrated In Vivo and In Vitro Evaluation of a Powder-to-Hydrogel, Film-Forming Polymer Complex Base with Tissue-Protective and Microbiome-Supportive Properties
Authors: Banov Daniel , Song Guiyun , Foraida Zahraa , Tkachova Oksana , Zdoryk Oleksandr , Carvalho Maria
Published: July 2024

The study aimed to perform a comprehensive in vitro and in vivo evaluation of a newly developed, patent-pending, powder-to-hydrogel, film-forming polymer complex base, which possesses tissue-protective and microbiome-supportive properties, and to compare its characteristics with poloxamer 407. The study used a combination of in vitro assays, including tissue viability and cell migration, and in vivo wound healing evaluations in male diabetic mice. Microbiome dynamics at wound sites were also analyzed. The in vitro assays demonstrated that the polymer complex base was non-cytotoxic and that it enhanced cell migration over poloxamer 407. In vivo, the polymer complex base demonstrated superior wound healing capabilities, particularly in combination with misoprostol and phenytoin, as evidenced by the reduced wound area and inflammation scores. Microbiome analysis revealed favorable shifts in bacterial populations associated with the polymer complex base-treated wounds. The polymer complex base demonstrates clinical significance in wound care, potentially offering improved healing, safety and microbiome support. Its transformative properties and efficacy in drug delivery make it a promising candidate for advanced wound care applications, particularly in chronic wound management.
Efficacy of Therapeutic Exercise in Reducing Pain in Instrumental Musicians: Systematic Review and Meta-Analysis
Authors: Iglesias-Carrasco Cristina , de-la-Casa-Almeida María , Suárez-Serrano Carmen , Benítez-Lugo Maria-Luisa , Medrano-Sánchez Esther M.
Published: July 2024

Playing-related pain poses a significant health concern for musicians, often impacting their ability to perform. Therapeutic exercise emerges as a viable approach to alleviate these symptoms, offering a low-cost intervention with minimal side effects. This review seeks to examine and assess the efficacy of therapeutic exercise in reducing pain intensity among instrumental musicians. Three major databases (PubMed, Web of Science, and Scopus) were systematically searched from November 2023 to June 2024. The inclusion criteria required studies to be randomized clinical trials focusing on pain intensity in instrumental musicians, published in the last 10 years. Two independent researchers assessed the characteristics and methodological quality of the selected studies. Out of 305 identified studies, 15 underwent full-text reviews, with 5 ultimately included in the analysis. The total participant count was 273, with an average intervention duration of 32.5 min per session, twice weekly for eight weeks. Overall, therapeutic exercise interventions demonstrated favorable effects, with three studies exhibiting good methodological quality. The meta-analysis revealed significant positive results favoring exercise in reducing pain intensity, with positive responses observed across all clinical populations, so therapeutic exercise appears to be an effective approach for reducing pain intensity in musicians experiencing playing-related pain.
Work-Related Quality of Life among Physicians in Poland: A Cross-Sectional Study
Authors: Jakimów Krzysztof , Ciesielka Jakub , Bonczek Monika , Rak Joanna , Matlakiewicz Magdalena , Majewska Karolina , Gruszczyńska Katarzyna , Winder Mateusz
Published: July 2024

Background and objectives: Working in a healthcare setting is associated with high levels of stress and burnout syndrome. Work-related quality of life (WRQoL) remains insufficiently evaluated among physicians. The aim of this study is to assess the WRQoL among physicians of interventional, non-interventional, and diagnostic specialties in Poland. Materials and Methods: Standardized and anonymous WRQoL questionnaires have been filled in by 257 physicians working in Silesia, Poland. After the removal of missing data, 246 individuals were stratified in terms of specialties into the appropriate categories, including interventional, non-interventional, and diagnostics. These categories were compared using the following subscales: general well-being (GWB), home–work interface (HWI), job and career satisfaction (JCS), control at work (CAW), working conditions (WCS), and stress at work (SAW). Results: Out of 246 individuals, 132 were women (53.7%) and 112 (45.5%) were men. There were no differences in terms of WRQoL scores (p = 0.220) and subscales GWB (p = 0.148), HWI (p = 0.368), JCS (p = 0.117), CAW (p = 0.224), WCS (p = 0.609), SAW (p = 0.472) between interventional, non-interventional, and diagnostic specialties. The group of young doctors (age ≤ 30 years) had higher JCS scores than the older ones (mean score [SD], 22.7 [3.98] vs. 21 [4.6]; p = 0.013). Physicians who were not working in hospital had higher WRQoL score than respondents working in hospital (p = 0.061), with significant differences in terms of GWB (mean score [SD], 20.3 [4.93] vs. 22.8 [3.2], p = 0.014), HWI (mean score [SD], 9.1 [=2.65] vs. 10.6 [2.73], p = 0.011), and WCS (mean score [SD], 9.5 [2.61] vs. 10.8 [2.54], p = 0.035). Conclusion: There were no differences considering overall WRQoL between analyzed groups stratified according to specialty. However, we disclosed a significant association between the respondent’s WRQoL and age as well as place of work.
The Mental Health Outcomes and Cost Estimates of Korean Medicine for Anxiety Disorder Patients
Authors: Lee So-Young , Yoo Jong-Ho , Seo Sang-Il , Lee Ji-Eun , Kim Geun-Woo , Cho Eun
Published: July 2024

Korean medicine (KM) is used to treat anxiety disorders, but there is limited research on its effects. This study aimed to examine the associations between improved QoL and reduced clinical symptoms and KM in patients with anxiety disorders. The medical records of patients with anxiety who were treated with KM (acupuncture, psychotherapy, Chuna therapy, aromatherapy, or herbal medicine) for at least 4 weeks were retrospectively analyzed. Clinical, QoL, and cost outcomes were measured at baseline and at weeks 4 and 12 (Anxiety: State-Trait Anxiety Inventory [STAI X-1 (state), X-2 (trait)], Beck Anxiety Inventory [BAI]; anger: State-Trait Anger Expression Inventory State [STAXI-S (state), T (trait)], Anger Expression Inventory [AXI-K-I (anger-in), AXI-K-O (anger-out), AXI-K-C (anger-control); depression: Beck Depression Inventory-II [BDI II], QoL: QoL-related instruments Euro Quality of Life 5 Dimensions utility score [EQ-5D], Euro QoL Visual Analog Scale [EQ-VAS]). The total costs for each item were calculated in terms of NHIS-covered costs and patients’ out-of-pocket costs from the perspective of the healthcare system. The medical records of 67 patients were evaluated. The KM treatments were found to be associated with decreased anxiety (STAI X-1; STAI X-2; BAI, p < 0.0001), depression (BDI-II, p < 0.0001), and anger (AKI-K-I; AKI-K-O, p < 0.05) and increased QoL (EQ-5D; EQ-VAS, p < 0.0001). An average of USD 1360 was paid for the KM treatments for 4 weeks. The study findings suggested that KM may improve clinical symptoms and QoL outcomes in patients with anxiety disorders.
Evaluation of the Newborn Screening Pilot for Sickle Cell Disease in Suriname Using the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) Framework
Authors: Tang Ming-Jan , Roosblad Jimmy , Codrington John , Peters Marjolein , Toekoen Aartie , van Rheenen Patrick F. , Juliana Amadu
Published: July 2024

The early detection of sickle cell disease (SCD) is vital to reduce mortality among affected children. Suriname currently lacks a newborn screening programme (NSP) for SCD. We performed a pilot programme to evaluate the scalability of such an initiative. Dried blood spots were collected from five birth centres and subjected to electrophoresis analysis. The programme scalability was evaluated using the non-adoption, abandonment, scale-up, spread, and sustainability framework. Challenges across six domains (illness, technology, value proposition, adopter system, organisation, and societal system), were categorised hierarchically as simple 😊, complicated 😐, or complex 😢. It has been proven that implementing programmes with mainly complicated challenges is difficult and those in mainly complex areas may be unachievable. SCD was detected in 33 of 5185 (0.64%) successfully screened newborns. Most of the domains were classified as simple or complicated. Disease detection and technology suitability for screening in Suriname were confirmed, with favourable parental acceptance. Only minor routine adjustment was required from the medical staff for programme implementation. Complex challenges included a reliance on external suppliers for technical maintenance, ensuring timely access to specialised paediatric care for affected newborns, and securing sustainable financial funding. Scaling up is challenging but feasible, particularly with a targeted focus on identified complex challenges.
Customized Scleral Lenses: An Alternative Tool for Severe Dry Eye Disease—A Case Series
Authors: Nunziata Sebastiano , Petrini Daniele , Dell’Anno Serena , Barone Vincenzo , Coassin Marco , Di Zazzo Antonio
Published: July 2024

Purpose: Dry eye disease (DED) is a multifactorial condition significantly impacting patients’ quality of life (QoL). This study aims to present a case series highlighting the effectiveness of customized scleral lenses in managing severe DED and improving patient outcomes. Methods: This case series includes three patients with severe DED refractory to conventional treatments. Customized scleral lenses were fitted for each patient, and clinical outcomes were evaluated over a period of two months. Assessments included best-corrected visual acuity (BCVA), slit-lamp examination findings, and corneal National Eye Institute (NEI) scores. Results: All three patients demonstrated significant improvements in BCVA, reductions in ocular symptoms, and enhanced ocular surface health. Patient 1, with secondary Sjögren’s syndrome and suspected mucous membrane pemphigoid, showed resolution of conjunctival hyperemia and epithelial defects. Patient 2, with graft versus host disease, exhibited resolution of punctate keratitis and the absence of thread mucus. Patient 3, post-oncologic surgery, achieved complete resolution of keratoconjunctivitis sicca and the restoration of vision. Conclusions: Customized scleral lenses are a useful therapeutic option for severe DED, providing significant symptomatic relief and enhancing patients’ quality of life. Their use should be considered in refractory cases to optimize ocular surface health and visual outcomes.
Imaging the Area of Internal Limiting Membrane Peeling after Macular Hole Surgery
Authors: Clemens Christoph R. , Obergassel Justus , Heiduschka Peter , Eter Nicole , Alten Florian
Published: July 2024

Background: The aim of this study was to compare en-face optical coherence tomography (OCT) imaging and confocal scanning laser ophthalmoscopy (cSLO) imaging at different wavelengths to identify the internal limiting membrane (ILM) peeling area after primary surgery with vitrectomy and ILM peeling for macular hole (MH). Methods: In total, 50 eyes of 50 consecutive patients who underwent primary surgery with vitrectomy and ILM peeling for MH were studied. The true ILM rhexis based on intraoperative color fundus photography was compared to the presumed ILM rhexis identified by a blinded examiner using en-face OCT imaging and cSLO images at various wavelengths. To calculate the fraction of overlap (FoO), the common intersecting area and the total of both areas were measured. Results: The FoO for the measured areas was 0.93 ± 0.03 for en-face OCT, 0.76 ± 0.06 for blue reflectance (BR; 488 nm), 0.71 ± 0.09 for green reflectance (GR; 514 nm), 0.56 ± 0.07 for infrared reflectance (IR; 815 nm) and 0.73 ± 0.06 for multispectral (MS). The FoO in the en-face OCT group was significantly higher than in all other groups, whereas the FoO in the IR group was significantly lower compared to all other groups. No significant differences were observed in FoO among the MS, BR, and GR groups. In en-face OCT, there was no significant change in the ILM peeled area measured intraoperatively and postoperatively (8.37 ± 3.01 vs. 8.24 ± 2.81 mm2; p = 0.8145). Nasal-inferior foveal displacement was observed in 38 eyes (76%). Conclusions: En-face OCT imaging demonstrates reliable postoperative visualization of the ILM peeled area. Although the size of the ILM peeling remains stable after one month, our findings indicate a notable inferior-nasal shift of the overall ILM peeling area towards the optic disc.
Anesthesia for Minimal Invasive Cardiac Surgery: The Bonn Heart Center Protocol
Authors: Piekarski Florian , Rohner Marc , Monsefi Nadejda , Bakhtiary Farhad , Velten Markus
Published: July 2024

The development and adoption of minimally invasive techniques has revolutionized various surgical disciplines and has also been introduced into cardiac surgery, offering patients less invasive options with reduced trauma and faster recovery time compared to traditional open-heart procedures with sternotomy. This article provides a comprehensive overview of the anesthesiologic management for minimally invasive cardiac surgery (MICS), focusing on preoperative assessment, intraoperative anesthesia techniques, and postoperative care protocols. Anesthesia induction and airway management strategies are tailored to each patient’s needs, with meticulous attention to maintaining hemodynamic stability and ensuring adequate ventilation. Intraoperative monitoring, including transesophageal echocardiography (TEE), processed EEG monitoring, and near-infrared spectroscopy (NIRS), facilitates real-time assessment of cardiac and cerebral perfusion, as well as function, optimizing patient safety and improving outcomes. The peripheral cannulation techniques for cardiopulmonary bypass (CPB) initiation are described, highlighting the importance of cannula placement to minimize tissue as well as vessel trauma and optimize perfusion. This article also discusses specific MICS procedures, detailing anesthetic considerations and surgical techniques. The perioperative care of patients undergoing MICS requires a multidisciplinary approach including surgeons, perfusionists, and anesthesiologists adhering to standardized treatment protocols and pathways. By leveraging advanced monitoring techniques and tailored anesthetic protocols, clinicians can optimize patient outcomes and promote early extubation and enhanced recovery.
An Increasing Triglyceride–Glucose Index Is Associated with a Pro-Inflammatory and Pro-Oxidant Phenotype
Authors: Adams-Huet Beverley , Jialal Ishwarlal
Published: July 2024

Background/Objectives: Insulin resistance is crucial in the pathogenesis of Metabolic Syndrome (MetS), type 2 diabetes mellitus (T2DM) and premature atherosclerotic cardiovascular disease (ASCVD). The triglyceride–glucose index (TyG index), a validated measure of insulin resistance, also predicts MetS, T2DM, the severity of albuminuria and ASCVD. There are scant data providing mechanistic insights into these sequalae. Accordingly, we investigated the relationship between the TyG index and biomarkers of inflammation, oxidative stress, free fatty acid (FFA) levels and adipokine dysregulation in a cohort comprising both controls and patients with nascent MetS. Methods: Participants (n = 102) included 59 patients with MetS and 43 controls. People with diabetes, ASCVD, smoking and macro-inflammation were excluded. Fasting blood was obtained for both plasma and monocyte isolation. Results: Receiver Operating Characteristic (ROC) curve analysis revealed that the TyG index was an excellent predictor of MetS with an area under the curve of 0.87, and it correlated with both hepatic and adipose tissue insulin resistance. Both serum RBP-4 levels and non-HDL cholesterol increased significantly over tertiles of the TyG index. Based on the TyG index tertiles and/or correlations, oxidized LDL, nitrotyrosine, C-reactive protein, endotoxin, chemerin, interleukin-6 levels and monocyte toll-like receptor (TLR)-4 and TLR-2 and their cellular signaling were significantly associated with the TyG index. Conclusions: Increased non-HDL-C and, most importantly, a pro-inflammatory and pro-oxidant state could be advanced as potential mechanisms explaining the increased risk for T2DM and ASCVD with an increasing TyG index.
Facing Life in Old Age: Exploring Resilience in Older Adults with Bipolar Disorder
Authors: Montejo Laura , Retuerto Mònica , Solé Brisa , Martín Sara , Ruiz Andrea , Clougher Derek , Bort Marta , Sánchez-Moreno Jose , Martínez-Arán Anabel , Vieta Eduard , Torrent Carla
Published: July 2024

Background: Older adults with bipolar disorder (OABD) are individuals aged 50 years and older with bipolar disorder (BD). People with BD may have fewer coping strategies or resilience. A long duration of the disease, as seen in this population, could affect the development of resilience strategies, but this remains under-researched. Therefore, this study aims to assess resilience levels within the OABD population and explore associated factors, hypothesizing that resilience could improve psychosocial functioning, wellbeing and quality of life of these patients. Methods: This study sampled 33 OABD patients from the cohort at the Bipolar and Depressive Disorders Unit of the Hospital Clinic of Barcelona. It was an observational, descriptive and cross-sectional study. Demographic and clinical variables as well as psychosocial functioning, resilience and cognitive reserve were analyzed. Resilience was measured using the CD-RISC-10. Non-parametric tests were used for statistical analysis. Results: The average CD-RISC-10 score was 25.67 points (SD 7.87). Resilience negatively correlated with the total number of episodes (p = 0.034), depressive episodes (p = 0.001), and the FAST (p < 0.001). Participants with normal resilience had a lower psychosocial functioning (p = 0.046), a higher cognitive reserve (p = 0.026), and earlier onset (p = 0.037) compared to those with low resilience. Conclusions: OABD individuals may have lower resilience levels which correlate with more psychiatric episodes, especially depressive episodes and worse psychosocial functioning and cognitive reserve. Better understanding and characterization of resilience could help in early identification of patients requiring additional support to foster resilience and enhance OABD management.
Intramedullary Screw versus Locking Plate Fixation for Traumatic Displaced Proximal Fifth Metatarsal Fractures: A Systematic Review
Authors: Lo Yu-Chieh , Tai Ting-Han , Huang Yu-Min , Chen Chih-Yu
Published: July 2024

Background/Objectives: Intramedullary screw fixation (IMS) and locking plate fixation (LPF) are currently recommended treatments for proximal fifth metatarsal fractures (PFMF). However, treating comminuted or small displaced avulsion PFMF with IMS poses challenges due to complications. A novel alternative fixation method, the locking compression plate for distal ulna hook plate fixation (LPF), has been introduced recently for distal ulna fractures and has shown improved clinical results. This scoping review aims to assess whether LPF yields superior outcomes, such as postoperative AOFAS scores and rate of postoperative complications, compared to IMS in PFMF treatment. Methods: This review included randomized controlled trials (RCTs), prospective cohort studies, retrospective cohort studies, or case series involving patients with PFMF who underwent plate fixation or screw fixation. The primary outcome was the postoperative American Orthopedic Foot and Ankle Society (AOFAS) score. Studies were sourced from databases including PubMed, Embase, and Scopus, with the search conducted up to February 2024. The Systematic Review protocol was registered in the CRD PROSPERO database (CRD42024532593). Results: Ten studies were included, comprising 3 cohort studies, 1 case–control study, and 6 case series, with a total of 309 patients (158 with LPF and 142 with IMS). The postoperative AOFAS scores showed no significant difference between LPF and IMS in treating PFMF. However, LPF demonstrated efficient surgical procedures and enhanced functional outcomes. Complications were minimal in both groups, with no significant difference in the rate of postoperative complications. Conclusions: Although there was no significant difference in AOFAS scores between LPF and IMS, LPF demonstrated efficient surgical procedures and enhanced functional outcomes, making it a reasonable alternative method for PFMF. Effective shared decision-making (SDM) with patients becomes paramount in choosing the optimal surgical approach. In the surgical landscape, thoughtful deliberation, patient engagement, and adherence to biomechanical principles are crucial for achieving successful outcomes in the treatment of PFMF.