bluuebunny/crossref_metadata_2025 huggingface dataset:
RL-Cervix.Net: A Hybrid Lightweight Model Integrating Reinforcement Learning for Cervical Cell Classification
Authors: Muksimova Shakhnoza , Umirzakova Sabina , Baltayev Jushkin , Cho Young-Im
Published: February 2025

Background: Reinforcement learning (RL) represents a significant advancement in artificial intelligence (AI), particularly for complex sequential decision-making challenges. Its capability to iteratively refine decisions makes it ideal for applications in medicine, such as the detection of cervical cancer; a major cause of mortality among women globally. The Pap smear test, a crucial diagnostic tool for cervical cancer, benefits from enhancements in AI, facilitating the development of automated diagnostic systems that improve screening effectiveness. This research introduces RL-Cervix.Net, a hybrid model integrating RL with convolutional neural network (CNN) technologies, aimed at elevating the precision and efficiency of cervical cancer screenings. Methods: RL-Cervix.Net combines the robust ResNet-50 architecture with a reinforcement learning module tailored for the unique challenges of cytological image analysis. The model was trained and validated using three extensive public datasets to ensure its effectiveness under realistic conditions. A novel application of RL for dynamic feature refinement and adjustment based on reward functions was employed to optimize the detection capabilities of the model. Results: The innovative integration of RL into the CNN framework allowed RL-Cervix.Net to achieve an unprecedented classification accuracy of 99.98% in identifying atypical cells indicative of cervical lesions. The model demonstrated superior accuracy and interpretability compared to existing methods, addressing variability and complexities inherent in cytological images. Conclusions: The RL-Cervix.Net model marks a significant breakthrough in the application of AI for medical diagnostics, particularly in the early detection of cervical cancer. By significantly improving diagnostic accuracy and efficiency, RL-Cervix.Net has the potential to enhance patient outcomes through earlier and more precise identification of the disease, ultimately contributing to reduced mortality rates and improved healthcare delivery.
Combined Effects of Social and Behavioral Factors on Stress and Depression
Authors: Obeng-Gyasi Emmanuel , Parker Sonya
Published: February 2025

Background: Chronic stress, driven by the persistent activation of the body’s stress response system—including the sympathetic nervous system and hypothalamic–pituitary–adrenal (HPA) axis—has far-reaching effects on both physical and mental health. This study examines the combined effects of social and behavioral factors on a latent variable consisting of stress and depressive symptoms, using a comprehensive framework to explore the complex interactions of these factors. Methods: Leveraging data from the United States Centers for Disease Control and Prevention’s (CDC’s) National Health and Nutrition Examination Survey (NHANES), we operationalized allostatic load—a measure of cumulative physiological stress—through 10 biomarkers spanning cardiovascular, inflammatory, and metabolic systems. Depressive symptoms were measured via the Patient Health Questionnaire-9 (PHQ-9), and a latent variable capturing the shared variance between stress and depressive symptoms was derived using factor analysis. To assess the influence of social (income and education) and behavioral (alcohol consumption and smoking) factors on this latent variable, we employed Bayesian Kernel Machine Regression (BKMR), allowing us to examine potential non-linear and interactive effects among these predictors. Results: Our results revealed a significant positive association between allostatic load and depressive symptoms across the sample, regardless of ethnic background. Alcohol consumption emerged as a key behavioral factor, with significant positive associations with stress. Conversely, education showed a protective effect, with higher education levels associated with decreased stress and depressive symptoms. Conclusions: These findings underscore the importance of addressing both social determinants and behavioral risk factors in mitigating the cumulative impacts of stress and depressive symptoms. By highlighting the roles of alcohol consumption and education, this study provides insights that can inform public health strategies aimed at promoting resilience and reducing stress-related health disparities.
Multi-Unmanned Aerial Vehicle Path Planning Based on Improved Nutcracker Optimization Algorithm
Authors: Xiao Chang , Yang Huiliao , Zhang Bo
Published: February 2025

For the multi-UAV path planning problem, environmental modeling and an improved swarm intelligence-based optimization algorithm are discussed in this paper. Firstly, to align with reality, specific constraints of UAVs in motions, attitudes and altitudes, real-world threats such as radars and no-fly zones, and inter-UAV collisions are considered. Thus, multi-UAV path planning is transformed into a multi-objective constrained optimization problem. Accordingly, an improved nutcracker optimization algorithm is proposed to solve this problem. Through initializing with logistic chaotic mapping and the lens imaging inverse learning strategy, a more fit elite initialization population is produced to increase the efficiency of path planning. Furthermore, by adjusting adaptive parameters and integrating an improved sine-cosine search strategy, a balance between global exploration capability and local exploitation capability during path planning is achieved. Experimental results show that the improved nutcracker optimization algorithm surpasses other algorithms with respect to both convergence speed and convergence value, making it an effective method for multi-UAV path planning.
Tracking the Green Transition in the European Union Within the Framework of EU Cohesion Policy: Current Results and Future Paths
Authors: Tijanić Lela , Kersan-Škabić Ines
Published: February 2025

Green transition is one of the priority areas in the European Union (EU), and thus also the focus of EU cohesion policy implementation during the 2021–2027 programming period, through “green growth”. To establish adequate guidelines and achieve better outcomes, it is necessary to observe and evaluate current results connected with these aspects. In terms of the complexity of the green transition domains, measuring green transition is still developing. The aim of this paper is to give an overview of the approaches that can be used in tracking the green transition as a result of EU cohesion policy implementation and to analyse achievements associated with the green transition. This will be done using desk research, previous studies, documents, evaluation reports and secondary data on the financing under the European Structural and Investment Funds (ESIFs) in EU member states, with a special emphasis on themes such as the low-carbon economy, climate change adaptation and risk prevention, environment protection and resource efficiency, and network infrastructure in transport and energy. The paper discusses these results in the context of the current challenges faced by the EU in becoming a leader in the green transition and contributes to the evaluation of the EU cohesion policy.
Leveling up Learning: Enhancing Self-Directed Learning in Computer Applications Technology with Classcraft
Authors: Stoltz J. H. , Bunt Byron , van Zyl Sukie
Published: February 2025

This study explores how gamification can be incorporated when facilitating theoretical content in Computer Applications Technology (CAT) to promote self-directed learning of Generation Z learners. The CAT curriculum consists of practical and theoretical content, and Generation Z learners tend to perceive theoretical content as less engaging and less stimulating. The dynamic nature of CAT, however, requires CAT learners to be self-directed learners who take ownership of their learning and are motivated and engaged in learning both the practical and theoretical components. A basic interpretive study, within an interpretivist paradigm, was applied as the research design. Purposive sampling was utilized, and 106 CAT learners at a South African high school participated in the research. A traditional teacher-centered approach was first followed to facilitate theoretical content. Thereafter, gamification with Classcraft was applied as an intervention. Data collection was performed by implementing post-open-ended questionnaires and focus group interviews. Results indicate that Generation Z learners crave instant gratification and lack skills such as self-motivation and critical thinking. A teacher-centered approach was found unsuitable for facilitating theoretical content to Generation Z learners. Gamification has the potential to entice Generation Z learners from different socioeconomical and cultural backgrounds to experience theoretical content in a more engaging and enjoyable manner and foster self-directed learning.
Framework for Investment in Electricity Distribution to Enable Energy Transition
Authors: Andrade Fernando , Peyerl Drielli , Mattos Claudia A. de
Published: February 2025

The climate crisis, caused by the emission of greenhouse gases, requires urgent attention and the implementation of effective measures to mitigate it. Within this scenario, the energy transition, a shift from an energy matrix based on fossil fuels to one with low or zero carbon emissions, emerges as a fundamental strategy for neutralizing these emissions. Given this context, the main objective of this study is to propose and validate an investment model in distribution infrastructure to enable the integral and effective development of the energy transition in Brazil. To this end, a systematic review was conducted, which provided the necessary foundation for elaborating a model aimed at estimating the investment required in the distribution of electricity in Brazil, based on the variables identified in the literature. Through the Delphi method, this model was validated by experts. From this perspective, electric vehicles, distributed generation, energy storage, and demand response are key elements in this process. Given this scenario, the electric sector, particularly the distribution of electric power, plays a crucial role in enabling the energy transition.
Energy Scheduling Strategy for the Gas–Steam–Power System in Steel Enterprises Under the Influence of Time-Of-Use Tariff
Authors: Yan Jun , Zhao Yuqi , Hao Qianpeng , Ji Yu , Zhang Minhao , Ma Huan , Meng Nan
Published: February 2025

Fully harnessing the inherent flexible adjustment potential of steel enterprises and fostering their interaction with the power grid is a crucial pathway to advancing green transformation. However, traditional research usually takes reducing energy consumption as the optimization goal, which limits the adjustment response capability, or ignores the storage and conversion constraints of secondary energy sources such as gas, steam, and electricity, making it difficult to fully explore and reasonably utilize the potential of multi-energy coordination. This study considers the production constraints of the surplus energy recovery and utilization system, establishes a collaborative scheduling model for a gas–steam–power system (GSPS) in an iron and steel enterprise, and proposes a demand response strategy that considers internal production constraints. Considering the time-of-use (TOU) tariff, iron and steel enterprises achieve a dynamic optimization adjustment range of electricity demand response through the conversion and storage process of gas, steam, and power. The adjustment capability of the GSPS reaches 26.94% of the initial electricity load, while reducing the total system energy cost by 2.24%. There is vast development potential of iron and steel enterprises participating in electricity demand response for promoting cost reduction and efficiency improvement, as well as enhancing the power grid flexibility.
Living Under the Volcano: Effects on the Nervous System and Human Health
Authors: Navarro-Sempere Alicia , Cobo Raúl , Camarinho Ricardo , Garcia Patricia , Rodrigues Armindo , García Magdalena , Segovia Yolanda
Published: February 2025

Volcanoes, during their explosive and post-explosive phases, as well as through continuous degassing processes, release a range of pollutants hazardous to human health, including toxic gases, fine particulate matter, and heavy metals. These emissions impact over 14% of the global population living in proximity to volcanoes, with effects that can persist for days, decades, or even centuries. Living conditions in these regions often involve chronic exposure to contaminants in the air, water, and soil, significantly increasing the risk of developing neurological disorders. Prolonged exposure to elements such as lead (Pb), mercury (Hg), and cadmium (Cd), among others, results in the accumulation of metals in the brain, which increases oxidative stress and causes neuronal damage and severe neurotoxicity in animals. An examination of metal accumulation in brain cells, particularly astroglia, provides valuable insights into the developmental neurotoxicity of these metals. Moreover, microglia may activate itself to protect from cytotoxicity. In this review, we consider the implications of living near an active volcano for neurotoxicity and the common neurodegenerative diseases. Additionally, we encourage governments to implement public health strategies and mitigation measures to protect vulnerable communities residing near active volcanoes.
Spatial Distribution and Influencing Factors of Chlorophyll a in Lianzhou Bay, Guangxi Province, China
Authors: Tan Xiao , Qu Bingliang , Zhu Yinling , Zhao Hui
Published: February 2025

Phytoplankton is essential in coastal marine ecosystems, aiding ecosystem stability and development of marine economy. Coastal ecosystems, as a transitional zone, feature complex, variable environmental factors that significantly affect phytoplankton growth. To assess the factors influencing the growth of phytoplankton in the bay area, this study measured chlorophyll a (Chla), nutrients, and four antibiotics (sulfamethoxazole, sulfadiazine, ciprofloxacin, and enrofloxacin) in seawater, as well as total nitrogen and total phosphorus contents in sediments at 25 stations in Lianzhou Bay. Principal component analysis and the risk quotient (RQ) were utilized for analysis and assessment. The results indicate that the factors influencing Chla concentrations are inconsistent between the nearshore and offshore areas of Lianzhou Bay. Specifically, abundant nutrients, high ammonia levels, and low enrofloxacin concentrations are the primary factors contributing to high Chla concentrations in the nearshore area. In contrast, hydrodynamic conditions, feeding by cultured shellfish, and adequate lighting collectively shape the distribution characteristics of Chla in the offshore area. Additionally, the ecological risk posed by antibiotics in this bay is relatively low. The findings of this study provide scientific evidence for local management of marine pollution sources and the optimization of aquaculture models, which is of great significance for sustainable utilization of marine ecological resources.
Wildfires During Early Summer in Greece (2024): Burn Severity and Land Use Dynamics Through Sentinel-2 Data
Authors: Castro-Melgar Ignacio , Tsagkou Artemis , Zacharopoulou Maria , Basiou Eleftheria , Athinelis Ioannis , Katris Efstratios-Aimilios , Kalavrezou Ioanna-Efstathia , Parcharidis Issaak
Published: February 2025

Wildfires are a recurrent and intensifying natural hazard in Mediterranean regions like Greece, driven by prolonged heatwaves, evolving climatic conditions, and human activities. This study leverages Sentinel-2 satellite imagery and Copernicus geospatial data to assess four early-season wildfire events during May and June 2024, which collectively affected 43.44 km2. Burn severity, land cover, and tree cover density were analyzed to evaluate the spatial and environmental impacts of these fires. Validation against Copernicus Emergency Management Service (CEMS) data yielded an overall accuracy of 95.79%, confirming the reliability of the methodology. The Achaia-Ilia wildfire, spanning 40.55 km2, exhibited the highest severity, with 26.93% classified as moderate to high severity. Smaller fires, such as Katsimidi (0.66 km2) and Stamata (1.41 km2), revealed the influence of vegetation type and density on fire dynamics, with Stamata’s sparse tree cover mitigating fire spread. The findings highlight the utility of remote sensing technologies for wildfire monitoring, and underscore the need for tailored management strategies, from vegetation control to urban planning, to enhance ecosystem resilience and mitigate wildfire risks in Mediterranean landscapes.
The Future of Education: A Multi-Layered Metaverse Classroom Model for Immersive and Inclusive Learning
Authors: Yeganeh Leyli Nouraei , Fenty Nicole Scarlett , Chen Yu , Simpson Amber , Hatami Mohsen
Published: February 2025

Modern education faces persistent challenges, including disengagement, inequitable access to learning resources, and the lack of personalized instruction, particularly in virtual environments. In this perspective, we envision a transformative Metaverse classroom model, the Multi-layered Immersive Learning Environment (Meta-MILE) to address these critical issues. The Meta-MILE framework integrates essential components such as immersive infrastructure, personalized interactions, social collaboration, and advanced assessment techniques to enhance student engagement and inclusivity. By leveraging three-dimensional (3D) virtual environments, artificial intelligence (AI)-driven personalization, gamified learning pathways, and scenario-based evaluations, the Meta-MILE model offers tailored learning experiences that traditional virtual classrooms often struggle to achieve. Acknowledging potential challenges such as accessibility, infrastructure demands, and data security, the study proposed practical strategies to ensure equitable access and safe interactions within the Metaverse. Empirical findings from our pilot experiment demonstrated the framework’s effectiveness in improving engagement and skill acquisition, with broader implications for educational policy and competency-based, experiential learning approaches. Looking ahead, we advocate for ongoing research to validate long-term learning outcomes and technological advancements to make immersive learning more accessible and secure. Our perspective underscores the transformative potential of the Metaverse classroom in shaping inclusive, future-ready educational environments capable of meeting the diverse needs of learners worldwide.
Crowdfunding and Energy Efficiency Contracting: Exploring New Pathways for Private Investment in Building Renovations
Authors: Magalhães Renan , Narracci Federico , Lowitzsch Jens
Published: February 2025

Energy Efficiency Contracting (EEC) enables structural improvements in buildings by financing upgrades through the savings generated, eliminating the need for upfront investment by property owners. Although the model supports the energy transition and the reduction in GHG emissions, its adoption in the private sector faces relevant barriers such as the lack of information from the Energy Service Companies (ESCOs), distrust from clients in benefits with no upfront costs, and legal and behavioral barriers. To overcome these challenges, the FinSESCo platform, funded by Era-Net 2020 joint call, aims to channel private investments into building renovations and renewable energy installations via a crowdfunding portal. The platform allows individuals and organizations to finance small-scale renewable energy installations and energy efficiency measures for homeowners, tenants, and apartment owners. The new platform is likely to change the way EE investments are made and reach out to new audiences. A survey of 2585 German households sought to understand the drivers of EE investments, factors affecting the decisions, and their relationships with several demographic variables. Using a stepwise backward regression model, the study found significant differences between traditional investors in EE and those who would use the FinSESCo platform. Low- and medium-income households were more likely to take up the platform, and previous renewable energy ownership, experience with EEC models, and knowledge of crowdfunding further raised willingness to participate. The results point to the potential of the FinSESCo platform to expand EEC to new audiences, underlining its role of democratization and diversification of investments in building energy efficiency.
YOLOv7scb: A Small-Target Object Detection Method for Fire Smoke Inspection
Authors: Shao Dan , Liu Yu , Liu Guoxing , Wang Ning , Chen Pu , Yu Jiaxun , Liang Guangmin
Published: February 2025

Fire detection presents considerable challenges due to the destructive and unpredictable characteristics of fires. These difficulties are amplified by the small size and low-resolution nature of fire and smoke targets in images captured from a distance, making it hard for models to extract relevant features. To address this, we introduce a novel method for small-target fire and smoke detection named YOLOv7scb. This approach incorporates two key improvements to the YOLOv7 framework: the use of space-to-depth convolution (SPD-Conv) and C3 modules, enhancing the model’s ability to extract features from small targets effectively. Additionally, a weighted bidirectional feature pyramid network (BiFPN) is integrated into the feature-extraction network to merge features across scales efficiently without increasing the model’s complexity. We also replace the conventional complete intersection over union (CIoU) loss function with Focal-CIoU, which reduces the degrees of freedom in the loss function and improves the model’s robustness. Given the limited size of the initial fire and smoke dataset, a transfer-learning strategy is applied during training. Experimental results demonstrate that our proposed model surpasses others in metrics such as precision and recall. Notably, it achieves a precision of 98.8% for small-target flame detection and 90.6% for small-target smoke detection. These findings underscore the model’s effectiveness and its broad potential for fire detection and mitigation applications.
Antimicrobial Activity of Probiotic Bacteria Isolated from Plants: A Review
Authors: Sharma Anshul , Lee Hae-Jeung
Published: February 2025

Lactic acid bacteria (LAB) constitute a heterogeneous group of bacteria isolated from fermented foods, animals, plants, and mammalian guts, with many health-promoting properties. Probiotics with antagonistic properties against human pathogens and foodborne bacteria have garnered significant attention from the scientific fraternity. A dedicated review focusing on plant-derived probiotic bacteria and their antagonistic properties has not been comprehensively reviewed. Thus, this review aimed at providing an overview of LAB isolates derived from several unconventional sources such as fruits, seeds, fruit pulp, leaves, roots, vegetables, grasses, and flowers and with their antibacterial, antifungal, and antiviral properties. This paper reviewed the antimicrobial properties of different genera, Lactobacillus, Leuconostoc, Weissella, Enterococcus, Pediococcus, Bacillus, and Fructobacillus, their postbiotics, and paraprobiotics. Several important mechanisms, including the secretion of bacteriocins, bacteriocin-like substances, reuterin, organic acids (lactic and acetic), peptides, exopolysaccharides, and hydrogen peroxide, have been attributed to their antimicrobial actions against pathogens. However, their precise mode of action is poorly understood; hence, further research should be conducted to reveal detailed mechanisms. Finally, the review discusses the summary and future implications. Given the significance, LAB and derived antimicrobial compounds can potentially be exploited in food preservation and safety or for medicinal applications after evaluating their safety.
Finite-Time Stability of Fractional-Order Switched Systems Based on Lyapunov Method
Authors: Feng Tian , Wang Lizhen , Chen Yangquan
Published: February 2025

This paper investigates the finite-time stability of a class of fractional-order switched systems with order 0<α<1, employing the fractional Lyapunov direct method. First, based on the Mittag-Leffler function and Gronwall inequality, two corresponding sufficient conditions are presented to ensure the finite-time stability of the considered system. Second, in consideration of the effectiveness of dwell time technique in switched systems, a sufficient condition is derived under a minimum average dwell time constraint. Finally, numerical simulations are performed to validate the effectiveness of the theoretical formulation.
Enhancing Banking Transaction Security with Fractal-Based Image Steganography Using Fibonacci Sequences and Discrete Wavelet Transform
Authors: Tabirca Alina Iuliana , Dumitrescu Catalin , Radu Valentin
Published: February 2025

The growing reliance on digital banking and financial transactions has brought significant security challenges, including data breaches and unauthorized access. This paper proposes a robust method for enhancing the security of banking and financial transactions. In this context, steganography—hiding information within digital media—is valuable for improving data protection. This approach combines biometric authentication, using face and voice recognition, with image steganography to secure communication channels. A novel application of Fibonacci sequences is introduced within a direct-sequence spread-spectrum (DSSS) system for encryption, along with a discrete wavelet transform (DWT) for embedding data. The secret message, encrypted through Fibonacci sequences, is concealed within an image and tested for effectiveness using the Mean Square Error (MSE) and Peak Signal-to-Noise Ratio (PSNR). The experimental results demonstrate that the proposed method achieves a high PSNR, particularly for grayscale images, enhancing the robustness of security measures in mobile and online banking environments.
History and Development of Water Treatment for Human Consumption
Authors: Hartemann Philippe , Montiel Antoine
Published: February 2025

Throughout history, humans have sought to drink water that is good for their health, according to the knowledge of the time. Hippocrates’ definition of water quality, “good water should be clear, light, aerated, without any perceptible odor or taste, warm in winter and cold in summer”, remained virtually unchanged until 1887, when it was added that water should dissolve soap and foam well, be clear and colorless, have a pleasant taste, leave no large deposits after boiling, and cook vegetables and wash clothes well. This definition guided all treatments to remove the substances responsible for cloudiness, odor and discoloration, as well as the choice of resources: clear water and water with low mineral content. The discoveries by Pasteur and Koch led to the addition of microbiological criteria, like the absence of pathogens, and the definition of microbiological indicators. Throughout the 20th century, advances in scientific knowledge in microbiology, chemistry and toxicology led to major progress in treatment methods. These filtration and disinfection treatments are described here according to their historical implementation. Due to progress in numerous areas, e.g., both chemical and microbiological analytical detection limits, speed of information flow and origins of certain diseases that are discovered to be waterborne, the consumer is now exposed to anxiety-provoking news (microplastics, eternal pollutants (cf. per- and polyfluoroalkyl substances (PFASs)), drugs, pesticides residues, etc.). Thus, the consumer tends to lose confidence in tap or bottled water and turn to buying home purifiers. Drinking water treatment will continue to evolve with more sophisticated processes, as analytical progress enables us to expect further developments.
Colorectal Cancer: Current and Future Therapeutic Approaches and Related Technologies Addressing Multidrug Strategies Against Multiple Level Resistance Mechanisms
Authors: Puzzo Marianna , De Santo Marzia , Morelli Catia , Leggio Antonella , Catalano Stefania , Pasqua Luigi
Published: February 2025

Colorectal cancer (CRC) is the third most common cancer and is associated with a poor prognosis. The mutation profile and related involved pathways of CRC have been, in broad terms, analyzed. The main current therapeutic approaches have been comprehensively reviewed here, and future possible therapeu-tic options and related technologies have been perspectively presented. The complex scenario represented by the multiple-level resistance mechanism in the epidermal growth factor receptor (EGFR) pathway, including mutations in KRAS, NRAS, and BRAF V600E, is discussed. Examples of engineered therapeutic approaches from the literature along with a drug combination tested in clinical trials are discussed. The encouraging results observed with the latter combination (the BEACON clinical trial), totally free from chemotherapy, prompted the authors to imagine a future possible nanotechnology-assisted therapeutic approach for bypassing multiple-level resistance mechanisms, hopefully allowing, in principle, a complete biological cancer remission.
Therapeutic Potential of Bifidobacterium longum subsp. infantis B8762 on Gut and Respiratory Health in Infant
Authors: Richmond Rocky Vester , Mageswary Uma , Ali Adli , Taib Fahisham , Koo Thai Hau , Yusof Azianey , Hamid Intan Juliana Abd , Zhao Feiyan , Rahman Nik Norashikin Nik Abd , Hasan Taufiq Hidayat , Zhang Heping , Liong Min-Tze
Published: February 2025

Respiratory tract and gastrointestinal infections in pediatric populations are major public health concerns. Addressing these challenges necessitates effective preventative and therapeutic strategies. This study assessed the efficacy of the probiotic Bifidobacterium longum subsp. infantis B8762 (0.5 × 1010 CFU) in reducing the duration and frequency of these infections in young children. In a randomized trial, 115 eligible children were assigned to either the probiotic (n = 57; 3.51 ± 0.48 months old) or placebo (n = 58; 2.78 ± 0.51 months old) group, with daily consumption for 4 weeks. The probiotic group demonstrated a lower duration of infections than the placebo group (p < 0.05). The probiotic group also showed fewer clinical visits due to respiratory and gastrointestinal problems as compared to the placebo group (p = 0.009 & p = 0.004, respectively). Oral swab samples revealed that the placebo group had higher levels of pro-inflammatory cytokine TNF-α after 4 weeks (p = 0.033), while the probiotic group demonstrated a balanced cytokine response, indicating modulation of the immune system. Genomic analysis showed that B8762 harbors various genes for the synthesis of proteins and vitamins crucial for the gut health of children. Both the clinical and genomic findings suggested that B8762 offered a therapeutic effect on gut and respiratory health in children, highlighting its potential in managing common pediatric infections.
CYP6B Subtype Expression Fluctuates in the Great Mormon, Papilio memnon, with Changes in the Components of the Host Plants
Authors: Nakano Miho , Sakamoto Takuma , Kitano Yoshikazu , Bono Hidemasa , Tabunoki Hiroko
Published: February 2025

Cytochrome P-450 (CYP) is one of the metabolic enzymes which is conserved among organisms to metabolise xenobiotics. The metabolic role and transcriptomic profiles of the CYP6B subfamily have been studied in some Papilionidae insects. However, the role of CYP6Bs expressed in Rutaceae plant-fed swallowtails has yet to be fully examined. Here, the expression profile of CYP6B in the Great Mormon (Papilio memnon) larvae, which prefer Citrus plants to the Rutaceae plant, was investigated by RNA sequencing analysis and real-time quantitative PCR when feeding different kinds of Citrus plants. We found that six kinds of CYP6B subtype transcripts were expressed in the larval fat body and midgut. Then, we focused on CYP6B2, CYP6B5, and CYP6B6 transcripts and examined their mRNA expression in the larvae fed on different plants. These CYP6B mRNA expressions were changed in the larval fat body and the midgut by changing the host plants. The presence of chemicals specific to each host plant was confirmed when the host plant components were examined by database, literature, and thin-layer chromatography. Our study suggests that phytochemicals in the host plant affect CYP6B subtypes mRNA expression in P. memnon larval fat body and midgut, and CYP6B subtypes may relate to metabolise the phytochemicals in the host plants.
The Application of the Vesikari and Modified Vesikari Severity Scores in Complicated Pediatric Gastroenteritis of Viral Origin: An Observational Study
Authors: Săsăran Maria Oana , Mărginean Cristina Oana , Muntean Carmen Viorica , Pitea Ana Maria , Man Lidia , Grama Alina , Koller Ana Maria
Published: February 2025

Background/Objectives: Viral gastroenteritis can have a potentially fatal outcome at young ages and the recognition of severe cases could be aided by clinically derived severity scores. Methods: This observational study intended to conduct a comparative assessment of the utility of the Vesikari and modified Vesikari score in the evaluation of viral gastroenteritis severity and for the possible prediction of the dehydration degree. A total number of 113 children diagnosed with gastroenteritis were retrospectively enrolled and divided based on viral etiology into group 1 (34 children with unknown viral etiology), group 2 (60 children with rotavirus) and group 3 (19 children with adenovirus). Results: The highest mean Vesikari and modified Vesikari scores were found in group 2 (p < 0.01; p = 0.01). A significant increase in liver enzymes was also identified in patients infected with rotavirus. The highest mean diarrhea, vomiting duration and body temperature were found in group 3 (p < 0.01; p < 0.01; p = 0.02), as well as the highest mean inflammatory markers, such as C-reactive protein (CRP; p = 0.01) and the erythrocyte sedimentation rate (p < 0.01). Significant linear associations were found between pH, bicarbonate level, base excess and the Vesikari scores, whereas urea, CRP and aspartate aminotransferase levels were associated with both severity scores. ROC curve analysis revealed a significant correlation between the Vesikari scores and dehydration degree (p < 0.01), with numeric cut-off values of 11.5 being proposed for the differentiation between mild and moderate gastroenteritis and 13.5 for the distinction between moderate and severe gastroenteritis. Conclusions: Both severity scores are useful in clinical settings, but more studies enrolling populations with various enteral infections could provide more insight into their etiology-based performance and reflection of paraclinical changes.
Proposal of a New Composite Score (DAMADECO) to Simultaneously Evaluate Asthma and CRSwNP Severity in Comorbid Patients
Authors: D’Amato Maria , Pasqualetti Patrizio , Cantone Elena , Caminati Marco , Bonini Matteo , Di Marco Fabiano , Pipolo Carlotta , Seccia Veronica , Sotgiu Giovanni , De Corso Eugenio
Published: February 2025

Background: Asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) are chronic respiratory conditions that frequently coexist. However, an integrated assessment tool for both conditions is currently lacking. This study aimed to develop and preliminarily evaluate a composite score capable of simultaneously assessing asthma and CRSwNP in comorbid patients. Methods: An expert panel comprising three pulmonologists, one allergist/clinical immunologist, and four ear, nose and throat (ENT) specialists developed a tool to capture asthma and CRSwNP severity. The tool (D’Amato-De Corso score, or DAMADECO score) incorporates eight parameters, four specific to asthma and four specific to CRSwNP, to assign individual scores for each condition. A composite score is then calculated to reflect the overall disease burden (ranging from −8: poor control and +8: optimal control). A retrospective pilot study was conducted to evaluate the tool. Results: The DAMADECO composite score was applied to 21 comorbid patients. The mean partial scores for asthma and CRSwNP were −1.57 and −1.67, respectively, with a mean total composite score of −3.24. A total of 13 out of 21 patients had uncontrolled domains in both diseases, while fewer patients had only uncontrolled domains in asthma (1/21) or CRSwNP (6/21). The DAMADECO score also allows researchers to track disease progression and monitor treatment effectiveness. Conclusions: The preliminary results suggest that the DAMADECO score is a promising tool for simultaneously assessing asthma and CRSwNP, addressing the unmet need for an integrated approach to comorbid respiratory diseases. Further validation studies are needed to validate the tool in larger patient populations.
Acute Kidney Injury During Sepsis and Prognostic Role of Coexistent Chronic Heart Failure
Authors: Soukup Jens , Pliquett Rainer U.
Published: February 2025

Background: The recently updated definition of sepsis considers pathophysiologic mechanisms to guide initial therapy. Clearly, generalized recommendations for sepsis therapy may be limited by pre-existing multimorbidity in addition to sepsis-related multi-organ failure. In particular, a recommendation regarding fluid rescue therapy may require adequate cardiac function and/or the absence of sepsis-induced cardiomyopathy. In all sepsis patients with compromised cardiac function or sepsis-induced cardiomyopathy, a patient-specific therapy regimen is required to prevent pulmonary edema and early death. Similarly, in sepsis, acute kidney injury with or without pre-existing chronic kidney disease requires attention to be paid to excretory renal function to avoid hypervolemia-mediated acute heart failure. In addition, hyponatremia related to intravascular hypovolemia may be explained by vasopressin stimulation. However, hypothetically, vasopressin hyporesponsiveness may contribute to sepsis-related acute kidney injury. In this review, relevant cardiorenal pathomechanisms will be assessed in the context of sepsis therapy. Conclusions: In conclusion, therapy for sepsis with acute kidney injury has to take cardiac comorbidity, if present, into account. The extent to which vasopressin hyporesponsiveness aggravates sepsis-mediated hypovolemia and renal insufficiency should remain a subject of further study.
Pharmacological Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ) with Pentoxifylline and Tocopherol
Authors: Słowik Łukasz , Totoń Ewa , Nowak Aleksy , Wysocka-Słowik Aleksandra , Okła Maciej , Ślebioda Zuzanna
Published: February 2025

Background: This study aimed to evaluate the efficacy of pentoxifylline and tocopherol therapy in patients with medication-related osteonecrosis of the jaw (MRONJ). Methods: During this study, 43 patients participated, including 21 women and 22 men with a mean age of 66.8 years, who showed 63 areas of osteitis altogether. The diagnosis was made based on X-ray imaging and histopathological findings. All the subjects received pharmacological treatment with pentoxifylline 400 mg and tocopherol 400 IU. The study scheme consisted of initial observation and two follow-up examinations every 5–6 months. MRONJ severity, peripheral blood parameters, and CRP levels were evaluated. The obtained results were statistically analyzed. Results: Complete remission occurred in 46% of the subjects, with a higher rate among those taking bisphosphonates intravenously compared to oral administration. The efficacy of pentoxifylline and tocopherol treatment was not influenced by gender or lesion location. Moreover, the worst response to treatment was observed in the group with the highest disease stage, as determined in the initial study. Conclusions: Pentoxifylline and tocopherol therapy in MRONJ was effective in patients taking oral and intravenous bisphosphonates, in patients with osteoporosis, and undergoing oncological treatment. This treatment approach allows surgery to be avoided or significantly reduced. The good response to pharmacotherapy observed in patients with early stages of MRONJ shows an urgent need to monitor the patients treated with bisphosphonates carefully to diagnose MRONJ at the initial phase.
Intubation Versus Tracheotomy Outcomes in Critically Ill COVID-19 Patients in Low-Resource Settings: What Do We Know?
Authors: Kovacevic Pedja , Baric Goran , Dragic Sasa , Momcicevic Danica , Zlojutro Biljana , Jandric Milka , Kovacevic Tijana , Lovric Daniel , Palibrk Ivan , Mallat Jihad
Published: February 2025

Background: Patients undergoing prolonged mechanical ventilation commonly require tracheotomy. The main aim of this study was to evaluate the outcomes of tracheotomy for patients with acute respiratory distress syndrome (ARDS) associated with COVID-19 in low-resource settings. Methods: A retrospective, single-center, observational cohort study was performed on patients with ARDS associated with COVID-19. Patients who underwent intubation alone were compared with those who received both intubation and subsequent tracheotomy. The analysis included patient demographics, comorbidities, and outcomes. Results: Patients undergoing tracheotomy (n = 89) were compared with intubated patients (n = 622). The median time from intubation to tracheotomy was 10 days (IQR: 6–15 days). Overall, 608 patients (85.5%) died in the hospital. Thirty-seven patients (35.9%) in the survival group had tracheostomy compared with fifty-two patients (8.5%) in the non-survival group (p < 0.001). The Kaplan–Meier curve shows a higher probability of survival in the tracheotomy group compared with the non-tracheotomy group (log-rank test: p < 0.001). Tracheotomy was found to be independently associated with lower in-hospital mortality (HR = 0.16 [95% CI: 0.11–0.23], p < 0.001) in the multivariable Cox proportional hazards regression analysis after adjusting for potential confounding factors. Furthermore, tracheotomy was associated with a higher cumulative incidence of being alive and off the ventilator at day 28 (SHR = 2.87 [95% CI: 1.88–4.38], p < 0.001). Conclusions: Tracheotomy was associated with reduced in-hospital mortality and longer ventilator-free days.
Exploring Resting Sinus Tachycardia in Cancer Care: A Comprehensive Review
Authors: Fakih Yeva , Al Sakan Moied , El Ghazawi Alaaeddine , Khoury Maurice , Refaat Marwan M.
Published: February 2025

Resting sinus tachycardia is frequently encountered in cancer patients. It affects a wide variety of cancer patients and is associated with distressing symptoms. Cancer-associated resting sinus tachycardia varies in its underlying mechanism. It can stem from the tumor burden or the side effects of chemotherapy/radiotherapy, or it can be secondary to paraneoplastic syndrome or the sequalae of cancer itself (infection, anemia, thrombosis, etc.). The clinical significance of resting sinus tachycardia extends beyond mere symptomatology, as it can potentially indicate severe complications which may facilitate or exacerbate a new or underlying cardiovascular dysfunction. Therefore, this necessitates thorough diagnostic tools to discern the underlying cause and tailor appropriate management strategies, whether pharmacological, non-pharmacological, or conservative. While resting sinus tachycardia has been extensively investigated in the context of cardiovascular disease, its underlying etiology, clinical implication, prognostic value, and treatment options remain vague in the context of cancer. This review aims to explore the topic of resting sinus tachycardia in cancer patients through delving deeper into its underlying mechanism, presenting the current evidence on its effect on cancer-independent cardiovascular and all-cause mortality, as well as providing some insight into the currently available treatment options. It will also propose therapeutic interventions and strategies aimed at optimizing cancer patient care. Lastly, it will highlight research gaps which need to be addressed further, as future research is needed to refine the diagnostic criteria, develop targeted therapies, find alternative cardioprotective/cardio-neutral chemotherapy options, and establish evidence-based guidelines to improve outcomes in this vulnerable patient population.
Exploring the Utility of ChatGPT in Cleft Lip Repair Education
Authors: Mahedia Monali , Rohrich Rachel N. , Sadiq Kaiser O’Sahil , Bailey Lauren , Harrison Lucas M. , Hallac Rami R.
Published: February 2025

Background/Objectives: The evolving capabilities of large language models, such as generative pre-trained transformers (ChatGPT), offer new avenues for disseminating health information online. These models, trained on extensive datasets, are designed to deliver customized responses to user queries. However, as these outputs are unsupervised, understanding their quality and accuracy is essential to gauge their reliability for potential applications in healthcare. This study evaluates responses generated by ChatGPT addressing common patient concerns and questions about cleft lip repair. Methods: Ten commonly asked questions about cleft lip repair procedures were selected from the American Society of Plastic Surgeons’ patient information resources. These questions were input as ChatGPT prompts and five board-certified plastic surgeons assessed the generated responses on quality of content, clarity, relevance, and trustworthiness, using a 4-point Likert scale. Readability was evaluated using the Flesch reading ease score (FRES) and the Flesch–Kincaid grade level (FKGL). Results: ChatGPT responses scored an aggregated mean rating of 2.9 out of 4 across all evaluation criteria. Clarity and content quality received the highest ratings (3.1 ± 0.6), while trustworthiness had the lowest rating (2.7 ± 0.6). Readability metrics revealed a mean FRES of 44.35 and a FKGL of 10.87, corresponding to approximately a 10th-grade literacy standard. None of the responses contained grossly inaccurate or potentially harmful medical information but lacked citations. Conclusions: ChatGPT demonstrates potential as a supplementary tool for patient education in cleft lip management by delivering generally accurate, relevant, and understandable information. Despite the value that AI-powered tools can provide to clinicians and patients, the lack of human oversight underscores the importance of user awareness regarding its limitations.
Dual-Model Synergy for Fingerprint Spoof Detection Using VGG16 and ResNet50
Authors: Cheniti Mohamed , Akhtar Zahid , Chandaliya Praveen Kumar
Published: February 2025

In this paper, we address the challenge of fingerprint liveness detection by proposing a dual pre-trained model approach that combines VGG16 and ResNet50 architectures. While existing methods often rely on a single feature extraction model, they may struggle with generalization across diverse spoofing materials and sensor types. To overcome this limitation, our approach leverages the high-resolution feature extraction of VGG16 and the deep layer architecture of ResNet50 to capture a more comprehensive range of features for improved spoof detection. The proposed approach integrates these two models by concatenating their extracted features, which are then used to classify the captured fingerprint as live or spoofed. Evaluated on the Livedet2013 and Livedet2015 datasets, our method achieves state-of-the-art performance, with an accuracy of 99.72% on Livedet2013, surpassing existing methods like the Gram model (98.95%) and Pre-trained CNN (98.45%). On Livedet2015, our method achieves an average accuracy of 96.32%, outperforming several state-of-the-art models, including CNN (95.27%) and LivDet 2015 (95.39%). Error rate analysis reveals consistently low Bonafide Presentation Classification Error Rate (BPCER) scores with 0.28% on LivDet 2013 and 1.45% on LivDet 2015. Similarly, the Attack Presentation Classification Error Rate (APCER) remains low at 0.35% on LivDet 2013 and 3.68% on LivDet 2015. However, higher APCER values are observed for unknown spoof materials, particularly in the Crossmatch subset of Livedet2015, where the APCER rises to 8.12%. These findings highlight the robustness and adaptability of our simple dual-model framework while identifying areas for further optimization in handling unseen spoof materials.