bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Clinical and Genetic Factors on the Progression of Age-Related Macular Degeneration: A 3-Year Follow-Up
Authors: Krytkowska Elżbieta , Ulańczyk Zofia , Grabowicz Aleksandra , Safranow Krzysztof , Kawa Miłosz Piotr , Pałucha Andrzej , Wąsowska Anna , Matczyńska Ewa , Boguszewska-Chachulska Anna , Machalińska Anna
Published: March 2023

The aim of the present study was to analyze the relationship of age-related macular degeneration (AMD) progression with clinical characteristics, demographic, and environmental risk factors that would affect disease development. In addition, the influence of three genetic AMD polymorphisms (CFH Y402H, ARMS2 A69S, and PRPH2 c.582-67T>A) on AMD progression was investigated. In total, 94 participants with previously diagnosed early or intermediate AMD in at least one eye were recalled for an updated re-evaluation after 3 years. The initial visual outcomes, medical history, retinal imaging data, and choroidal imaging data were collected to characterize the AMD disease status. Among the AMD patients, 48 demonstrated AMD progression, and 46 showed no disease worsening at 3 years. Disease progression was significantly associated with worse initial visual acuity (OR = 6.74, 95% CI = 1.24-36.79, p = 0.03) and the presence of the wet AMD subtype in fellow eyes (OR = 3.79, 95%CI = 0.94-15.2, p = 0.05). In addition, a higher risk of AMD progression appeared in the patients with active thyroxine supplementation (OR = 4.77, CI = 1.25–18.25, p = 0.002). The CC variant of CFH Y402H was associated with AMD advancement compared to the TC+TT phenotype (OR = 2.76, 95% CI: 0.98–7.79, p = 0.05). Identifying risk factors of AMD progression may lead to earlier intervention and better outcomes, preventing the expansion of the late stage of the disease.
Lapses of the Heart: Frequency and Subjective Salience of Impressions Reported by Patients after Cardiac Arrest
Authors: Sterz Fritz , Berger Michael L. , Ruzicka Gerhard , Beisteiner Roland
Published: March 2023

After cardiac arrest (CA), some patients report impressions with highly realistic features, often referred to as near-death experience (NDE). The frequency of such episodes seems to be variable, with various types of content. In a prospective study, we subjected 126 CA cases treated at the Department of Emergency Medicine of the Medical University of Vienna under carefully controlled conditions to a structured interview. We included all patients admitted due to CA, whose communicative abilities were restored and who agreed to participate in the study. The questionnaire inquired as to living conditions, attitudes towards issues of life and death, and last recollections before and first impressions after the CA. The majority of the subjects (91 = 76%) replied to inquiries concerning impressions during CA with “nothing” or “blackout”, but 20 (16%) gave a detailed account. A German version of the Greyson questionnaire specifically addressing NDE phenomena (included towards the end of the interview) resulted in ≥7 points in five patients (4%). Three patients reported a meeting with deceased relatives (one with 6 Greyson points), one an out-of-body episode, and one having been sucked into a colorful tunnel. Eleven of these twenty cases had their cardiopulmonary resuscitation (CPR) started within the first min of CA, a higher fraction than cases without experience. Reported experience after CA was of high significance for the patients; many of them changed their point of view on issues of life and death.
A Review, Update, and Commentary for the Cough without a Cause: Facts and Factoids of the Habit Cough
Authors: Weinberger Miles , Buettner Dennis , Anbar Ran D.
Published: March 2023

Background: A habitual cough, persisting after the cause is gone, was described in a 1694 medical book. Successful treatment of this disorder known as habit cough was reported in 1966 by the “art of suggestion”. The purpose of this article is to provide the current basis for diagnosis and treatment of the Habit Cough Syndrome. Method: The epidemiology and clinical course of habit cough were reviewed; original data were obtained from three sources. Results: Unique clinical presentation was the basis for diagnosis of habit cough. Diagnosis was made 140 times with increasing frequency over 20 years at the University of Iowa clinic and 55 times over 6 years at a London clinic. Suggestion therapy provided more frequent cessation of cough than just reassurance. A Mayo Clinic archive of chronic involuntary cough found 16 of 60 still coughing 5.9 years after initial evaluation. Ninety-one parents of children with habit cough and 20 adults reported cessation of coughing from viewing a publicly available video of successful suggestion therapy. Conclusions: Habit cough is recognizable from the clinical presentation. It is effectively treated in most children by suggestion therapy in clinics, by remote video conferencing, and by proxy from viewing a video of effective suggestion therapy.
Role of the Pfannenstiel Incision in Robotic Hepato-Pancreato-Biliary Surgery
Authors: Takagi Kosei , Umeda Yuzo , Yoshida Ryuichi , Fuji Tomokazu , Yasui Kazuya , Kimura Jiro , Hata Nanako , Yagi Takahito , Fujiwara Toshiyoshi
Published: March 2023

Studies remain limited on the role of the Pfannenstiel incision in minimally invasive hepato-pancreato-biliary (HPB) surgery, especially robotic surgery. The role of various extraction sites in robotic HPB surgery should be understood. Herein, we describe the surgical techniques, outcomes, advantages, and disadvantages of the Pfannenstiel incision in robotic pancreatic surgery. Seventy patients underwent robotic pancreatectomy at our institution between September 2020 and October 2022. The Pfannenstiel incision was used for specimen retrieval in 55 patients. Advantages of the Pfannenstiel incision include less pain, cosmetic benefits, and a lower incidence of complications. Moreover, the specimen could be removed using the robotic system docked. However, all complex reconstructions should be performed intra-abdominally during robotic pancreatoduodenectomies. The incidence of mortality and postoperative pancreatic fistula (grade B) was 0% and 9.1%, respectively. During the median follow-up (11.2 months) after surgery, complications at the Pfannenstiel incision site included surgical site infection (n = 1, 1.8%) and incisional hernia (n = 1, 1.8%). The Pfannenstiel incision can be a useful option for specimen retrieval in minimally invasive HPB surgery, according to the surgeon’s preferences and the patient’s condition.
Mobile Apps to Improve Brace-Wearing Compliance in Patients with Idiopathic Scoliosis: A Quality Analysis, Functionality Review and Future Directions
Authors: Cho Han Eol , Jang Chan Woong , Cho Sung Rae , Choi Won Ah , Park Jung Hyun
Published: March 2023

This study was performed to review which mHealth apps that improve brace-wearing compliance are currently available, and to carry out their quality assessments by listing their functionalities. We found ten mHealth apps in the literature review and commercial mHealth apps market (Google Play and App store). Then, the quality of these apps was evaluated by their transparency, health content, excellent technical content, security/privacy, issues of usability, and subjective ratings (THESIS) scale, and the functionalities of the included apps were reviewed. Regarding these functionalities, four categories (data acquisition, compliance enhancement, educational components, and additional functionalities) and twelve subcategories were identified. The mean overall quality of the apps was 3.00 out of 5. Although four of the apps achieved a score of 3.0 or more for their overall quality, indicating an acceptable quality, none of the apps scored higher than 4.0, which indicated a high or excellent quality. According to the sections, the transparency section had the highest rating (3.92) and the security/privacy section received the lowest rating (2.02). Given that the overall quality of current mHealth apps was not high, and their potential to motivate patients with idiopathic scoliosis to adhere to their bracing treatment, it is necessary to develop high-quality apps with appropriate functionalities for supporting brace treatment.
Comparison of Automated Thresholding Algorithms in Optical Coherence Tomography Angiography Image Analysis
Authors: Prangel David , Prasuhn Michelle , Rommel Felix , Grisanti Salvatore , Ranjbar Mahdy
Published: March 2023

(1) Background: Calculation of vessel density in optical coherence tomography angiography (OCTA) images with thresholding algorithms varies in clinical routine. The ability to discriminate healthy from diseased eyes based on perfusion of the posterior pole is critical and may depend on the algorithm applied. This study assessed comparability, reliability, and ability in the discrimination of commonly used automated thresholding algorithms. (2) Methods: Vessel density in full retina and choriocapillaris slabs were calculated with five previously published automated thresholding algorithms (Default, Huang, ISODATA, Mean, and Otsu) for healthy and diseased eyes. The algorithms were investigated with LD-F2-analysis for intra-algorithm reliability, agreement, and the ability to discriminate between physiological and pathological conditions. (3) Results: LD-F2-analyses revealed significant differences in estimated vessel densities for the algorithms (p < 0.001). For full retina and choriocapillaris slabs, intra-algorithm values range from excellent to poor, depending on the applied algorithm; the inter-algorithm agreement was low. Discrimination was good for the full retina slabs, but poor when applied to the choriocapillaris slabs. The Mean algorithm demonstrated an overall good performance. (4) Conclusions: Automated threshold algorithms are not interchangeable. The ability for discrimination depends on the analyzed layer. Concerning the full retina slab, all of the five evaluated automated algorithms had an overall good ability for discrimination. When analyzing the choriocapillaris, it might be useful to consider another algorithm.
Inter-Rater Agreement in Assessing Risk of Bias in Melanoma Prediction Studies Using the Prediction Model Risk of Bias Assessment Tool (PROBAST): Results from a Controlled Experiment on the Effect of Specific Rater Training
Authors: Kaiser Isabelle , Pfahlberg Annette B. , Mathes Sonja , Uter Wolfgang , Diehl Katharina , Steeb Theresa , Heppt Markus V. , Gefeller Olaf
Published: March 2023

Assessing the risk of bias (ROB) of studies is an important part of the conduct of systematic reviews and meta-analyses in clinical medicine. Among the many existing ROB tools, the Prediction Model Risk of Bias Assessment Tool (PROBAST) is a rather new instrument specifically designed to assess the ROB of prediction studies. In our study we analyzed the inter-rater reliability (IRR) of PROBAST and the effect of specialized training on the IRR. Six raters independently assessed the risk of bias (ROB) of all melanoma risk prediction studies published until 2021 (n = 42) using the PROBAST instrument. The raters evaluated the ROB of the first 20 studies without any guidance other than the published PROBAST literature. The remaining 22 studies were assessed after receiving customized training and guidance. Gwet’s AC1 was used as the primary measure to quantify the pairwise and multi-rater IRR. Depending on the PROBAST domain, results before training showed a slight to moderate IRR (multi-rater AC1 ranging from 0.071 to 0.535). After training, the multi-rater AC1 ranged from 0.294 to 0.780 with a significant improvement for the overall ROB rating and two of the four domains. The largest net gain was achieved in the overall ROB rating (difference in multi-rater AC1: 0.405, 95%-CI 0.149–0.630). In conclusion, without targeted guidance, the IRR of PROBAST is low, questioning its use as an appropriate ROB instrument for prediction studies. Intensive training and guidance manuals with context-specific decision rules are needed to correctly apply and interpret the PROBAST instrument and to ensure consistency of ROB ratings.
External Auditory Canal Cholesteatoma after Radiation Therapy for Nasopharyngeal Cancer: Case Series and Systematic Review
Authors: Mammarella Fulvio , Loperfido Antonella , Cianciulli Michele , Fionda Bruno , Stasolla Alessandro , Bellocchi Gianluca
Published: March 2023

The authors performed a systematic review, in accordance with the PRISMA guidelines, across multiple databases, including all original studies published until November 2022, focusing on External auditory canal cholesteatoma (EACC) after radiation therapy (RT) for nasopharyngeal cancer (NC). Inclusion criteria were original articles reporting on secondary EACC after RT for NC. Articles were critically appraised to assess level of evidence using the Oxford Center for Evidence-Based Medicine criteria. Overall, 138 papers were identified and after duplicate removal (34 papers) and excluding papers not in English, 93 papers were assessed for eligibility; finally, only five papers were included and summarized with the three cases coming from our institution. These mainly involved the anterior and the inferior part of the EAC. The mean time of diagnosis after RT was the largest series of 6.5 years (with a range from 0.5 to 15.4 years). Patients undergoing RT for NC have 18 times a higher risk of developing EACC compared to the normal population. EACC is probably one of the most underreported side effects, because patients may present variable clinical findings, which could lead to misdiagnosis. Early diagnosis of RT related EACC is advised to enable conservative treatment.
Autoimmune Hepatitis and Fibrosis
Authors: Pellicano Rinaldo , Ferro Arianna , Cicerchia Francesca , Mattivi Simone , Fagoonee Sharmila , Durazzo Marilena
Published: March 2023

Autoimmune hepatitis (AIH) is a chronic immune-inflammatory disease of the liver, generally considered a rare condition. The clinical manifestation is extremely varied and can range from paucisymptomatic forms to severe hepatitis. Chronic liver damage causes activation of hepatic and inflammatory cells leading to inflammation and oxidative stress through the production of mediators. This results in increased collagen production and extracellular matrix deposition leading to fibrosis and even cirrhosis. The gold standard for the diagnosis of fibrosis is liver biopsy; however, there are serum biomarkers, scoring systems, and radiological methods useful for diagnosis and staging. The goal of AIH treatment is to suppress fibrotic and inflammatory activities in the liver to prevent disease progression and achieve complete remission. Therapy involves the use of classic steroidal anti-inflammatory drugs and immunosuppressants, but in recent years scientific research has focused on several new alternative drugs for AIH that will be discussed in the review.
Sex Differences in Delayed Hospitalization in Patients with Non-ST-Segment Elevation Myocardial Infarction Undergoing New-Generation Drug-Eluting Stent Implantation
Authors: Kim Yong Hoon , Her Ae-Young , Rha Seung-Woon , Choi Cheol Ung , Choi Byoung Geol , Kim Ji Bak , Park Soohyung , Kang Dong Oh , Park Ji Young , Choi Woong Gil , Park Sang-Ho , Jeong Myung Ho
Published: March 2023

We compared the effects of sex differences in delayed hospitalization (symptom-to-door time [SDT], ≥24 h) on major clinical outcomes in patients with non-ST-segment elevation myocardial infarction after new-generation drug-eluting stent implantation. A total of 4593 patients were classified into groups with (n = 1276) and without delayed hospitalization (SDT < 24 h, n = 3317). Thereafter, these two groups were subdivided into male and female groups. The primary clinical outcomes were major adverse cardiac and cerebrovascular events (MACCE), defined as all-cause death, recurrent myocardial infarction, repeat coronary revascularization, and stroke. The secondary clinical outcome was stent thrombosis. After multivariable- and propensity score-adjusted analyses, in-hospital mortalities were similar between the male and female groups in both the SDT < 24 h and SDT ≥ 24 h groups. However, during a 3-year follow-up period, in the SDT < 24 h group, all-cause death (p = 0.013 and p = 0.005, respectively) and cardiac death (CD, p = 0.015 and p = 0.008, respectively) rates were significantly higher in the female group than those in the male group. This may be related to the lower all-cause death and CD rates (p = 0.022 and p = 0.012, respectively) in the SDT < 24 h group than in the SDT ≥ 24 h group among male patients. Other outcomes were similar between the male and female groups and between the SDT < 24 h and SDT ≥ 24 h groups. In this prospective cohort study, female patients showed higher 3-year mortality, especially in the SDT < 24 h, compared to male patients.
Should Multifocal Intraocular Lenses Become a Standard in Phacoemulsification Cataract Surgery?
Authors: Nemet Achia , Kanclerz Piotr , Tuuminen Raimo
Published: March 2023

Cataracts impair daily activities such as reading, outdoor sports, and driving, which may not match best-corrected visual acuity at optimal room light conditions, but can be just as important to patients [...]
Individual and Combined Effects of Reinforcements on Fractured Surface of Artificially Aged Al6061 Hybrid Composites
Authors: Shettar Manjunath , Sharma Sathyashankara , M C Gowrishankar , H M Vishwanatha , Ranjan Rakesh , Doddapaneni Srinivas
Published: March 2023

The present work mainly focuses on a comparative study of the individual and combined effect of reinforcements on tensile strength and fracture surface analysis of Al6061 alloy and its composites during artificial aging. SiC and B4C are the two reinforcements used in the present work for the preparation of Al6061 composites by the stir casting process, and the reinforcement percentage from 2, 4, and 6 wt.% varied. Both Al6061 alloy and its composites are solution-treated at 558 °C/2 h and artificially aged at 100 and 200 °C for different time intervals to achieve peak aging. The results show substantial improvement in ultimate tensile strength during low temperature aging at 100 °C. Approximately 80–110% increase in UTS value is observed in both individual and hybrid composites compared to Al6061 alloy. The mechanism of failure governing the tensile strength for both alloy and its composites is thoroughly analyzed and discussed using a scanning electron microscope. The morphology of crack propagation is also studied to determine the mechanism of failure. Al6061 alloy shows ductile failure due to coarser dimples. Al6061-SiC composites show particle-matrix interface cracking and shear failure. Al6061-B4C composites show elongated dimple rupture mode of failure, whereas Al6061-SiC + B4C hybrid composites fail due to nucleation growth and mixed fracture mode.
Effect of the Sintering Conditions on the Neck Growth during the Powder Bed Fusion with Electron Beam (PBF-EB) Process
Authors: Rizza Giovanni , Galati Manuela , Antonioni Paolo , Iuliano Luca
Published: March 2023

A distinctive characteristic of the powder bed fusion with electron beam (PBF-EB) process is the sintering of the powder particles. For certain metallic materials, this is crucial for the success of the subsequent step, the melting, and, generally, the whole process. Despite the sintering mechanisms that occur during the PBF-EB process being similar to well-known powder metallurgy, the neck growth rates are significantly different. Therefore, specific analyses are needed to understand the influence of the PBF-EB process conditions on neck growth and neck growth rate. Additionally, some aspects, such as the rigid body motion of the particles during the sintering process, are still challenging to analyze. This work systematically investigated the effects of different particle diameters and particle diameter ratios. Additionally, the impact of the rigid body motion of the particles in the sintering was analyzed. This work demonstrated that the sintering results significantly depended on the EB-PBF process conditions.
The Hydrostatic Buckling of SPM Systems of Fish Cages and a Design Method to Prevent It
Authors: Mont Guy , Drimer Nitai
Published: March 2023

This study presents an inherent buckling issue of SPM (Single Point Mooring) systems for open sea aquaculture and a design method to analyze and solve this issue. The SPM arrangement of a row of cages is very efficient, as it minimizes the anchoring load by masking of the current applied to the downstream cages, hence saves anchors and mooring lines. However, a sudden reversal of the current direction presents a risk of buckling of the row of cages, if it applies a compression load along the array of cages before rotation of the entire cage system takes place. This study presents the concept of Hydrostatic Buckling of a row of cages and a method of design and analysis to control the stability of the system at the situation of sudden current reversal. First, a simple method for preliminarily assessment by applying the principle of virtual work is formulated. Then, an analysis of the structure by a parametric finite elements code is presented. The reversal current limits for the stability of the structure, are parametrically studied, by the analyses of two hypothetical practical scenarios. This study presents practical design tools and results, such as the method of the analysis, simplified loading states for representing the critical events, the scantlings of the structure, as well as guidelines for designing a SPM system of cages that withstand critical situations of reversal current.
How Gender and Primary Language Influence the Acquisition of Economic Knowledge of Secondary School Students in the United States and Germany
Authors: Happ Roland , Schmidt Susanne , Zlatkin-Troitschanskaia Olga , Walstad William
Published: March 2023

Economics has become an essential component of secondary school curricula in many countries as a result of the growing awareness that young adults need fundamental economic knowledge to manage their personal finances. Accordingly, an increasing number of comparative studies are being conducted of commonalities and differences in students’ economic knowledge and its most decisive influencing factors within and across countries. In this study, we compare the performance of secondary school students in the United States (N = 3517) and Germany (N = 983) on the fourth version of the Test of Economic Literacy. We investigate two personal characteristics that have been found to influence the students’ acquisition of economic knowledge: gender and primary language. Although these two characteristics have been considered in numerous studies of economic education in both countries, they have not been investigated together in an international comparison, which would allow more effective pedagogical approaches for economic education to be formulated. We found male students in both countries exhibited greater economic knowledge, and students whose primary language was the same as the national language performed better. We discuss implications for economic education in both countries and cross-nationally.
Challenges in Understanding Western Economic and Financial Concepts from the Perspective of Young Adults with a Post-Soviet Migration Background in Germany—Findings from a Qualitative Interview Study
Authors: Heidel Sebastian , Happ Roland
Published: March 2023

The content of economic education in Germany is based largely on the laws and ideals of the prevailing economic system. While Western concepts such as the competitive market typically are addressed in economic programs in Germany, they may be unfamiliar in Eastern European countries that were part of, or under the influence of, the former Soviet Union, where many youths living in Germany originate. Findings from large-scale quantitative studies of economic and financial literacy in Germany indicate that people who have a migration background (MB) perform worse on tests of economic literacy than those who do not; however, these studies do not provide sufficient insight into the underlying migration-related causes of the deficits in economic literacy. In this study we investigate the influence of family financial socialization on young adults’ understanding of economic and financial concepts. We interview eight young adults with a post-Soviet MB living in Germany using a two-part procedure: problem-centered and think-aloud interviews. We found that migrant parents directly and indirectly influenced their children’s understanding of economic and financial concepts in numerous ways, and we maintain that the best way to remedy the deficits in their understanding of such concepts is through targeted programs and teacher training.
Farm Business Model on Smart Farming Technology for Sustainable Farmland in Hilly and Mountainous Areas of Japan
Authors: Iba Haruhiko , Lilavanichakul Apichaya
Published: March 2023

Farmlands in Japan’s hilly and mountainous (HM) areas face the critical challenges of aging farmers, depopulation, and disadvantageous conditions for farm management and economic performance, leading to the abandonment of farmland. Rice farming in HM areas is rarely profitable; however, it occupies 40% of Japanese agricultural production and affects food security. We proposed a farm business model to utilize smart farming technology (SFT) for rice production in the HM areas and analyzed the financial performance of the case study. The farm business model applying SFT has three stakeholders: collective activity by the farmers, farm operations by the enterprise, and a government subsidy. The model conceptualizes diversifying farm business into rice farming and other business units. Three scenarios of SFT in the farm business model consist of combinations of conventional and SFT machines: conventional machines, intermediate SFT, and advanced SFT. The results of the financial analysis on the case study were consistent with the theoretical framework of farm business models. This study revealed that the elasticity of labor productivity on fixed assets of advanced SFT (0.94) was more productive than intermediate SFT (0.63). To utilize SFT to sustain farmland in HM areas, balance between financial security and profitability, and linkage of the enterprise and community are indispensable.
Comparative Analysis of Animal-Powered Waterwheels in Mediterranean Alluvial Plains: Medjerda (Tunisia) and Jucar Rivers (Spain)
Authors: Fansa Saleh Ghaleb , Iranzo García Emilio , Pérez Cueva Alejandro J.
Published: March 2023

The animal-powered waterwheels of the meandering River Medjerda in Testour, a Tunisian town of Moorish foundation, are compared with those in the alluvial plain of the River Júcar in the region of Ribera Alta (Valencia, Spain). The methodology used in this research is qualitative-analytical and based on the comparative study of groundwater catchment systems on Mediterranean alluvial plains. The environmental characteristics (geological, climatic, hydrological and hydrogeomorphic) of both sectors are analysed to confirm the environmental similarities between both sites. The location and characteristics of these systems have also been analysed, including aspects such as technological evolution and current status, as well as their coexistence with other traditional irrigation systems. The similarity in the location, characteristics, and state of the systems in the two chosen sectors is confirmed, as well as the near absence of significant differences. For this reason, the work highlights the importance of environmental factors as opposed to cultural factors in the use and location of waterwheels.
Coupling Coordination and Spatial-Temporal Evolution of Water-Land-Food Nexus: A Case Study of Hebei Province at a County-Level
Authors: Luo Wenzhe , Jiang Yanling , Chen Yuansheng , Yu Zhigang
Published: March 2023

Exploring the interaction between water, land, and food (WLF) is a premise guaranteeing to ease resource restrictions and achieve sustainable development in major agricultural production areas. We chose 26 indicators to build a WLF nexus evaluation index system. We used the coupling coordination model to measure the coupling coordination degree of the WLF nexus in 15 prefecture-level cities and 151 counties under the jurisdiction of Hebei Province in 2000, 2005, 2010, 2015, and 2020. Then, the spatial correlation was analyzed using the global and local Moran’s I. Finally, the regional differences and spatiotemporal patterns were analyzed using a spatial gravity center model and kernel density estimation. The results are as follows: (1) In 11 cities, the comprehensive evaluation index of the WLF and of each subsystem shows a fluctuating upward trend. More than 95% of the counties’ comprehensive evaluation indices improved, and the difference between counties in the north and south narrowed after 2010. (2) The spatial pattern of the WLF in counties has evolved from a pattern of “high in the south and low in the north” to “high in the north and low in the south”, with the development speed of the north being higher than that of the south. (3) The coupling coordination degree of the WLF has a positive spatial autocorrelation relationship in different counties; however, the spatial connection eventually deteriorates, and the geographic pattern exhibits “agglomeration decrease” characteristics. In Hebei Province, the WLF coupling coordination rate slowly improves, and there is a significant development gap between counties. Therefore, local conditions should be taken into consideration when implementing measures to reduce the conflict between water, land, and food in actual regional conditions.
Cognitive Load Increases Spoken and Gestural Hesitation Frequency
Authors: Betz Simon , Bryhadyr Nataliya , Türk Olcay , Wagner Petra
Published: March 2023

This study investigates the interplay of spoken and gestural hesitations under varying amounts of cognitive load. We argue that not only fillers and silences, as the most common hesitations, are directly related to speech pausing behavior, but that hesitation lengthening is as well. We designed a resource-management card game as a method to elicit ecologically valid pausing behavior while being able to finely control cognitive load via card complexity. The method very successfully elicits large amounts of hesitations. Hesitation frequency increases as a function of cognitive load. This is true for both spoken and gestural hesitations. We conclude that the method presented here is a versatile tool for future research and we present foundational research on the speech-gesture link related to hesitations induced by controllable cognitive load.
Sentence Production in Bilingual and Multilingual Aphasia: A Scoping Review
Authors: Norhan Aslam , Hassan Fatimah Hani , A Razak Rogayah , A Aziz Mohd Azmarul
Published: March 2023

Language processing impairments across different dimensions result in deficits of informational content, syntactic complexity, and morphological well-formedness of sentences produced by people with aphasia (PWA). Deficits in language processing affect linguistic skills of bi/multilingual PWA in all languages that they have acquired prior to aphasia. However, the impairments of dual or multiple languages in aphasia may not necessarily be parallel. One language may be more preserved than another and be recovered at different paces, including sentence production abilities. This scoping review aims to compare syntactic characteristics and errors demonstrated by bi/multilingual PWAs between their acquired languages and to explore the nature of bilingual impairments in primary progressive aphasia (PPA). We conducted an online search on three databases (MEDLINE, SciVerse Scopus, and Taylor and Francis publications) for original studies on sentence production of bi/multilingual aphasia that were published between 1991 and 2021 using keywords related to “bilingualism”, “aphasia”, and “speech production”. Based on the titles, abstracts, and full-text screenings, 13 studies were found to have met our inclusion criteria. A qualitative synthesis of the accumulated evidence was conducted following the PRISMA guidelines. Collectively, past researchers reported dominance in L1 with higher occurrences of linguistic errors in L2 among participants with sudden onset aphasia. In PPA, language impairments were found to be comparable between L1 and L2, which may indicate parallel deterioration. It is noted that this review is not exhaustive and many of the reviewed studies were based on single case studies. This review also highlighted an urgent need for investigation into multilingual PPA to fully comprehend the nature of sentence production impairment.
The Impact of Vitamin D Levels on Clinical Manifestations of Multisystem Inflammatory Syndrome in Children: A Cross-Sectional Study
Authors: Petrovic Davor , Benzon Benjamin , Srsen Sasa , Polic Branka , Vukovic Novogradec Antonija , Milic Petra , Markic Josko
Published: March 2023

Background: Hyperinflammatory response that resembles Kawasaki disease may develop in children after COVID-19 disease, and it is called multisystem inflammatory syndrome in children. The cause of MIS-C is dysregulated innate immune response and a subsequent cytokine storm that results in endothelial damage. It has been determined that low levels of serum 25(OH)D increase the risk of developing immune-related diseases and disorders. Methods: To determine the incidence of hypovitaminosis D, and a possible correlation between 25(OH)D levels and the clinical severity of MIS-C, 21 patients hospitalized in the University Hospital of Split due to MIS-C were evaluated. Results: Hypovitaminosis D was detected in 95% of MIS-C patients. We found a significant relationship between the severity of MIS-C and 25(OH)D levels, as patients with more severe MIS-C had lower 25(OH)D. MIS-C patients with lower vitamin D levels had worse systolic and diastolic function of the left ventricle according to echocardiograms. There was no relationship between 25(OH)D levels and the tested laboratory inflammatory and cardiac markers. Conclusion: Hypovitaminosis D is very common in children with MIS-C and influences the severity of the disease. VD could be a new potential biomarker in MIS-C, and VD replacement therapy should be considered early on in the treatment of MIS-C.
Astrobiology in Space: A Comprehensive Look at the Solar System
Authors: De Mol Maarten L.
Published: March 2023

The field of astrobiology aims to understand the origin of life on Earth and searches for evidence of life beyond our planet. Although there is agreement on some of the requirements for life on Earth, the exact process by which life emerged from prebiotic conditions is still uncertain, leading to various theories. In order to expand our knowledge of life and our place in the universe, scientists look for signs of life through the use of biosignatures, observations that suggest the presence of past or present life. These biosignatures often require up-close investigation by orbiters and landers, which have been employed in various space missions. Mars, because of its proximity and Earth-like environment, has received the most attention and has been explored using (sub)surface sampling and analysis. Despite its inhospitable surface conditions, Venus has also been the subject of space missions due to the presence of potentially habitable conditions in its atmosphere. In addition, the discovery of habitable environments on icy moons has sparked interest in further study. This article provides an overview of the origin of life on Earth and the astrobiology studies carried out by orbiters and landers.
Multiwall Rectangular Plates under Transverse Pressure—A Non-Linear Experimental and Numerical Study
Authors: Hakim Gilad , Abramovich Haim
Published: March 2023

Large deflection of rectangular plates under transverse pressure is described by Föppl–von Kármán equations, which have only approximated solutions. One of these methods is the separation into a small deflection plate and a thin membrane described by a simple third order polynomial expression. The present study presents an analysis to obtain analytical expressions for its coefficients by using the plate’s elastic properties and dimensions. To validate the non-linear relationship between the pressure and the lateral displacement of the multiwall plate, a vacuum chamber loading test is used to measure the plate’s response, with a large number of plates and length–width combinations. In addition, to further validate the analytical expressions, several finite element analyses (FEA) were performed. It has been found that the polynomial expression fairly describes the measured and calculated deflections. This method allows the prediction of plate deflections under pressure as soon as the elastic properties and the dimensions are known.
Effect of Magnetic Coupling on the Optical Properties of Oxide Co Nanowires on Vicinal Pt Surfaces
Authors: Tsysar Kseniya M. , Bazhanov Dmitry I. , Smelova Ekaterina M.
Published: March 2023

Nowadays, modern scientific research has sparked a renewed interest to study the interaction of electromagnetic field (EM) with magnetic nanostructures and in particular in nanophotonics and spintronics. The current work is devoted to an ab initio study of the magneto-optical properties of step-decorated oxide Co nanowires (1D oxides) on vicinal Pt surfaces. Theoretical calculations of the magnetic moments are based on ab initio spin-polarized density-functional theory (DFT) including a self-consistent treatment of spin-orbit coupling. The first-principles calculations revealed the effect of magnetic coupling between cobalt spins on refractivity and extinction spectra of these 1D oxides governed by atomic structure and cobalt-oxygen interaction within a nanowire at the step edge. The emergence of a sharp pronounced peak in the spectral difference of the refractive indexes has been observed between ferromagnetic and antiferromagnetic configurations of the nanowire. Anisotropy of an extinction coefficient in the terahertz (THz) range of the spectra was established for oxide Co nanowires in an antiferromagnetic state in contrast with a ferromagnetic one.
An Intelligent Edge-as-a-Service Framework to Combat COVID-19 Using Deep Learning Techniques
Authors: Hassan Mohammad Mehedi , AlRakhami Mabrook S. , Alabrah Amerah A. , AlQahtani Salman A.
Published: March 2023

This study proposes and develops a secured edge-assisted deep learning (DL)-based automatic COVID-19 detection framework that utilizes the cloud and edge computing assistance as a service with a 5G network and blockchain technologies. The development of artificial intelligence methods through services at the edge plays a significant role in serving many applications in different domains. Recently, some DL approaches have been proposed to successfully detect COVID-19 by analyzing chest X-ray (CXR) images in the cloud and edge computing environments. However, the existing DL methods leverage only local and small training datasets. To overcome these limitations, we employed the edges to perform three tasks. The first task was to collect data from different hospitals and send them to a global cloud to train a DL model on massive datasets. The second task was to integrate all the trained models on the cloud to detect COVID-19 cases automatically. The third task was to retrain the trained model on specific COVID-19 data locally at hospitals to improve and generalize the trained model. A feature-level fusion and reduction were adopted for model performance enhancement. Experimental results on a public CXR dataset demonstrated an improvement against recent related work, achieving the quality-of-service requirements.
A One-Parameter Memoryless DFP Algorithm for Solving System of Monotone Nonlinear Equations with Application in Image Processing
Authors: Ullah Najib , Shah Abdullah , Sabi’u Jamilu , Jiao Xiangmin , Awwal Aliyu Muhammed , Pakkaranang  Nuttapol , Shah Said Karim , Panyanak Bancha
Published: March 2023

In matrix analysis, the scaling technique reduces the chances of an ill-conditioning of the matrix. This article proposes a one-parameter scaling memoryless Davidon–Fletcher–Powell (DFP) algorithm for solving a system of monotone nonlinear equations with convex constraints. The measure function that involves all the eigenvalues of the memoryless DFP matrix is minimized to obtain the scaling parameter’s optimal value. The resulting algorithm is matrix and derivative-free with low memory requirements and is globally convergent under some mild conditions. A numerical comparison showed that the algorithm is efficient in terms of the number of iterations, function evaluations, and CPU time. The performance of the algorithm is further illustrated by solving problems arising from image restoration.
Patient Perspective on the Monitoring of Their Wet Age-Related Macular Degeneration during Coronavirus Disease 2019: A Retrospective Study
Authors: Tsiropoulos Georgios N. , Vallée Rodolphe , Calci Coraline , Gallo Castro Daniela , Ambresin Aude
Published: March 2023

Background and Objectives: The purpose was to provide the patients’ perspective on the monitoring of their wet age-related macular degeneration (wet AMD) during coronavirus disease 2019 (COVID-19) and the importance of telemedicine. Materials and Methods: Wet AMD patients that underwent intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections in two Swiss ophthalmology clinics, completed two questionnaires after the first confinement due to COVID-19 in Switzerland. The first evaluated their views concerning their adherence to scheduled injections during the confinement, and the application of telemedicine in the future. The second, adapted from the National Eye Institute Visual Function Questionnaire-25, assessed their opinions on visual function change during confinement. Results: From a total of 130 patients, 8.5% responded they did not respect their assigned schedule (group 1) while 91.5% responded they did (group 2). A total of 78.7% of group 2 considered treatment reception as more relevant compared to the risk of COVID-19 contraction. During the pre-lockdown period, group 2 patients required more help from others than group 1 patients (p = 0.02). In the possibility of another lockdown, 36.3% of group 1 and 8.7% of group 2 would choose telemedicine to monitor their wet AMD (p = 0.02), 54.5% and 86.9% would rather visit the clinic (p = 0.02), while 9.0% and 4.3% would cancel their appointment, respectively. It was found that 70% of group 1 and 33.6% of group 2 would prefer to use the telemedicine services than visiting a telemedicine centre (p = 0.04). Conclusions: During circumstances similar to the COVID-19 confinement, most patients would prefer to visit the clinic. Group 1 would prefer wet AMD monitoring via telemedicine at a higher rate than group 2.
A Retrospective Study of the Efficacy and Safety of Naldemedine for Treatment of Opioid-Induced Constipation in Patients with Hepatobiliary Pancreatic Cancer
Authors: Kamiya Teruhiko , Imai Hisao , Fujita Yukiyoshi , Hiruta Eriko , Masuno Takashi , Yamazaki Shigeki , Tanaka Hajime , Sandoh Mitsuru , Takei Satoshi , Arai Kazuya , Nishiba Hiromi , Mogi Junnosuke , Koizuka Shiro , Saito Taeko , Obayashi Kyoko , Kaira Kyoichi , Minato Koichi
Published: March 2023

Background and Objectives: Opioid analgesics, which are used for cancer-related pain management, cause opioid-induced constipation (OIC). Naldemedine, a peripheral opioid receptor antagonist, is an OIC-modifying agent, but no focused efficacy and safety analysis has been conducted for its use in hepatobiliary pancreatic cancers. We performed a multi-institutional study on the efficacy and safety of naldemedine in patients with hepatobiliary pancreatic cancer using opioids in clinical practice. Materials and Methods: We retrospectively evaluated patients with hepatobiliary pancreatic cancer (including liver, biliary tract, and pancreatic cancers) treated with opioids and naldemedine during hospitalization at ten institutions in Japan from June 2017 to August 2019. We assessed the frequency of bowel movements before and after the initiation of naldemedine therapy. Responders were defined as patients who defecated ≥3 times/week, with an increase from a baseline of ≥1 defecations/week over seven days after the initiation of naldemedine administration. Results: Thirty-four patients were observed for one week before and one week after starting naldemedine. The frequency of bowel movements increased by one over the baseline frequency or to at least thrice per week in 21 patients. The response rate was 61.7% (95% confidence interval: 45.4–78.0%). The median number of weekly bowel movements before and after naldemedine treatment was 2 (range: 0–9) and 6 (range: 1–17), respectively, in the overall population (n = 34); the increase in the number of bowel movements following naldemedine administration was statistically significant (Wilcoxon signed-rank test, p < 0.0001). Diarrhea was the predominant gastrointestinal symptom, and 10 (29.4%) patients experienced grade 1, grade 2, or grade 3 adverse events. The only other adverse event included fatigue in one patient; grade 2–4 adverse events were absent. Conclusions: Naldemedine is effective, and its use may be safe in clinical practice for patients with hepatobiliary pancreatic cancer receiving opioid analgesics.
Perinatal Outcomes and Neurodevelopment 1 Year after Birth in Discordant Twins According to Chorionicity
Authors: Kim Mi Ju , Kim Hyun Mi , Cha Hyun-Hwa , Kim Haemin , Kim Hyo-Shin , Lim Bong Seon , Seong Won Joon
Published: March 2023

Background and Objectives: This study aimed to compare maternal complications, perinatal outcomes, and neurodevelopment 1 year after the birth between concordant and discordant twins in monochorionic and dichorionic twins. Materials and Methods: This retrospective study included twin pregnancies delivered between 24 + 1 and 38 + 2 weeks of gestation between January 2011 and September 2019. Chorionicity was confirmed by ultrasonography and was categorized into monochorionic and dichorionic. Each was then divided into two groups (concordant and discordant) according to birth weight discordancy. Maternal complications and neonatal outcomes, including neurodevelopmental delays, were compared between the two groups. Results: A total of 298 pairs of twin pregnancies were enrolled, of which 58 (19.26%) women were pregnant with monochorionic diamniotic twins and 240 (80.54%) with dichorionic diamniotic twins. In both monochorionic and dichorionic twins, the discordant twins had a greater incidence of emergency deliveries because of iatrogenic causes than the concordant twins. Among dichorionic twins, discordant twins had lower birth weight rates and higher hospitalization rates and morbidities than concordant twins. Among monochorionic twins, discordant twins had a lower birth weight and higher neonatal mortality than concordant twins. The neonatal size was not a predictor of neurodevelopment in this group. Based on the logistic regression analysis, male sex, respiratory distress syndrome, and bronchopulmonary dysplasia were risk factors for the neurodevelopmental delay; birth weight discordancy was significant only in dichorionic twins. Conclusions: Perinatal outcomes in discordant twins may be poor, and neurodevelopment 1 year after birth was worse in discordant twins than in concordant twins. Discordancy in twins can be a risk factor for neurodevelopmental delay.