bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Analysis of Monoaxial and Polyaxial Pedicle Screws in the Surgical Correction of Adolescent Idiopathic Scoliosis
Authors: Yang Jae Hyuk , Kim Hong Jin , Chang Tae Yeong , Suh Seung Woo , Chang Dong-Gune
Published: May 2024

Background: Although several biomechanical studies have been reported, few clinical studies have compared the efficacy of monoaxial and polyaxial pedicle screws in the surgical treatment of adolescent idiopathic scoliosis (AIS). This study aims to compare the radiological and clinical outcomes of mono- and polyaxial pedicle screws in the surgical treatment of AIS. Methods: A total of 46 AIS patients who underwent surgery to treat scoliosis using pedicle screw instrumentation (PSI) and rod derotation (RD) were divided into two groups according to the use of pedicle screws: the monoaxial group (n = 23) and polyaxial group (n = 23). Results: The correction rate of the main Cobb’s angle was higher in the monoaxial group (70.2%) than in the polyaxial group (65.3%) (p = 0.040). No differences in the rotational correction of the apical vertebra were evident between the two groups. SRS-22 scores showed no significant differences according to the type of pedicle screws used. Conclusions: The use of polyaxial pedicle screws resulted in coronal, sagittal, and rotational correction outcomes comparable to those associated with the use of monoaxial pedicle screws for surgical treatment using PSI and RD to treat moderate cases of AIS.
Inconsistent Methods Used to Set Airway Pressure Release Ventilation in Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Regression Analysis
Authors: Lutz Mark R. , Charlamb Jacob , Kenna Joshua R. , Smith Abigail , Glatt Stephen J. , Araos Joaquin D. , Andrews Penny L. , Habashi Nader M. , Nieman Gary F. , Ghosh Auyon J.
Published: May 2024

Airway pressure release ventilation (APRV) is a protective mechanical ventilation mode for patients with acute respiratory distress syndrome (ARDS) that theoretically may reduce ventilator-induced lung injury (VILI) and ARDS-related mortality. However, there is no standard method to set and adjust the APRV mode shown to be optimal. Therefore, we performed a meta-regression analysis to evaluate how the four individual APRV settings impacted the outcome in these patients. Methods: Studies investigating the use of the APRV mode for ARDS patients were searched from electronic databases. We tested individual settings, including (1) high airway pressure (PHigh); (2) low airway pressure (PLow); (3) time at high airway pressure (THigh); and (4) time at low pressure (TLow) for association with PaO2/FiO2 ratio and ICU length of stay. Results: There was no significant difference in PaO2/FiO2 ratio between the groups in any of the four settings (PHigh difference −12.0 [95% CI −100.4, 86.4]; PLow difference 54.3 [95% CI −52.6, 161.1]; TLow difference −27.19 [95% CI −127.0, 72.6]; THigh difference −51.4 [95% CI −170.3, 67.5]). There was high heterogeneity across all parameters (PhHgh I2 = 99.46%, PLow I2 = 99.16%, TLow I2 = 99.31%, THigh I2 = 99.29%). Conclusions: None of the four individual APRV settings independently were associated with differences in outcome. A holistic approach, analyzing all settings in combination, may improve APRV efficacy since it is known that small differences in ventilator settings can significantly alter mortality. Future clinical trials should set and adjust APRV based on the best current scientific evidence available.
Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach
Authors: Staromłyński Jakub , Kowalówka Adam , Gocoł Radosław , Hudziak Damian , Żurawska Małgorzata , Nowak Wojciech , Pasierski Michał , Sarnowski Wojciech , Smoczyński Radosław , Bartczak Maciej , Brączkowski Jakub , Sadecka Sabina , Drobiński Dominik , Deja Marek , Szymański Piotr , Suwalski Piotr , Kowalewski Mariusz
Published: May 2024

Background: Aortic valve-sparing aortic root replacement (VSARR) David procedure has not been routinely performed via minimally invasive access due to its complexity. Methods: We compared our results for mini-VSARR to sternotomy-VSARR from another excellence center. Results: Eighty-four patients, 62 in the sternotomy-VSARR group and 22 in the mini-VSARR group, were included. A baseline, the aneurysm dimensions were higher in the mini-VSARR group. Propensity matching resulted in 17 pairs with comparable characteristics. Aortic cross-clamp and cardiopulmonary bypass times were significantly longer in the mini-VSARR group, by 60 and 20 min, respectively (p < 0.001). In-hospital outcomes were comparable between the groups. Drainage volumes were numerically lower, and hospital length of stay was, on average, 3 days shorter (p < 0.001) in the mini-VSARR group. At a median follow-up of 5.5 years, there was no difference in mortality (p = 0.230). Survival at 1, 5 and 10 years was 100%, 100%, and 95% and 95%, 87% and 84% in the mini-VSARR and sternotomy-VSARR groups, respectively. No repeat interventions on the aortic valve were documented. Echocardiographic follow-up was complete in 91% with excellent durability of repair regardless of the approach: no cases of moderate/severe aortic regurgitation were reported in the mini-VSARR group. Conclusions: The favorable outcomes, reduced drainage, and shorter hospital stays associated with the mini-sternotomy approach underscore its potential advantages expanding beyond cosmetic outcome.
Validation of the IWATE Criteria in Robotic-Assisted Liver Resections
Authors: Lamberty Sophia A. , Hoelzen Jens Peter , Katou Shadi , Becker Felix , Juratli Mazen A. , Andreou Andreas , Morgül M. Haluk , Pascher Andreas , Strücker Benjamin
Published: May 2024

Background/Objectives: The IWATE criteria are well-established as a helpful tool to preoperatively estimate the difficulty and perioperative outcome of laparoscopic liver resections. We evaluated the relationship between the IWATE criteria and the perioperative outcomes in robotic-assisted liver resections (RARLs). Methods: We retrospectively analyzed the data of 58 patients who underwent robotic-assisted liver surgery at our center between July 2019 and April 2023. The operative difficulty of every patient was graded according to the IWATE criteria and compared to the perioperative outcome. Results: The median operation time was 236.5 min (range 37–671 min), and the median length of stay was 6 days (range 3–37 min). The majority had no complications (65.5%; n = 38), 18 (31.0%) patients suffered from mild complications (CD ≤ 3A) and 2 patients (3.4%) suffered from relevant complications (CD ≥ 3B). We observed no deaths within 30 postoperative days. The surgery time, postoperative ICU stay and perioperative blood transfusions increased significantly with a higher difficulty level (p = < 0.001; p < 0.001; p = 0.016). The length of stay, conversion to open surgery (n = 2) and complication rate were not significantly linked to the resulting IWATE group. Conclusions: The IWATE criteria can be implemented in robotic-assisted liver surgery and can be helpful in preoperatively estimating the difficulty of robotic liver resections. Whether there is a “robotic effect” in minimally invasive liver resections has to be further clarified. The IWATE criteria can help to develop curricula for robotic training.
The Dawn and Advancement of the Knowledge of the Genetics of Migraine
Authors: Zalaquett Nader G. , Salameh Elio , Kim Jonathan M. , Ghanbarian Elham , Tawk Karen , Abouzari Mehdi
Published: May 2024

Background: Migraine is a prevalent episodic brain disorder known for recurrent attacks of unilateral headaches, accompanied by complaints of photophobia, phonophobia, nausea, and vomiting. Two main categories of migraine are migraine with aura (MA) and migraine without aura (MO). Main body: Early twin and population studies have shown a genetic basis for these disorders, and efforts have been invested since to discern the genes involved. Many techniques, including candidate-gene association studies, loci linkage studies, genome-wide association, and transcription studies, have been used for this goal. As a result, several genes were pinned with concurrent and conflicting data among studies. It is important to understand the evolution of techniques and their findings. Conclusions: This review provides a chronological understanding of the different techniques used from the dawn of migraine genetic investigations and the genes linked with the migraine subtypes.
Periapical Lesions in Panoramic Radiography and CBCT Imaging—Assessment of AI’s Diagnostic Accuracy
Authors: Kazimierczak Wojciech , Wajer Róża , Wajer Adrian , Kiian Veronica , Kloska Anna , Kazimierczak Natalia , Janiszewska-Olszowska Joanna , Serafin Zbigniew
Published: May 2024

Background/Objectives: Periapical lesions (PLs) are frequently detected in dental radiology. Accurate diagnosis of these lesions is essential for proper treatment planning. Imaging techniques such as orthopantomogram (OPG) and cone-beam CT (CBCT) imaging are used to identify PLs. The aim of this study was to assess the diagnostic accuracy of artificial intelligence (AI) software Diagnocat for PL detection in OPG and CBCT images. Methods: The study included 49 patients, totaling 1223 teeth. Both OPG and CBCT images were analyzed by AI software and by three experienced clinicians. All the images were obtained in one patient cohort, and findings were compared to the consensus of human readers using CBCT. The AI’s diagnostic accuracy was compared to a reference method, calculating sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and F1 score. Results: The AI’s sensitivity for OPG images was 33.33% with an F1 score of 32.73%. For CBCT images, the AI’s sensitivity was 77.78% with an F1 score of 84.00%. The AI’s specificity was over 98% for both OPG and CBCT images. Conclusions: The AI demonstrated high sensitivity and high specificity in detecting PLs in CBCT images but lower sensitivity in OPG images.
Role of Vascular Function in the Prognosis of Heart Failure Patients
Authors: Kiuchi Shunsuke , Hisatake Shinji , Dobashi Shintaro , Murakami Yoshiki , Ikeda Takanori
Published: May 2024

Background: Blood vessels have the Windkessel effect and are involved in blood circulation. The breakdown of this mechanism is also involved in the pathogenesis of heart failure (HF); however, the relationship between vascular dysfunction and HF prognosis is not fully understood. Methods: We evaluated 214 patients hospitalized for HF at our institution who underwent a cardio–ankle vascular index (CAVI), which evaluates vascular function, between January 2012 and July 2018. To investigate factors (including CAVI) associated with major adverse cardiac events (MACE) during 1 year after patients with HF were discharged, we evaluated clinical profiles, blood tests, chest X-P, 12-lead electrocardiography, and transthoracic echocardiographic findings. MACE was defined as cardiovascular death or readmission for HF. Results: The severity of HF between the MACE and non-MACE was not significantly different. Previous HF and chronic kidney disease were significantly more common in the MACE group. CAVI and % mean atrial pressure in the MACE group were statistically higher than those in the non-MACE group. The cardiac shadow as shown by chest X-P and left ventricular size in the MACE group were significantly bigger, and HF preserved ejection fraction (EF) (EF > 50%) was significantly more common in the MACE group. In multivariate analysis, CAVI was an independent predictive factor for the occurrence of MACE (model 1; hazard ratio (HR): 1.33, 95% confidence interval (CI): 1.05–1.68, p = 0.018; model 2; HR: 1.31, 95% CI: 1.07–1.60, p = 0.009). Conclusions: Because high CAVI is associated with poor prognosis of HF, these patients require more careful treatment.
Alcohol Consumption Is a Coping Mechanism for Male Patients with Severe Anxiety Disorders Treated with Antidepressants Monotherapy
Authors: Mușat Mădălina Iuliana , Militaru Felicia , Udriștoiu Ion , Mitran Smaranda Ioana , Cătălin Bogdan
Published: May 2024

Background: Anxiety disorders are prevalent mental health conditions often accompanied by various comorbidities. The association between anxiety and liver disease, as well as fluctuations in blood sugar levels, highlights the importance of carefully evaluating patients with anxiety undergoing antidepressant therapy. The aim of this study was to conduct a comparative assessment of liver function and blood glucose levels in patients diagnosed with anxiety disorders while considering potential gender-specific differences. Methods: An analysis was conducted over a 24-month period. This study included 88 patients diagnosed with anxiety disorders, with symptoms severe enough to require hospitalization, aged 18 or older, undergoing antidepressant monotherapy, without any additional pathologies. Liver enzymes (AST, ALT, GGT), AST/ALT ratio, and blood glucose levels were measured and compared. Results: While no significant differences were found between antidepressant classes, increased GGT levels were observed in men older than 40 years compared to women of the same age, suggesting that alcohol consumption may be a coping mechanism for anxiety. This gender difference was not observed among young patients. Conclusions: Early detection of alcohol consumption is essential in patients with anxiety disorders in order to prevent alcohol-related liver damage and to adjust the management of both conditions accordingly.
Thermomechanical Responses and Energy Conversion Efficiency of a Hybrid Thermoelectric–Piezoelectric Layered Structure
Authors: Jin Zhihe , Yang Jiashi
Published: May 2024

This paper develops a thermoelectric (TE)–piezoelectric (PE) hybrid structure with the PE layer acting as both a support membrane and a sensor for the TE film for microelectronics applications. The TE and PE layers are assumed to be perfectly bonded mechanically and thermally but electrically shielded and insulated with each other. The thermo-electro-mechanical responses of the hybrid bilayer under the TE generator operation conditions are obtained, and the influence of the PE layer on the TE energy conversion efficiency is investigated. The numerical results for a Bi2Te3/PZT-5H bilayer structure show that large compressive stresses develop in both the PE and TE layers. With a decrease in the PE layer thickness, the magnitude of the maximum compressive stress in the PE layer increases whereas the maximum magnitude of the stress in the TE layer decreases. The numerical result of the TE energy conversion efficiency shows that increasing the PE layer thickness leads to lower energy conversion efficiencies. A nearly 40% reduction in the peak efficiency is observed with a PE layer of the same thickness as that of the TE layer. These results suggest that design of TE films with supporting/sensing membranes must consider both aspects of energy conversion efficiency and the thermomechanical reliability of both the TE and PE layers.
A Review on Fusion Welding of Dissimilar Ferritic/Austenitic Steels: Processing and Weld Zone Metallurgy
Authors: Giudice Fabio , Missori Severino , Scolaro Cristina , Sili Andrea
Published: May 2024

Dissimilar welds between ferritic and austenitic steels represent a good solution for exploiting the best performance of stainless steels at high and low temperatures and in aggressive environments, while minimizing costs. Therefore, they are widely used in nuclear and petrochemical plants; however, due to the different properties of the steels involved, the welding process can be challenging. Fusion welding can be specifically applied to connect low-carbon or low-alloy steels with high-alloy steels, which have similar melting points. The welding of thick plates can be performed with an electric arc in multiple passes or in a single pass by means of laser beam equipment. Since the microstructure and, consequently, the mechanical properties of the weld are closely related to the composition, the choice of the filler metal and processing parameters, which in turn affect the dilution rate, plays a fundamental role. Numerous technical solutions have been proposed for welding dissimilar steels and much research has developed on welding metallurgy; therefore, this article is aimed at a review of the most recent scientific literature on issues relating to the fusion welding of ferritic/austenitic steels. Two specific sections are dedicated, respectively, to electric arc and laser beam welding; finally, metallurgical issues, related to dilution and thermal field are debated in the discussion section.
Importance of Dark Septate Endophytes in Agriculture in the Face of Climate Change
Authors: Huertas Victoria , Jiménez Alicia , Diánez Fernando , Chelhaoui Rabab , Santos Mila
Published: May 2024

Climate change is a notable challenge for agriculture as it affects crop productivity and yield. Increases in droughts, salinity, and soil degradation are some of the major consequences of climate change. The use of microorganisms has emerged as an alternative to mitigate the effects of climate change. Among these microorganisms, dark septate endophytes (DSEs) have garnered increasing attention in recent years. Dark septate endophytes have shown a capacity for mitigating and reducing the harmful effects of climate change in agriculture, such as salinity, drought, and the reduced nutrient availability in the soil. Various studies show that their association with plants helps to reduce the harmful effects of abiotic stresses and increases the nutrient availability, enabling the plants to thrive under adverse conditions. In this study, the effect of DSEs and the underlying mechanisms that help plants to develop a higher tolerance to climate change were reviewed.
Clinical Evaluation of Oral Midazolam Containing Cyclodextrin in Pediatric Magnetic Resonance: A Retrospective Cohort Study
Authors: Garra Rossella , Piersanti Alessandra , Del Vicario Miryam , Pizzo Cecilia Maria , Festa Rossano , Tosi Federica , Sbaraglia Fabio , Spano Michelangelo Mario , Della Sala Filomena , Rossi Marco
Published: May 2024

Background: Reducing a child’s level of anxiety before magnetic resonance imaging (MRI) procedures allows for better behavioral outcomes. The aim of this retrospective study was to evaluate anxiolytic efficacy of Midazolam/γ-cyclodextrin oral formulation. Methods: We retrospectively reviewed 100 medical charts of children who, between 1 February and 31 July 2022, underwent MRI under general anesthesia with or without premedication with midazolam/γ-cyclodextrin. Primary outcome was comparison of behavior to facemask positioning, while secondary endpoints were degree of drugs acceptance, anxiolytic effect evaluation, child’s behavior on separation, and sevoflurane need. Results: Facemask positioning was accepted by 58% of the midazolam/γ-cyclodextrin group compared to 22% of children in the control group. The rate of acceptance was >90%. At the moment of separation from parent, none of the premedicated children needed to be restrained compared to 18% in the control group. A lower percentage of sevoflurane was needed for eye-closure at induction of anesthesia and for anesthesia maintenance. At emergence from anesthesia, 46% of children in the premedicated group compared to 66% of children in the control group showed transient agitation. Conclusions: Midazolam/γ-cyclodextrin showed a good profile of acceptance, satisfactory anxiolytic properties, and reduced need for anesthetics when administered to children before MRI under general anesthesia.
Influence of Heart Rate and Change in Wavefront Direction through Pacing on Conduction Velocity and Voltage Amplitude in a Porcine Model: A High-Density Mapping Study
Authors: Wilhelm Theresa Isabelle , Lewalter Thorsten , Reiser Judith , Werner Julia , Keil Andreas , Oesterlein Tobias , Gleirscher Lukas , Tiemann Klaus , Jilek Clemens
Published: May 2024

Background: Understanding the dynamics of conduction velocity (CV) and voltage amplitude (VA) is crucial in cardiac electrophysiology, particularly for substrate-based catheter ablations targeting slow conduction zones and low voltage areas. This study utilizes ultra-high-density mapping to investigate the impact of heart rate and pacing location on changes in the wavefront direction, CV, and VA of healthy pig hearts. Methods: We conducted in vivo electrophysiological studies on four healthy juvenile pigs, involving various pacing locations and heart rates. High-resolution electroanatomic mapping was performed during intrinsic normal sinus rhythm (NSR) and electrical pacing. The study encompassed detailed analyses at three levels: entire heart cavities, subregions, and localized 5-mm-diameter circular areas. Linear mixed-effects models were used to analyze the influence of heart rate and pacing location on CV and VA in different regions. Results: An increase in heart rate correlated with an increase in conduction velocity and a decrease in voltage amplitude. Pacing influenced conduction velocity and voltage amplitude. Pacing also influenced conduction velocity and voltage amplitude, with varying effects observed based on the pacing location within different heart cavities. Pacing from the right atrium (RA) decreased CV in all heart cavities. The overall CV and VA changes in the whole heart cavities were not uniformly reflected in all subregions and subregional CV and VA changes were not always reflected in the overall analysis. Overall, there was a notable variability in absolute CV and VA changes attributed to pacing. Conclusions: Heart rate and pacing location influence CV and VA within healthy juvenile pig hearts. Subregion analysis suggests that specific regions of the heart cavities are more susceptible to pacing. High-resolution mapping aids in detecting regional changes, emphasizing the substantial physiological variations in CV and VA.
Fetal Splenic Artery Pulsatility Index May Predict the Need for Neonatal Intensive Care in Gestational Diabetes Class A1 Cases
Authors: Albayrak Mehmet , Akbas Humeyra , Guvendag Guven Emine Seda , Guven Suleyman
Published: May 2024

The fetal splenic artery pulsatility index is a parameter that reflects fetal well-being and has been used as a predictor of adverse pregnancy outcomes. The aim of this study was to investigate the predictive value of the splenic artery pulsatility index in gestational diabetes mellitus class A1 cases for intensive care unit admission. In this prospective case-controlled study, only sixty single pregnancy cases diagnosed with gestational diabetes mellitus class A1 were evaluated. Fetal splenic artery Doppler parameters such as peak systolic velocity, pulsatility index, resistivity index, and end-diastolic velocity were measured in all cases. The rate of requirements for the neonatal intensive care unit was noted. In cases requiring fetal intensive care, the fetal splenic pulsatility index was found to be statistically significantly lower than in healthy cases without it (0.94 ± 0.29 vs. 1.70 ± 0.53, respectively, p < 0.001, Student’s t-test). When the fetal splenic PI cutoff value was selected as 1.105 cm3, the sensitivity was calculated as 97.9% and the specificity as 58.3% for predicting the need for fetal intensive care (AUC 0.968, p < 0.001, 95% CI 0.929–0.998). The use of a low fetal splenic artery PI parameter is a significant and good indicator for predicting the need for fetal intensive care according to the binary logistic regression analysis result (p = 0.006). This study suggests that evaluation of fetal splenic artery Doppler in mothers with gestational diabetes mellitus may be used to predict neonates requiring a newborn intensive care unit. Therefore, it is recommended that obstetricians use this simple, rapid, and valuable evaluation of fetal splenic artery Doppler and alert the neonatologist that a newborn intensive care unit may be required.
Immunologic Factors Associated with Differential Response to Neoadjuvant Chemoimmunotherapy in Triple-Negative Breast Cancer
Authors: Seager Robert J. , Ko Heidi , Pabla Sarabjot , Senosain Maria-Fernanda , Kalinski Pawel , Van Roey Erik , Gao Shuang , Strickland Kyle C. , Previs Rebecca Ann , Nesline Mary K. , Hastings Stephanie , Zhang Shengle , Conroy Jeffrey M. , Jensen Taylor J. , Eisenberg Marcia , Caveney Brian , Severson Eric A. , Ramkissoon Shakti , Gandhi Shipra
Published: May 2024

Background: KEYNOTE-522 resulted in FDA approval of the immune checkpoint inhibitor pembrolizumab in combination with neoadjuvant chemotherapy for patients with early-stage, high-risk, triple-negative breast cancer (TNBC). Unfortunately, pembrolizumab is associated with several immune-related adverse events (irAEs). We aimed to identify potential tumor microenvironment (TME) biomarkers which could predict patients who may attain pathological complete response (pCR) with chemotherapy alone and be spared the use of anti-PD-1 immunotherapy. Methods: Comprehensive immune profiling, including RNA-seq gene expression assessment of 395 immune genes, was performed on matched FFPE tumor samples from 22 stage I-III TNBC patients (14 patients treated with neoadjuvant chemotherapy alone (NAC) and 8 treated with neoadjuvant chemotherapy combined with pembrolizumab (NAC+I)). Results: Differential gene expression analysis revealed that in the NAC group, IL12B and IL13 were both significantly associated with pCR. In the NAC+I group, LCK and TP63 were significantly associated with pCR. Patients in both treatment groups exhibiting pCR tended to have greater tumor inflammation than non-pCR patients. In the NAC+I group, patients with pCR tended to have greater cell proliferation and higher PD-L1 expression, while in the NAC group, patients with pCR tended to have lower cancer testis antigen expression. Additionally, the NAC+I group trended toward a lower relative dose intensity averaged across all chemotherapy drugs, suggesting that more dose reductions or treatment delays occurred in the NAC+I group than the NAC group. Conclusions: A comprehensive understanding of immunologic factors could potentially predict pCR to chemotherapy alone, enabling the avoidance of the unnecessary treatment of these patients with checkpoint inhibitors.
A Noninvasive Arterial Stiffness Index to Estimate the Severity of Coronary Atherosclerosis in Patients Undergoing Coronary Angiography
Authors: Uchida Kotaro , Chen Lin , Minegishi Shintaro , Sugawara Takuya , Sasaki-Nakashima Rie , Arakawa Kentaro , Doi Hiroshi , Kino Tabito , Tada Naoki , Tarumi Sho , Kawaura Noriyuki , Tamura Kouichi , Hibi Kiyoshi , Ishigami Tomoaki
Published: May 2024

The early diagnosis and appropriate treatment of subclinical atherosclerosis before the onset of life-threatening cardiovascular (CV) diseases are major unmet medical needs in current clinical practice. Noninvasive arterial stiffness indices, the arterial velocity–pulse index (AVI) and the arterial pressure–volume index (API) have been associated with CV risks, conventional arterial stiffness indices, and the severity of coronary atherosclerosis. However, few studies have examined the relationship between these indices and the occurrence of CV events. We measured the AVI and API in 113 consecutive patients admitted to Yokohama City University Hospital for cardiac catheterization between June 2015 and March 2016. Patients were followed until September 2022, and the occurrence of CV events was assessed. The mean age was 71.2 ± 10.7 years, and 83 patients (73.5%) were male. In total, 80 patients (70.8%) had hypertension, 87 (77.0%) had dyslipidemia, and 91 (80.5%) had a history of ischemic heart disease (IHD). The mean follow-up duration was 1752 ± 819 days. Patients who received elective percutaneous coronary intervention (PCI) based on the results of coronary angiography (CAG) at the time of enrollment had significantly higher API than those who did not (38.5 ± 12.6, n = 17 vs. 31.3 ± 7.4, n = 96, p = 0.001). The API was independently associated with the risk of elective PCI in multiple logistic regression analysis. In conclusion, the API could be a useful indicator for estimating the need for coronary interventional treatment in patients with a high CV risk.
Land Characterization System Software: Implementing Land Cover Ontology
Authors: Mosca Nicola , Mushtaq Fatima , Munene Victor , Maleh Peter , Mnyanda Ndyebo , Jalal Rashed , Ghosh Amit
Published: May 2024

Land cover (LC) plays a crucial role in the monitoring and planning of the environment among various domains, such as climate change, the management of natural resources, and sustainable development. However, inconsistent LC legends hamper their usability, particularly as technologies, like remote sensing, rapidly improve data quality and quantity for extracting valuable information. Ontologies play a pivotal role in improving the standardization and harmonization of different LC taxonomies, enabling both a reduction in inconsistencies and a way to harness ever-increasing computing power to help scientists provide faster and better answers. However, using ontologies without suitable tools, especially when expressive power is matched with complexity, can prove a daunting task. This paper introduces the land characterization system (LCHS), an innovative tool built to support the ontology discussed in the ISO 19144-2 standard, known as Land Cover Meta Language (LCML). The LCHS can help streamline and speed up the creation and editing of LC legends using a data-driven design approach.
Interpreting Different Narratives about Land Services and Land Use Economics of Common Agricultural Policy
Authors: Poláková Jana , Humpál Jaroslav , Svoboda Adam , Soukup Josef
Published: May 2024

Since 2023, a new format of the Common Agricultural Policy (CAP) has been implemented in Europe. Market forces alone cannot guarantee land services, which can be described as flows of goods and services from ecosystems to human systems as functions of nature. Market forces also cannot ensure food security everywhere and at all times, so deliberate measures should incentivize farmers to adopt sustainable agricultural practices and maintain necessary skills and resources. This study identifies, quantifies, and interprets four narratives that are typical in the approach to food security and the public debate about the land services in the CAP Strategic Plans: (A) provision of land services within the Pillar 1 economics; (B) small vs. large farms; (C) direct payments in comparison with rural development; and (D) choices by the old and new member states. Participatory processes, descriptive statistics, and partial component analysis were used in terms of the methodology. The key finding is that the importance attached to eco-schemes varies among member states, although a majority dedicate approximately 25% of the Pillar 1 budget to them. We showed that small-scale farming countries move resources from Pillar 2 to strengthen direct payments. In contrast, affluent countries with robust agricultural structures can afford to reinforce Pillar 2 rural development through transfers from direct payments. To support small-scale and medium farms, appropriate support requires a combination of several measures, including the sizable hectare payment in Pillar 1 and farmer-oriented agri-environmental measures.
‘Refuse Dump, Hurry Up!’: A Cognitive Onomastic and Cultural Metaphor Perspective of Nzema Death-Prevention Names
Authors: Yakub Mohammed
Published: May 2024

African personal names have communicative contents that reflect the experiences and expectations of the name-giver as well as the bearer. Death-prevention names, for instance, provide some assurance and security that are vital for a child’s survival, given the implicit assumption that certain spiritual forces are at work. The bestowal of despicable and ‘ugly’ names on children whose preceding siblings died shortly after birth is also a common practice among the Nzema, aiming at preventing succeeding children from death. This study examines cultural conceptions and metaphorical correlations in Nzema death-prevention names. Using 42 death-prevention names obtained through interviews, the study discusses the implications of the names and their metaphoric connections with the objects used to identify this category of people. The study reveals that features of entities such as ɛkpɔtɛ ‘vulture’, nrɛzenra ‘housefly’, kɛndɛne ‘basket’, and fovolɛ ‘refuse dump’ are attributed to these children to make them seem ‘unpleasant’ to the ancestral spirits who are believed to have been snatching them after birth. Other ‘long-lasting’ entities like nyevile ‘sea’, bolɛ ‘rock’, and kpɔma ‘walking stick’ are used metaphorically to refer to a child with the belief that they would survive right from birth and live long on the earth.
A Compact Model for the Clustered Orienteering Problem
Authors: Montemanni Roberto , Smith Derek H.
Published: May 2024

Background: The Clustered Orienteering Problem is an optimization problem faced in last-mile logistics. The aim is, given an available time window, to visit vertices and to collect as much profit as possible in the given time. The vertices to visit have to be selected among a set of service requests. In particular, the vertices belong to clusters, the profits are associated with clusters, and the price relative to a cluster is collected only if all the vertices of a cluster are visited. Any solving methods providing better solutions also imply a new step towards sustainable logistics since companies can rely on more efficient delivery patterns, which, in turn, are associated with an improved urban environment with benefits both to the population and the administration thanks to an optimized and controlled last-mile delivery flow. Methods: In this paper, we propose a constraint programming model for the problem, and we empirically evaluate the potential of the new model by solving it with out-of-the-box software. Results: The results indicate that, when compared to the exact methods currently available in the literature, the new approach proposed stands out. Moreover, when comparing the quality of the heuristic solutions retrieved by the new model with those found by tailored methods, a good performance can be observed. In more detail, many new best-known upper bounds for the cost of the optimal solutions are reported, and several instances are solved to optimality for the first time. Conclusions: The paper provides a new practical and easy-to-implement tool to effectively deal with an optimization problem commonly faced in last-mile logistics.
A Study on the Materials Used in Ancient Wooden Architectural Paintings at DaZhong Gate in Confucius Temple, Qufu, Shandong, China
Authors: Li Kuiju , Han Kezhu , Teri Gele , Tian Yuxiao , Cui Menglei , Qi Yunpeng , Li Yuhu
Published: May 2024

This study analyzes the pigments and binders used in the painted wooden structure of DaZhong Gate in the Confucius Temple in Qufu, Shandong Province, China. Five samples were collected from the building and analyzed using techniques such as polarized light microscopy (PLM), energy-dispersive X-ray spectroscopy (EDX), micro-Raman spectroscopy (m-RS), and Fourier-transform infrared spectroscopy (FT-IR). The findings reveal that the red, yellow, green, and blue pigments are identified as lead red, lead chromate yellow, emerald green, and ultramarine, respectively. The white pigment is determined to be a combination of chalk and lead white or anglesite. Considering the production period of the yellow and green pigments, it is inferred that architectural paintings underwent restoration or repainting during the late Qing Dynasty. The analysis of the binder in the pigment using pyrolysis–gas chromatography/mass spectrometry (Py-GC/MS) reveals that the binder employed is a protein-based glue. Additionally, the detected presence of Heat-bodied tung oil suggests a potential connection to traditional Chinese painting techniques on wooden surfaces. This discovery not only contributes to the historical research of the Confucius Temple but also provides crucial data for the conservation and restoration efforts of this culturally significant heritage site.
A Review of Wrist Rehabilitation Robots and Highlights Needed for New Devices
Authors: Garcia Gabriella Faina , Gonçalves Rogério Sales , Carbone Giuseppe
Published: May 2024

Various conditions, including traffic accidents, sports injuries, and neurological disorders, can impair human wrist movements, underscoring the importance of effective rehabilitation methods. Robotic devices play a crucial role in this regard, particularly in wrist rehabilitation, given the complexity of the human wrist joint, which encompasses three degrees of freedom: flexion/extension, pronation/supination, and radial/ulnar deviation. This paper provides a comprehensive review of wrist rehabilitation devices, employing a methodological approach based on primary articles sourced from PubMed, ScienceDirect, Scopus, and IEEE, using the keywords “wrist rehabilitation robot” from 2007 onwards. The findings highlight a diverse array of wrist rehabilitation devices, systematically organized in a tabular format for enhanced comprehension. Serving as a valuable resource for researchers, this paper enables comparative analyses of robotic wrist rehabilitation devices across various attributes, offering insights into future advancements. Particularly noteworthy is the integration of serious games with simplified wrist rehabilitation devices, signaling a promising avenue for enhancing rehabilitation outcomes. These insights lay the groundwork for the development of new robotic wrist rehabilitation devices or to make improvements to existing prototypes incorporating a forward-looking approach to improve rehabilitation outcomes.
High-Level Process Modeling—An Experimental Investigation of the Cognitive Effectiveness of Process Landscape Diagrams
Authors: Polančič Gregor , Kous Katja
Published: May 2024

Unlike business process diagrams, where ISO/IEC 19510 (BPMN 2.0) prevails, high-level process landscape diagrams are being designed using a variety of standard- or semi-standard-based notations. Consequently, landscape diagrams differ among organizations, domains, and modeling tools. As (process landscape) diagrams need to be understandable in order to communicate effectively and thus form the basis for valid business decisions, this study aims to empirically validate the cognitive effectiveness of common landscape designs, including those BPMN-L-based, which represent a standardized extension of BPMN 2.0 specifically aimed at landscape modeling. Empirical research with 298 participants was conducted in which cognitive effectiveness was investigated by observing the speed, ease, accuracy, and efficiency of answering questions related to semantically equivalent process landscape diagrams modeled in three different notations: value chains, ArchiMate, and BPMN-L. The results demonstrate that BPMN-L-based diagrams performed better than value chain- and ArchiMate-based diagrams concerning speed, accuracy, and efficiency; however, subjects perceived BPMN-L-based diagrams as being less easy to use when compared to their counterparts. The results indicate that differences in cognitive effectiveness measures may result from the design principles of the underlying notations, specifically the complexity of the visual vocabulary and semiotic clarity, which states that modeling concepts should have unique visualizations.
Hyers–Ulam–Rassias Stability of Nonlinear Implicit Higher-Order Volterra Integrodifferential Equations from above on Unbounded Time Scales
Authors: Reinfelds Andrejs , Christian Shraddha
Published: May 2024

In this paper, we present sufficient conditions for Hyers-Ulam-Rassias stability of nonlinear implicit higher-order Volterra-type integrodifferential equations from above on unbounded time scales. These new sufficient conditions result by reducing Volterra-type integrodifferential equations to Volterra-type integral equations, using the Banach fixed point theorem, and by applying an appropriate Bielecki type norm, the Lipschitz type functions, where Lipschitz coefficient is replaced by unbounded rd-continuous function.
The Preventive Role of Glutamine Supplementation in Cardiac Surgery-Associated Kidney Injury from Experimental Research to Clinical Practice: A Narrative Review
Authors: Drăgan Anca , Drăgan Adrian Ştefan
Published: May 2024

Acute kidney injury represents a significant threat in cardiac surgery regarding complications and costs. Novel preventive approaches are needed, as the therapeutic modalities are still limited. As experimental studies have demonstrated, glutamine, a conditionally essential amino acid, might have a protective role in this setting. Moreover, the levels of glutamine after the cardiopulmonary bypass are significantly lower. In clinical practice, various trials have investigated the effects of glutamine supplementation on cardiac surgery with encouraging results. However, these studies are heterogeneous regarding the selection criteria, timing, dose, outcomes studied, and way of glutamine administration. This narrative review aims to present the potential role of glutamine in cardiac surgery-associated acute kidney injury prevention, starting from the experimental studies and guidelines to the clinical practice and future directions.
Serum Calprotectin in the Evaluation of Gastrointestinal Diseases: An Ace up Your Sleeve?
Authors: Saviano Angela , Migneco Alessio , Brigida Mattia , Petruzziello Carmine , Zanza Christian , Savioli Gabriele , Franceschi Francesco , Ojetti Veronica
Published: May 2024

Background: Calprotectin (CP) is a calcium- and zinc-binding protein that plays a key role in innate immunity and in the recruitment of inflammatory cells. CP can be detected both in serum and in fecal samples. Serum CP (sCP) is more specific for autoimmune diseases, while fecal CP (fCP) has been well investigated for gastrointestinal diseases. Few studies have shown the clinical effectiveness of sCP as an acute-phase biomarker for gastrointestinal diseases. Aim: The aim of this narrative review is to discuss the role of sCP as a useful alternative biomarker of the acute-phase activity of gastrointestinal diseases and as a possible tool for screening and monitoring these diseases. Material and Methods: We searched original articles, abstracts, reviews, case reports, and clinical trials on PubMed®, Up-to-Date®, and Medscape® in the last ten years. Conclusion: We found that sCP could represent a useful biomarker in the evaluation of the inflammatory stage in patients with immune-mediated gastrointestinal diseases, but more studies are needed to promote its routine use in clinical practice as a diagnostic and prognostic biomarker as a replacement for fCP.
Insights into Clinical Disorders in Cowden Syndrome: A Comprehensive Review
Authors: Pîrlog Lorin-Manuel , Pătrășcanu Andrada-Adelaida , Militaru Mariela Sanda , Cătană Andreea
Published: May 2024

PTEN Hamartoma Tumour Syndrome (PHTS) encompasses diverse clinical phenotypes, including Cowden syndrome (CS), Bannayan–Riley–Ruvalcaba syndrome (BRRS), Proteus syndrome (PS), and Proteus-like syndrome. This autosomal dominant genetic predisposition with high penetrance arises from heterozygous germline variants in the PTEN tumour suppressor gene, leading to dysregulation of the PI3K/AKT/mTOR signalling pathway, which promotes the overgrowth of multiple and heterogenous tissue types. Clinical presentations of CS range from benign and malignant disorders, affecting nearly every system within the human body. CS is the most diagnosed syndrome among the PHTS group, notwithstanding its weak incidence (1:200,000), for which it is considered rare, and its precise incidence remains unknown among other important factors. The literature is notably inconsistent in reporting the frequencies and occurrences of these disorders, adding an element of bias and uncertainty when looking back at the available research. In this review, we aimed to highlight the significant disparities found in various studies concerning CS and to review the clinical manifestations encountered in CS patients. Furthermore, we intended to emphasize the great significance of early diagnosis as patients will benefit from a longer lifespan while being unceasingly advised and supported by a multidisciplinary team.
Phytochemical Profiling Studies of Alkaloids and Coumarins from the Australian Plant Geijera parviflora Lindl. (Rutaceae) and Their Anthelmintic and Antimicrobial Assessment
Authors: Dugan Deepika , Bell Rachael J. , Brkljača Robert , Rix Colin , Taki Aya C. , Gasser Robin B. , Urban Sylvia
Published: May 2024

Phytochemical profiling followed by antimicrobial and anthelmintic activity evaluation of the Australian plant Geijera parviflora, known for its customary use in Indigenous Australian ceremonies and bush medicine, was performed. In the present study, seven previously reported compounds were isolated including auraptene, 6′-dehydromarmin, geiparvarin, marmin acetonide, flindersine, and two flindersine derivatives from the bark and leaves, together with a new compound, chlorogeiparvarin, formed as an artefact during the isolation procedure and isolated as a mixture with geiparvarin. Chemical profiling allowed for a qualitative and quantitative comparison of the compounds in the leaves, bark, flowers, and fruit of this plant. Subsequently, a subset of these compounds as well as crude extracts from the plant were evaluated for their antimicrobial and anthelmintic activities. Anthelmintic activity assays showed that two of the isolated compounds, auraptene and flindersine, as well as the dichloromethane and methanol crude extracts of G. parviflora, displayed significant activity against a parasitic nematode (Haemonchus contortus). This is the first report of the anthelmintic activity associated with these compounds and indicates the importance of such fundamental explorations for the discovery of bioactive phytochemicals for therapeutic application(s).
Metabolome in Tibialis and Soleus Muscles in Wild-Type and Pin1 Knockout Mice through High-Resolution Magic Angle Spinning 1H Nuclear Magnetic Resonance Spectroscopy
Authors: Righi Valeria , Grosso Martina , Battini Renata , Uchida Takafumi , Gambini Anna , Molinari Susanna , Mucci Adele
Published: May 2024

Skeletal muscles are heterogenous tissues composed of different myofiber types that can be classified as slow oxidative, fast oxidative, and fast glycolytic which are distinguished on the basis of their contractile and metabolic properties. Improving oxidative metabolism in skeletal muscles can prevent metabolic diseases and plays a protective role against muscle wasting in a number of neuromuscular diseases. Therefore, achieving a detailed understanding of the factors that regulate myofiber metabolic properties might provide new therapeutic opportunities for these diseases. Here, we investigated whether peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 (PIN1) is involved in the control of myofiber metabolic behaviors. Indeed, PIN1 controls glucose and lipid metabolism in a number of tissues, and it is also abundant in adult skeletal muscles; however, its role in the control of energy homeostasis in this tissue is still to be defined. To start clarifying this topic, we compared the metabolome of the tibialis anterior muscle (mainly glycolytic) and soleus muscle (oxidative) in wild-type and Pin1 knockout mice with High-Resolution Magic Angle Spinning (HR-MAS) NMR on intact tissues. Our analysis reveals a clear demarcation between the metabolomes in the two types of muscles and allows us to decode a signature able to discriminate the glycolytic versus oxidative muscle phenotype. We also detected some changes in Pin1-depleted muscles that suggest a role for PIN1 in regulating the metabolic phenotype of skeletal muscles.