bluuebunny/crossref_metadata_2025 huggingface dataset:
Orthodontic System Modeled and Simulated with the Lingual Technique to Assess Tooth Forces
Authors: Hazem Abbas , Mărășescu Felicia Ileana , Țuculină Mihaela Jana , Popescu Alexandru Dan , Popa Dragoș Laurențiu , Mihai Lelia Laurența , Cumpătă Cristian Niky , Iliescu Alexandru , Mărășescu Petre , Dascălu Ionela Teodora
Published: June 2024

CBCT (cone beam computed tomography) is an imaging investigation that provides three-dimensional (3D) images of craniofacial structures. The purpose of this study is to determine the mechanical behavior of an orthodontic system where the lingual treatment technique was used in a 25-year-old female patient from whom a set of CBCT scans was used. CBCT images were processed through software programs such as Invesalius, Geomagic, and Solid Works, to create models containing virtual solids. These models were then imported into Ansys Workbench 2019 R3 (a finite element method software program) for successive simulations to generate displacement maps, deformations, stress distributions, and diagrams. We observed that in the lingual technique, the lowest force occurring on the maxillary teeth is at 1.1, while the highest force appears at 2.3. In the mandible, the lowest force occurs at 4.6, and the highest force at 3.1. The values of the forces and the results of the finite element method can represent a basis for the innovation of new orthodontic springs and also of bracket elements. Thus, by using new technologies, orthodontic practice can be significantly improved for the benefit of patients. Other virtual methods and techniques can be used in future studies, including the application of virtual reality for orthodontic diagnosis.
Struma Ovarii during Pregnancy
Authors: Dumachița-Șargu Gabriela , Socolov Răzvan , Balan Teodora Ana , Gafițanu Dumitru , Akad Mona , Balan Raluca Anca
Published: June 2024

Struma ovarii is a rare type of ovarian teratoma primarily composed of over 50% thyroid tissue. Its occurrence is reported in 2–5% of all ovarian teratomas, with approximately 0.5% to 10% showing malignant transformation. Managing it during pregnancy poses significant challenges as pregnancy can promote the growth of malignant struma ovarii due to elevated levels of ovarian and pregnancy-related hormones, including estrogen, progesterone, and human chorionic gonadotrophin (hCG). Most ovarian tumors, including struma ovarii, are detected during routine ultrasonography in the first and second trimesters, often as acute emergencies. Diagnosis during pregnancy is rare, with some cases incidentally discovered during cesarean section when inspecting the adnexa for ovarian cysts. This review explores the diagnostic, management, and therapeutic approaches to struma ovarii during pregnancy.
A Data-Centric AI Paradigm for Socio-Industrial and Global Challenges
Authors: Majeed Abdul , Hwang Seong Oun
Published: June 2024

Due to huge investments by both the public and private sectors, artificial intelligence (AI) has made tremendous progress in solving multiple real-world problems such as disease diagnosis, chatbot misbehavior, and crime control. However, the large-scale development and widespread adoption of AI have been hindered by the model-centric mindset that only focuses on improving the code/architecture of AI models (e.g., tweaking the network architecture, shrinking model size, tuning hyper-parameters, etc.). Generally, AI encompasses a model (or code) that solves a given problem by extracting salient features from underlying data. However, when the AI model yields a low performance, developers iteratively improve the code/algorithm without paying due attention to other aspects such as data. This model-centric AI (MC-AI) approach is limited to only those few businesses/applications (language models, text analysis, etc.) where big data readily exists, and it cannot offer a feasible solution when good data are not available. However, in many real-world cases, giant datasets either do not exist or cannot be curated. Therefore, the AI community is searching for appropriate solutions to compensate for the lack of giant datasets without compromising model performance. In this context, we need a data-centric AI (DC-AI) approach in order to solve the problems faced by the conventional MC-AI approach, and to enhance the applicability of AI technology to domains where data are limited. From this perspective, we analyze and compare MC-AI and DC-AI, and highlight their working mechanisms. Then, we describe the crucial problems (social, performance, drift, affordance, etc.) of the conventional MC-AI approach, and identify opportunities to solve those crucial problems with DC-AI. We also provide details concerning the development of the DC-AI approach, and discuss many techniques that are vital in bringing DC-AI from theory to practice. Finally, we highlight enabling technologies that can contribute to realizing DC-AI, and discuss various noteworthy use cases where DC-AI is more suitable than MC-AI. Through this analysis, we intend to open up a new direction in AI technology to solve global problems (e.g., climate change, supply chain disruption) that are threatening human well-being around the globe.
Enhancing Financial Time Series Prediction with Quantum-Enhanced Synthetic Data Generation: A Case Study on the S&P 500 Using a Quantum Wasserstein Generative Adversarial Network Approach with a Gradient Penalty
Authors: Orlandi Filippo , Barbierato Enrico , Gatti Alice
Published: June 2024

This study introduces a novel Quantum Wasserstein Generative Adversarial Network approach with a Gradient Penalty (QWGAN-GP) model that leverages a quantum generator alongside a classical discriminator to synthetically generate time series data. This approach aims to accurately replicate the statistical properties of the S&P 500 index. The synthetic data generated by this model were compared to the original series using various metrics, including Wasserstein distance, Dynamic Time Warping (DTW) distance, and entropy measures, among others. The outcomes demonstrate the model’s robustness, with the generated data exhibiting a high degree of fidelity to the statistical characteristics of the original data. Additionally, this study explores the applicability of the synthetic time series in enhancing prediction models. An LSTM (Long-Short Term Memory)-based model was developed to evaluate the impact of incorporating synthetic data on forecasting accuracy, particularly focusing on general trends and extreme market events. The findings reveal that models trained on a mix of synthetic and real data significantly outperform those trained solely on historical data, improving predictive performance.
Analysis and Construction of Hardware Accelerators for Calculating the Shortest Path in Real-Time Robot Route Planning
Authors: Esteves Linton Thiago Costa , Oliveira Wagner Luiz Alvez de , Farias Paulo César Machado de Abreu
Published: June 2024

This study introduces an optimization approach for calculating the shortest path in mobile robot route planning. The proposed solution targets real-time processing requirements by offering a high-performance alternative. This is achieved by embedding in the dedicated hardware an architecture which emphasizes parallelism. Through improvements in parallel exploration techniques, our solution aims to present not only a boost in performance but also a dynamic adaptation to graph changes, accommodating randomly occurring edge insertions or deletions as environmental conditions fluctuate. We present the developed architecture alongside its results. Our method efficiently updates obstacle matrices, resulting in a remarkable 120-fold improvement for 1024-node graphs. When utilizing a cost-effective device like the Cyclone IV E, it achieves approximately 12 times the performance of software applications.
Hardware and Software Design of Programmable Medium and High-Speed Data Acquisition (DAQ) Board of Fiber Optic Signal for Partial Discharge Acquisition
Authors: Tong Ziquan , Zhang Jiatong , Zhang Weichao
Published: June 2024

The anti-electromagnetic interference capability of partial discharge (PD) acoustic signal conversion and collection circuits severely restrict the sensitivity of PD detection. The data acquisition (DAQ) systems available in the current market are costly and have limited functionality, making it difficult to satisfy the acquisition requirements for PD detection. This paper proposes a medium to high-speed fiber optic signal acquisition board with an adjustably controlled sampling rate and filter cutoff frequency. The circuit achieves a higher signal-to-noise (SNR) ratio by distributing the noise in each part of the signal acquisition chain reasonably. The temperature characteristics of the acquisition module are improved by utilizing the programmable T-type structure for transimpedance amplification of photocurrent. The DAQ card performs data acquisition and processing using STM32H743 internal ADC and caches data in bulk with an SRAM and SD card. A data uploading method based on time reference has been proposed, which enables full, effective information signal upload through a low-cost transmission interface. The research ultimately achieves a stable sampling of three channels at 1 MSps, SNR of 63 dB, and programmable gain amplification of the photocurrent with 0–60 dB. Finally, the system is used for PD acoustic signal acquisition in the frequency range of 20 Hz to 100 kHz.
A Comprehensive Survey on Enabling Techniques in Secure and Resilient Smart Grids
Authors: Wang Xueyi , Li Shancang , Rahman Md Arafatur
Published: June 2024

Smart grids are a cornerstone of the transition to a decentralised, low-carbon energy system, which offer significant benefits, including increased reliability, improved energy efficiency, and seamless integration of renewable energy sources. However, ensuring the security and resilience of smart grids is paramount. Cyber attacks, physical disruptions, and other unforeseen threats pose a significant risk to the stability and functionality of the grid. This paper identifies the research gaps and technical hurdles that hinder the development of a robust and secure smart grid infrastructure. This paper addresses the critical gaps in smart grid security research, outlining the technical challenges and promising avenues for exploration by both the industry and academia. A novel framework designed to enhance the reliability and security of smart grids was proposed against cyber attacks, considering the interconnectedness of the physical and cyber components. The paper further explores future research trends and identifies the key open issues in the ongoing effort to strengthen the security and resilience of smart grids.
The Real-Time Image Sequences-Based Stress Assessment Vision System for Mental Health
Authors: Khomidov Mavlonbek , Lee Deokwoo , Kim Chang-Hyun , Lee Jong-Ha
Published: June 2024

Early detection and prevention of stress is crucial because stress affects our vital signs like heart rate, blood pressure, skin temperature, respiratory rate, and heart rate variability. There are different ways to determine stress using different devices, such as the electrocardiogram (ECG), electrodermal activity (EDA), the electroencephalogram (EEG), photoplethysmography (PPG), or a questionnaire-based method of stress assessment. In this study, we proposed a camera-based real-time stress detection system using remote photoplethysmography (rPPG). We trained different machine learning models using three datasets: the SWELL dataset, the PPG sensor dataset, and the last ECG and EEG-based stress dataset. The models with the highest predictive accuracy were used to classify stress based on HR and HRV features obtained from the face using a camera. HR and HRV estimations from the face were validated on the PURE public dataset and the custom dataset. In this study, it was observed that the random forest algorithm performs significantly better than other models, achieving an impressive 99% predictive accuracy in the SWELL dataset. In the second dataset, the logistic regression technique shows the best result, achieving an accuracy rate of 84.24%. In the last dataset, the ensemble model achieved an accuracy rate of 67%. We also checked the proposed algorithm in the process of public speaking to estimate stress in a real-time situation.
Temporal Attention for Few-Shot Concept Drift Detection in Streaming Data
Authors: Lin Ximing , Chang Longtao , Nie Xiushan , Dong Fei
Published: June 2024

Concept drift describes unforeseeable changes in the underlying distribution of streaming data over time. Concept drift is a phenomenon in which the statistical properties of a target domain change over time in an arbitrary way. These changes might be caused by changes in hidden variables that cannot be measured directly. With the onset of the big data era, domains such as social networks, meteorology, and finance are generating copious amounts of streaming data. Embedded within these data, the issue of concept drift can affect the attributes of streaming data in various ways, leading to a decline in the accuracy and performance of models. There is a pressing need for new models to re-adapt to the changes in streaming data. Traditional concept drift detection algorithms struggle to effectively capture and utilize the key feature points of concept drift within complex time series, thereby failing to maintain the accuracy and efficiency of the models. In light of these challenges, this study introduces a novel concept drift detection method that incorporates a temporal attention mechanism within a prototypical network. By integrating a temporal attention mechanism during the feature extraction process, our approach enhances the capability to process complex time series data, preserves temporal locality, strengthens the learning of key features, and reduces the amount of labeled data required. This method significantly improves the detection accuracy and efficiency of small sample streaming data by better capturing the local features of the data. Experiments conducted across multiple datasets demonstrate that this method exhibits comprehensive leading performance in terms of accuracy and F1-score, with excellent recall and precision, thereby validating its effectiveness in enhancing concept drift detection in streaming data.
How the “Olive Oil Polyphenols” Health Claim Depends on Anthracnose and Olive Fly on Fruits
Authors: Peres Fátima , Gouveia Cecília , Vitorino Conceição , Oliveira Helena , Ferreira-Dias Suzana
Published: June 2024

Olive anthracnose, caused by Colletotrichum fungi, and the olive fruit fly Bactrocera olea are, respectively, the most important fungal disease and pest affecting olive fruits worldwide, leading to detrimental effects on the yield and quality of fruits and olive oil. This study focuses on the content of hydroxytyrosol (HYT) and its derivatives (the “olive oil polyphenols” health claim) in olive oils extracted from fruits of ‘Galega Vulgar’ and ‘Cobrançosa’ cultivars, naturally affected by olive anthracnose and olive fly. The olives, with different damage levels, were harvested from organic rainfed orchards, located in the center of Portugal, at four harvest times over three years. Galega oils extracted from olives with a higher anthracnose and olive fly incidence showed no conformity for the extra virgin olive oil (EVOO) and virgin olive oil (VOO) categories, presenting high acidity and negative sensory notes accompanied by the disappearance of oleacein. Conversely, no sensory defects were observed in Cobrançosa oils, regardless of disease and pest incidence levels, and quality criteria were still in accordance with the EVOO category. The total HYT and tyrosol (TYR) content (>5 mg/20 g) allows for the use of the “olive oil polyphenols” health claim on the label of all the analyzed Cobrançosa olive oils.
Alterations in pH of Coffee Bean Extract and Properties of Chlorogenic Acid Based on the Roasting Degree
Authors: Kim Yi Kyeoung , Lim Jae-Min , Kim Young Jae , Kim Wook
Published: June 2024

Factors influencing the sour taste of coffee and the properties of chlorogenic acid are not yet fully understood. This study aimed to evaluate the impact of roasting degree on pH-associated changes in coffee bean extract and the thermal stability of chlorogenic acid. Coffee bean extract pH decreased up to a chromaticity value of 75 but increased with higher chromaticity values. Ultraviolet–visible spectrophotometry and structural analysis attributed this effect to chlorogenic and caffeic acids. Moreover, liquid chromatography-mass spectrometry analysis identified four chlorogenic acid types in green coffee bean extract. Chlorogenic acid isomers were eluted broadly on HPLC, and a chlorogenic acid fraction graph with two peaks, fractions 5 and 9, was obtained. Among the various fractions, the isomer in fraction 5 had significantly lower thermal stability, indicating that thermal stability differs between chlorogenic acid isomers.
Illusory Arguments by Artificial Agents: Pernicious Legacy of the Sophists
Authors: Clark Micah H. , Bringsjord Selmer
Published: June 2024

To diagnose someone’s reasoning today as “sophistry” is to say that this reasoning is at once persuasive (at least to a significant degree) and logically invalid. We begin by explaining that, despite some recent scholarly arguments to the contrary, the understanding of ‘sophistry’ and ‘sophistic’ underlying such a lay diagnosis is in fact firmly in line with the hallmarks of reasoning proffered by the ancient sophists themselves. Next, we supply a rigorous but readable definition of what constitutes sophistic reasoning (=sophistry). We then discuss “artificial” sophistry: the articulation of sophistic reasoning facilitated by artificial intelligence (AI) and promulgated in our increasingly digital world. Next, we present, economically, a particular kind of artificial sophistry, one embodied by an artificial agent: the lying machine. Afterward, we respond to some anticipated objections. We end with a few speculative thoughts about the limits (or lack thereof) of artificial sophistry, and what may be a rather dark future.
The Molecular Key to Understanding the Medical Ozone Action
Authors: Re Lamberto
Published: June 2024

Currently, treatment with medical ozone (MO) is considered one of the most interesting and safe integrative options that can effectively complement many conventional medical therapies, mainly, but not exclusively, involving aging and pain [...]
Pilot Study on High-Intensity Focused Ultrasound (HIFU) for Basal Cell Carcinoma: Effectiveness and Safety
Authors: Calik Jacek , Sauer Natalia , Woźniak Bartosz , Wojnar Andrzej , Pietkiewicz Paweł , Dzięgiel Piotr
Published: June 2024

Background: The rising incidence of Basal Cell Carcinoma (BCC), especially among individuals with significant sun exposure, underscores the need for effective and minimally invasive treatment alternatives. Traditional surgical approaches, while effective, often result in notable cosmetic and functional limitations, particularly for lesions located on the face. This study explores High-Intensity Focused Ultrasound (HIFU) as a promising, non-invasive treatment option that aims to overcome these challenges, potentially revolutionizing BCC treatment by offering a balance between efficacy and cosmetic outcomes. Methods: Our investigation enrolled 8 patients, presenting a total of 15 BCC lesions, treated with a 20 MHz HIFU device. The selection of treatment parameters was precise, utilizing probe depths from 0.8 mm to 2.3 mm and energy settings ranging from 0.7 to 1.3 Joules (J) per pulse, determined by the lesion’s infiltration depth as assessed via pre-procedure ultrasonography. A key component of our methodology included dermatoscopic monitoring, which allowed for detailed observation of the lesions’ response to treatment over time. Patient-reported outcomes and satisfaction levels were systematically recorded, providing insights into the comparative advantages of HIFU. Results: Initial responses after HIFU treatment included whitening and edema, indicative of successful lesion ablation. Early post-treatment observations revealed minimal discomfort and quick recovery, with crust formation resolving within two weeks for most lesions. Over a period of three to six months, patients reported significant improvement, with lesions becoming lighter and blending into the surrounding skin, demonstrating effective and aesthetically pleasing outcomes. Patient satisfaction surveys conducted six months post-treatment revealed high levels of satisfaction, with 75% of participants reporting very high satisfaction due to minimal scarring and the non-invasive nature of the procedure. No recurrences of BCC were noted, attesting to the efficacy of HIFU as a treatment option. Conclusions: The findings from this study confirm that based on dermoscopy analysis, HIFU is a highly effective and patient-preferred non-invasive treatment modality for Basal Cell Carcinoma. HIFU offers a promising alternative to traditional surgical and non-surgical treatments, reducing the cosmetic and functional repercussions associated with BCC management. Given its efficacy, safety, and favorable patient satisfaction scores, HIFU warrants further investigation and consideration for broader clinical application in the treatment of BCC, potentially setting a new standard in dermatologic oncology care. This work represents a pilot study that is the first to describe the use of HIFU in the treatment of BCC.
Evaluation of a Lung Ultrasound Score in Hospitalized Adult Patients with COVID-19 in Barcelona, Spain
Authors: Lightowler Maria S. , Sander Julia Verena , García de Casasola Sánchez Gonzalo , Mateos González Maria , Güerri-Fernández Robert , Lorenzo Navarro Maria Dolores , Nackers Fabienne , Stratta Erin , Lanusse Candelaria , Huerga Helena
Published: June 2024

Background/Objectives: During the COVID-19 pandemic and the burden on hospital resources, the rapid categorization of high-risk COVID-19 patients became essential, and lung ultrasound (LUS) emerged as an alternative to chest computed tomography, offering speed, non-ionizing, repeatable, and bedside assessments. Various LUS score systems have been used, yet there is no consensus on an optimal severity cut-off. We assessed the performance of a 12-zone LUS score to identify adult COVID-19 patients with severe lung involvement using oxygen saturation (SpO2)/fractional inspired oxygen (FiO2) ratio as a reference standard to define the best cut-off for predicting adverse outcomes. Methods: We conducted a single-centre prospective study (August 2020–April 2021) at Hospital del Mar, Barcelona, Spain. Upon admission to the general ward or intensive care unit (ICU), clinicians performed LUS in adult patients with confirmed COVID-19 pneumonia. Severe lung involvement was defined as a SpO2/FiO2 ratio <315. The LUS score ranged from 0 to 36 based on the aeration patterns. Results: 248 patients were included. The admission LUS score showed moderate performance in identifying a SpO2/FiO2 ratio <315 (area under the ROC curve: 0.71; 95%CI 0.64–0.77). After adjustment for COVID-19 risk factors, an admission LUS score ≥17 was associated with an increased risk of in-hospital death (OR 5.31; 95%CI: 1.38–20.4), ICU admission (OR 3.50; 95%CI: 1.37–8.94) and need for IMV (OR 3.31; 95%CI: 1.19–9.13). Conclusions: Although the admission LUS score had limited performance in identifying severe lung involvement, a cut-off ≥17 score was associated with an increased risk of adverse outcomes. and could play a role in the rapid categorization of COVID-19 pneumonia patients, anticipating the need for advanced care.
A Systematic Review to Evaluate the Barriers to Breast Cancer Screening in Women with Disability
Authors: Almohammed Huda I.
Published: June 2024

Background: Breast cancer (BC) is one of the leading causes of mortality worldwide. There are observed disparities in patients with disability as compared to those without disability, which leads to poor BC screening attendance, thereby worsening disease management. Aim: The aim of this systematic review is to investigate if there are disparities in screening rates in women with disability as compared to those without disability, as well as the different factors that pose barriers to patients with disability for enrolment in BC screening programs. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed published articles between 2008 and 2023, which assessed different factors that contributed to poor attendance in BC screening programs held across different countries. Detailed study characteristics were obtained, and methodological quality assessment was performed on the individual studies included in this review. Result: A total of fifty-three articles were identified as eligible studies based on the pre-defined inclusion and exclusion criteria. These included 7,252,913 patients diagnosed with BC (913,902 patients with disability/6,339,011 patients without disability). The results revealed there are demographic, clinical, financial, and service-related barriers that contributed to lower screening rates in disabled patients as compared to non-disabled. Patient age is the most common factor, with the highest effect observed for 80 years (vs. 30–44 years) [odds ratio (OR) = 13.93 (95% confidence interval (CI) = 8.27–23.47), p < 0.0001], followed by race/ethnicity for Hispanic (vs. non-Hispanic white) [OR = 9.5 (95%CI = 1.0–91.9), p < 0.05]. Additionally, patients with multiple disabilities had the highest rate of dropouts [OR = 27.4 (95%CI = 21.5–33.3)]. Other factors like education, income, marital status, and insurance coverage were essential barriers in screening programs. Conclusions: This study presents a holistic view of all barriers to poor BC screening attendance in disabled patients, thereby exacerbating health inequalities. A standardized approach to overcome the identified barriers and the need for a tailored guideline, especially for disability groups, is inevitable.
Real-World Outcomes of a Rhythm Control Strategy for Atrial Fibrillation Patients with Reduced Left Ventricular Ejection Fraction (<50%)
Authors: Choi Ji-Hoon , Kwon Chang Hee
Published: June 2024

Background/Objectives: The effectiveness of a rhythm control strategy in patients with atrial fibrillation (AF) and reduced left ventricular ejection fraction (LVEF < 50%) in real-world practice remains uncertain. Our objective was to evaluate the real-world outcomes of a rhythm control strategy in patients with AF and reduced LVEF, focusing on changes in LV systolic function and brain natriuretic peptide (BNP) levels. Methods: The study retrospectively reviewed the medical records of 80 patients with concurrent AF and reduced LVEF who underwent rhythm control therapy between March 2015 and December 2021. Results: The patients had an average age of 63.6 years and an initial LVEF of 34.3%. Sinus rhythm was restored using anti-arrhythmic drugs (38, 47.5%) or electrical cardioversion (42, 52.5%). Over a follow-up period of 53.0 months, AF recurred in 65% of patients, with 57.7% undergoing catheter ablation. Significant improvements were noted in LVEF (from 34.3% to 55.1%, p < 0.001) and BNP levels (from 752 pg/mL to 72 pg/mL, p < 0.001) at the last follow-up. Nearly all patients (97.5%) continued with the rhythm control strategy during the follow-up period. Conclusions: In real-world settings, a rhythm control strategy proves to be feasible and effective for improving LVEF and reducing BNP levels in AF patients with reduced LVEF.
A Comparison of Preoperative Predictive Scoring Systems for Postoperative Pancreatic Fistula after Pancreaticoduodenectomy Based on a Single-Center Analysis
Authors: Verdeyen Naomi , Gryspeerdt Filip , Abreu de Carvalho Luìs , Dries Pieter , Berrevoet Frederik
Published: June 2024

Background: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is associated with major postoperative morbidity and mortality. Several scoring systems have been described to stratify patients into risk groups according to the risk of POPF. The aim of this study was to compare scoring systems in patients who underwent a PD. Methods: A total of 196 patients undergoing PD from July 2019 to June 2022 were identified from a prospectively maintained database of the University Hospital Ghent. After performing a literature search, four validated, solely preoperative risk scores and the intraoperative Fistula Risk Score (FRS) were included in our analysis. Furthermore, we eliminated the variable blood loss (BL) from the FRS and created an additional score. Univariate and multivariate analyses were performed for all risk factors, followed by a ROC analysis for the six scoring systems. Results: All scores showed strong prognostic stratification for developing POPF (p < 0.001). FRS showed the best predictive accuracy in general (AUC 0.862). FRS without BL presented the best prognostic value of the scores that included solely preoperative variables (AUC 0.783). Soft pancreatic texture, male gender, and diameter of the Wirsung duct were independent prognostic factors on multivariate analysis. Conclusions: Although all predictive scoring systems stratify patients accurately by risk of POPF, preoperative risk stratification could improve clinical decision-making and implement preventive strategies for high-risk patients. Therefore, the preoperative use of the FRS without BL is a potential alternative.
Alopecia Areata of the Nails: Diagnosis and Management
Authors: Pelzer Christin , Iorizzo Matilde
Published: June 2024

Background: Alopecia areata (AA) is a common form of non-scarring alopecia characterized by acute hair loss. Nail involvement, though not always present, can occur in AA patients. Nail changes are more frequent in severe forms of AA and in children. Methods: Literature related to nail changes in AA was comprehensively reviewed after a search on the PubMed database without time restrictions in order to identify common clinical presentations and associated factors to aid clinicians with the correct evaluation and management of these dystrophies. Results: Nail changes in AA include pitting, trachyonychia, leukonychia, red lunula, and miscellaneous alterations such as longitudinal ridging and brittle nails. Nail changes are usually asymptomatic but, nevertheless, sometimes cosmetically disfiguring and can be associated with a reduced quality of life and impaired daily activities. Conclusions: Nail changes in AA may precede or follow hair loss and can occur as an isolated finding. Diagnosis may require a biopsy for definitive identification. Spontaneous improvement is possible, particularly in children, and treatment is not always necessary. Further research is, however, needed to establish a consensus on treatment approaches according to age and severity.
10-Week Trajectories of Candidate Psychological Processes Differentially Predict Mental Health Gains from Online Dyadic versus Mindfulness Interventions: A Randomized Clinical Trial
Authors: Godara Malvika , Singer Tania
Published: June 2024

Background: App-based contemplative interventions, such as mindfulness-based interventions, have gained popularity for the promotion of mental health; however, the understanding of underlying intervention-specific mechanisms remains limited, especially related to novel inter-relational dyadic practices. Methods: We tested (n = 253) seven putative mechanisms underlying two brief (daily 12-min) online mental interventions: attention-focused mindfulness and socio-emotional partner-based, both supported by weekly online coaching. Weekly self-reports of rumination, worry, psychological flexibility, affective control, social support, acceptance, and mindfulness were obtained over 10 weeks of intervention, and depression, anxiety, and resilience were assessed as pre- and post-intervention outcomes. Results: Significant week-to-week reductions in rumination and increases in psychological flexibility were observed in both interventions. Only attention-based practice led to temporal reductions in worry, and only socio-emotional dyadic practice led to temporal increases in affective control. Mediation analyses with slopes of weekly variables as mediators detected no significant indirect effects. However, exploratory moderation analyses revealed that intervention-related reductions in depressive symptomatology and anxiety vulnerability and increases in resilience were predicted by weekly increases in acceptance and affective control in the socio-emotional dyadic group, and by weekly reductions in rumination and worry in the mindfulness group. Limitations of the study include reliance on brief self-report measures, relatively small sample size, and absence of long-term follow-up assessments indicating the need for future well-powered longitudinal studies comparing intervention modalities. Conclusions: We present preliminary evidence for practice-specific active ingredients of contemplative interventions, which can be leveraged to enhance their efficiency for mental health.
The Impact of Opportunistic Salpingectomy on Ovarian Reserve: A Systematic Review
Authors: Radu Teodora , Mar Matyas , Tudorache Vlad , Marginean Claudiu
Published: June 2024

Background: In the last decade, increasing evidence has suggested that high-grade serous ovarian cancers may have their origin in the fallopian tube rather than the ovary. This emerging theory presents an opportunity to prevent epithelial ovarian cancer by incorporating prophylactic bilateral salpingectomy into all surgical procedures for average-risk women. The aim of this review is to investigate the hypothesis that bilateral salpingectomy (BS) may have a negative impact on ovarian reserve, not only following hysterectomy for benign uterine pathologies but also when performed during cesarean sections as a method of sterilization or as a treatment for hydrosalpinx in Assisted Reproductive Technology interventions. Methods: PubMed, Medline, Google Scholar, and Cochrane were searched for original studies, meta-analyses, and opinion articles published between 2014 and 2024. Results: Out of 114 records from the database search, after the removal of duplicates, 102 articles were considered relevant for the current study. Conclusions: Performing opportunistic salpingectomy seems to have no adverse impact on ovarian function in the short term. However, because there is an existing risk of damaging ovarian blood supply during salpingectomy, there are concerns about potential long-term adverse effects on the ovarian reserve, which need further investigation.
First Clinical Experience with a New Device for the Removal of Cochlear Schwannomas
Authors: Pfeiffer Christoph J. , Riemann Conrad , Kim Rayoung , Scholtz Lars-Uwe , Schürmann Matthias , Todt Ingo
Published: June 2024

Background: In most cases, intralabyrinthine schwannoma (ILS) occurs in patients with unilateral hearing deterioration or neurofibromatosis type II (NF II). The pattern of localization of these tumors varies but mostly affects the cochlea. Extirpation of the cochlear schwannoma, if hidden by the cochlea modiolus, is difficult under the aspect of complete removal. Therefore, a tissue removal device (TRD) was designed and tested in temporal bones. The principle of handling the new device is a pushing and pipe cleaner handling inside the cochlea. This present study aimed to describe the first in vivo experience with the newly developed TRD for removing cochlear intralabyrinthine schwannomas. Methods: In three patients, the TRD was used for the tumor removal of cochlear schwannomas. In two patients with a cochlear schwannoma in combination with a cochlea implantation and one patient suffering from NF II, a cochlear schwannoma was removed with the TRD. The access was performed with a posterior tympanotomy, an enlarged round window approach and an additional second turn access. The device was inserted and extracted gradually from the second turn access until the rings were visible in the second turn access. By pushing and pipe cleaner handling, the tumors were removed. An MRI control was performed on the day postoperatively with a T1 GAD sequence. Results: Tumor removal with the TRD was performed in a 15-min procedure without any complications. An MRI control confirmed complete removal on the postoperative day in all cases. Conclusions: In vivo handling of the device confirmed straightforward handling for the tumor removal. MRI scanning showed complete removal of the tumor by the TRD.
Attention Deficit Hyperactivity Disorder: A Risk Factor for Premature Discontinuation of Inpatient Opioid Withdrawal Treatment
Authors: Gaspar Nikolas , Kilarski Laura Luisa , Rosen Helena , Huppertz Maximilian , Philipsen Alexandra , Rohner Henrik
Published: June 2024

Background: Substance use disorders present a tremendous challenge within contemporary healthcare systems. Specifically, in the domain of opioid use disorders (OUDs), several foundational elements are crucial for the efficacious management of afflicted individuals. Regrettably, the premature discontinuation of inpatient opioid withdrawal treatment is a prevalent phenomenon. This study aims to elucidate the prevalence of the premature termination of inpatient opioid withdrawal treatment among patients with comorbid ADHD. Methods: We conducted a comprehensive assessment of all participants currently undergoing inpatient opioid withdrawal treatment. Our assessment protocol included the administration of the ADHD Self-Report Scale (ADHD-SR) and the Wender Utah Rating Scale (WURS-k). Additionally, participants who met the thresholds on one or both questionnaires underwent further evaluation using the Diagnostic Interview for ADHD in Adults (DIVA-2.0). Results: The prevalence of individuals diagnosed with ADHD within the studied cohort was determined to be 29.3%. Among the subset of participants identified as ADHD-positive, a notable 54.5% prematurely ceased therapy. In contrast, among those identified as ADHD-negative, the premature discontinuation rate was substantially lower at 28.3%. Conclusions: In summary, the impact of ADHD as a comorbid condition on the efficacy of inpatient opioid withdrawal treatment has been underscored. By identifying comorbid ADHD early in the treatment process, tailored therapeutic approaches may help to maximize the effectiveness of interventions and may improve patient outcomes. This underscores the importance of proactive screening for ADHD as a psychiatric comorbidity in optimizing the management of individuals undergoing inpatient opioid withdrawal treatment.
Structural Analysis of Deck Reinforcement on Composite Yacht for Crane Installation
Authors: Dragatogiannis Dimitrios A. , Zaverdinos Georgios , Galanis Apostolos
Published: June 2024

The crane installation on the deck of a yacht redistributes the stress field and affects the local structural integrity and performance. The safe operation of the yacht is associated with the optimal placement of the crane on the deck and the proper local structural reinforcement. Here, the structural analysis of the bow part of a yacht made of composite materials is studied, considering the retrofit installation of a crane, in three different cases of reinforcing the deck: (a) without any reinforcement, (b) with a T-type reinforcement, and finally, (c) with a longitudinal beam. The T-type connects the longitudinal bulkhead and the deck, reinforced locally with overlamination skin and adhesive-filler. The longitudinal beam works as a local longitudinal stiffener attached to the deck and connects the second, third, and fourth transverse frames. The structural analysis is performed using the finite element method following the classification societies’ rules. The local reinforcements are made from the same composite materials as the unreinforced deck. The maximum deformations, the principal stresses, and the safety factors following Tsai-Wu and Hashin criteria are calculated and compared for the three different cases. The T-type and longitudinal reinforcements reduce deck stresses by 33%, with longitudinal reinforcement reducing deck deformation by 17%. Composite failure analysis shows the structure was near failure, and the reinforcements enhance safety; T-type is better for multiaxial loads (Tsai-Wu), and longitudinal is superior for micromechanical failure (Hashin). By considering the structural performance and safety aspects, designers and engineers can make optimal decisions regarding yacht crane installation and proper reinforcement, leading to safer and more efficient structures.
Intraoperative Oxygen Consumption and Postoperative Immune Response in Colorectal Oncological Surgery: A Prospective, Monocentric Pilot Study
Authors: Ivascu Robert , Dutu Madalina , Bucurica Sandica , Corneci Dan , Nitipir Cornelia
Published: June 2024

Surgical resection is the key treatment for colorectal cancer, but the extent of surgical trauma has been implied as a key factor for the oncologic outcome. The immune stress response to surgical trauma generates a cascade of immunological events implying neutrophils’ perioperative change generating NETosis, N killer decrease, and platelets’ activation that may influence postoperative surgical outcome, tumor cell growth, and future oncogenesis. The present study aimed to investigate the correlation between intraoperative oxygen consumption (VO2) and the dynamic variation of neutrophils, lymphocytes, and platelets in the perioperative period to identify an intraoperative tool that could predict the postoperative immune response. Twenty-six colorectal oncological surgical patients were enrolled in an observational, prospective, monocentric study, over 18 months. Serum neutrophils, lymphocytes, and thrombocytes values were collected in the preoperative period and on the third postoperative day, oxygen consumption was measured and recorded every 15 min during surgery using indirect calorimetry. We compared oxygen consumption measurements registered 30 min after induction of anesthesia (VO2a) and the first value registered after abdominal wall closure (VO2b) to perioperative variation of absolute neutrophils (VNC), lymphocytes (VLC), and platelets (VPC) count. Our results proved a significant correlation between VO2 variation and neutrophils’ perioperative dynamic assessed by VNC (correlation coefficient = 0.547, p < 0.01, 95% confidence interval (CI) =0.175, 0.783). We also noticed a correlation between VPC and VO2 (correlation coefficient = −0.603, p < 0.01, 95% CI = −0.815, −0.248). No correlation could be shown between VO2 and VLC variation (p = 0.39). In conclusion, intraoperative VO2 variation measured by indirect calorimetry correlates well with perioperative neutrophils and platelets count dynamic variations and can be used as an early prognosis marker of postoperative immune response and surgical outcome in colorectal oncological surgery.
A Study on the Effects of a Self-Administered Eye Exercise Program on the Balance and Gait Ability of Chronic Stroke Patients: A Randomized Controlled Trial
Authors: Son Chung-Hyun , Sim Geon-Woo , Kim Kyoung
Published: June 2024

This study investigates the effects of a self-administered eye exercise (SEE) program on the balance and gait ability of chronic stroke patients hospitalized due to hemiplegia. This study includes 42 patients diagnosed with stroke-related hemiplegia and hospitalized at D Rehabilitation Hospital. The researcher randomly allocated 42 patients into two groups: the experimental group (EG, n = 21, mean age = 58.14 ± 7.69 years, mean BMI = 22.83 ± 2.19 kg/m2) and the control group (CG, n = 21, mean age = 58.57 ± 6.53 years, mean BMI = 22.81 ± 2.36 kg/m2). The SEE program was applied to the EG and the general self-administered exercise (SE) program was applied to the CG. After 4 weeks of intervention, weight distribution of the affected side, the Timed Up and Go test (TUG), step length of the affected side, step length of the unaffected side, gait speed, and cadence were analyzed and compared. In the within-group comparison, both groups showed significant differences in weight distribution (p < 0.05), TUG (p < 0.05), step length of the affected side (p < 0.05), step length of the unaffected side (p < 0.05), gait speed (p < 0.05), and cadence (p < 0.05). In the between-group comparison, a significant difference in the TUG (p < 0.05) was observed. The SEE program had an overall similar effect to the SE program in improving the balance and gait ability of chronic stroke patients, and had a greater effect on dynamic balance ability. Therefore, the SEE program can be proposed as a self-administered exercise program to improve balance and gait ability in stroke patients who are too weak to perform the SE program in a clinical environment or have a high risk of falling.
Conservation Management Practices for Biodiversity Preservation in Urban Informal Green Spaces: Lessons from Central European City
Authors: Archiciński Piotr , Przybysz Arkadiusz , Sikorska Daria , Wińska-Krysiak Marzena , Da Silva Anderson Rodrigo , Sikorski Piotr
Published: June 2024

Urban informal green spaces (IGS) represent valuable reservoirs of biodiversity within urban areas and are increasingly recognized as integral components of green infrastructure. They are perceived as temporary ecosystems, and the management of their vegetation is relatively understudied. The development time of spontaneous vegetation on transformed lands is considered to be in the range of decades, which makes it even more necessary to provide managers with better guidelines for such a long period. Two suggested management approaches for these areas involve: (1) retaining vegetation at various stages of succession (non-forest IGS) and (2) protecting advanced developmental stages (forest IGS), with options for balanced intervention or complete non-intervention. However, the differences in biodiversity between these two types in cities across Central Europe remain unknown, as well as whether the predictors of biodiversity at both local and landscape scales are consistent for non-forest and forest IGS. We examined factors such as habitat continuity, landscape structure, soil quality, and human impact to shed light on pathways for enhancing urban floristic diversity. Conducting extensive botanical surveys in existing informal green spaces (IGS) in Warsaw, we derived various parameters, including the total number of species, Shannon-Wiener biodiversity index, hemeroby, urbanity, share of species from distinct ecological groups, and the number of rare and ancient forest plant species. Tracing habitat continuity from the early 20th century using digitized aerial imagery provided a unique long-term perspective on IGS development. We revealed that no management is pivotal for the conservation of select rare and ancient forest species. On the other hand, partial abandonment with occasional maintenance may enrich species diversity across different successional phases. We uncovered the significant influence of landscape structure and human activity on vegetation species composition within IGS. Notably, IGS proximate to extensive forest landscapes displayed a marked abundance of forest species, alongside a greater prevalence of rare species. However, the presence of other vegetation types in the vicinity did not yield similar effects. Our findings indicate that IGS, when left untouched for decades near forested areas, are valuable for urban biodiversity. As cities across the globe seek sustainable paths, this research underscores the importance of properly understanding and integrating IGS into urban ecological planning.