bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered Brain Reactivity to Food Cues in Undergraduate Students with Disordered Eating Behaviors
Authors: Hiluy Joao C. , David Isabel A. , Lobo Isabela , Braga Filipe , Fernandes Thayane , Ferreira Naiane Beatriz , Mauro Maria Francisca F. P. , Appolinario Jose C.
Published: July 2024

Purpose: A growing body of evidence has shown that electroencephalography (EEG) is an interesting method of assessing the underlying brain physiology associated with disordered eating. Using EEG, we sought to evaluate brain reactivity to hyper-palatable food cues in undergraduate students with disordered eating behavior (DEB). Methods: After assessing the eating behaviors of twenty-six undergraduate students using the Eating Attitudes Test (EAT-26), electroencephalographic signals were recorded while the participants were presented with pictures of hyper-palatable food. The current study used a temporospatial principal component analysis (PCA) approach to identify event-related potential (ERP) responses that differed between DEB and non-DEB individuals. Results: A temporospatial PCA applied to the ERPs identified a positivity with a maximum amplitude at 347 ms at the occipital–temporal electrodes in response to pictures of hyper-palatable food. This positivity was correlated with the EAT-26 scores. Participants with DEB showed reduced positivities in this component compared with those without DEB. Conclusion: Our findings may reflect greater motivated attention toward hyper-palatable food cues in undergraduate students with DEB. These results are an important step toward obtaining a more refined understanding of specific abnormalities related to reactivity to food cues in this population.
Human-Induced Pluripotent Stem Cell-Derived Neural Stem Cell Therapy Limits Tissue Damage and Promotes Tissue Regeneration and Functional Recovery in a Pediatric Piglet Traumatic-Brain-Injury Model
Authors: Schantz Sarah L. , Sneed Sydney E. , Fagan Madison M. , Golan Morgane E. , Cheek Savannah R. , Kinder Holly A. , Duberstein Kylee J. , Kaiser Erin E. , West Franklin D.
Published: July 2024

Traumatic brain injury (TBI) is a leading cause of death and disability in pediatric patients and often results in delayed neural development and altered connectivity, leading to lifelong learning, memory, behavior, and motor function deficits. Induced pluripotent stem cell-derived neural stem cells (iNSCs) may serve as a novel multimodal therapeutic as iNSCs possess neuroprotective, regenerative, and cell-replacement capabilities post-TBI. In this study, we evaluated the effects of iNSC treatment on cellular, tissue, and functional recovery in a translational controlled cortical impact TBI piglet model. Five days post-craniectomy (n = 6) or TBI (n = 18), iNSCs (n = 7) or PBS (n = 11) were injected into perilesional brain tissue. Modified Rankin Scale (mRS) neurological evaluation, magnetic resonance imaging, and immunohistochemistry were performed over the 12-week study period. At 12-weeks post-transplantation, iNSCs showed long-term engraftment and differentiation into neurons, astrocytes, and oligodendrocytes. iNSC treatment enhanced endogenous neuroprotective and regenerative activities indicated by decreasing intracerebral immune responses, preserving endogenous neurons, and increasing neuroblast formation. These cellular changes corresponded with decreased hemispheric atrophy, midline shift, and lesion volume as well as the preservation of cerebral blood flow. iNSC treatment increased piglet survival and decreased mRS scores. The results of this study in a predictive pediatric large-animal pig model demonstrate that iNSC treatment is a robust multimodal therapeutic that has significant promise in potentially treating human pediatric TBI patients.
Thermodynamic and Kinetic Studies of the Precipitation of Double-Doped Amorphous Calcium Phosphate and Its Behaviour in Artificial Saliva
Authors: Sezanova Kostadinka , Gergulova Rumiana , Shestakova Pavletta , Rabadjieva Diana
Published: July 2024

Simulated body fluid (SBF) and artificial saliva (AS) are used in biomedical and dental research to mimic the physiological conditions of the human body. In this study, the biomimetic precipitation of double-doped amorphous calcium phosphate in SBF and AS are compared by thermodynamic modelling of chemical equilibrium in the SBF/AS-CaCl2-MgCl2-ZnCl2-K2HPO4-H2O and SBF/AS-CaCl2-MgCl2-ZnCl2-K2HPO4-Glycine/Valine-H2O systems. The saturation indices (SIs) of possible precipitate solid phases at pH 6.5, close to pH of AS, pH 7.5, close to pH of SBF, and pH 8.5, chosen by us based on our previous experimental data, were calculated. The results show possible precipitation of the same salts with almost equal SIs in the two biomimetic environments at the studied pHs. A decrease in the saturation indices of magnesium and zinc phosphates in the presence of glycine is a prerequisite for reducing their concentrations in the precipitates. Experimental studies confirmed the thermodynamic predictions. Only X-ray amorphous calcium phosphate with incorporated Mg (5.86–8.85 mol%) and Zn (0.71–2.84 mol%) was obtained in the experimental studies, irrespective of biomimetic media and synthesis route. Solid-state nuclear magnetic resonance (NMR) analysis showed that the synthesis route affects the degree of structural disorder of the precipitates. The lowest concentration of dopant ions was obtained in the presence of glycine. Further, the behaviour of the selected amorphous phase in artificial saliva was studied. The dynamic of Ca2+, Mg2+, and Zn2+ ions between the solid and liquid phases was monitored. Both direct excitation 31P NMR spectra and 1H-31P CP-MAS spectra proved the increase in the nanocrystalline hydroxyapatite phase upon increasing the incubation time in AS, which is more pronounced in samples with lower additives. The effect of the initial concentration of doped ions on the solid phase transformation was assessed by solid-state NMR.
The Reliability of Field-Based Static and Dynamic Balance Tests in Primary School-Aged Autistic Children
Authors: Baldwin Emma , Kinsella Sharon , Byrne Paul J.
Published: July 2024

Previous research has proven that the balance of autistic children is poor. However, the reliability of assessing balance in this cohort has been inadequately researched. This study therefore aimed to examine if field-based static and dynamic balance tests can be reliably assessed in autistic children, to determine the number of familiarisation sessions required and whether autistic severity impacts on the reliability of these balance tests. The balance of eighteen primary school-aged autistic children was assessed three times a week over five weeks, using the flamingo balance test, a modified version of the balance error scoring system (BESS), the low beam walking test, and the heel to toe walking test. Reliability criteria included an intraclass correlation coefficient (ICC) level of ≥0.75 and a coefficient of variance (CV%) of ≤46% for the low beam walking test, the heel to toe walking test, and the BESS, and a CV% of ≤82% or the flamingo balance test. Inter-session reliability was achieved and required the least number of familiarisation sessions for the flamingo balance test, compared to the low beam walking test, which required a greater number of familiarisation sessions to achieve inter-session reliability. The heel to toe walking test and the BESS achieved inter-session reliability and familiarisation in an acceptable time frame. Due to the large CV% values reported in the current study, practitioners need to be aware that balance interventions need to achieve improvements greater than the CV% in this cohort.
A Numerical Investigation of the Influence of Diffuser Vane Height on Hydraulic Loss in the Volute for a Centrifugal Water Supply Pump
Authors: Liu Zhen , Zhu Xiangyuan , Liu Jiying , Kim Moon Keun , Jiang Wei
Published: July 2024

The energy efficiency of water supply systems in high-rise residential buildings has become a significant concern for sustainable development in recent times. This work presents a numerical investigation on the influence of diffuser vane height on flow variation and hydraulic loss in the volute for a water supply centrifugal pump. Experiments and numerical simulations were conducted with four different vane height ratios. The numerical results were validated against experimental data. The hydraulic losses of different flow components were numerically evaluated at varying guide vane blade heights. The changes in flow patterns within the volute and the resulting discrepancies in hydraulic losses due to variations in the inlet flow conditions at different blade heights were studied. The findings indicate that the total pressure drop within the volute is affected significantly. Compared to traditional guide vanes, the reduced height vanes can reduce the hydraulic loss in the volute by nearly 75%. Once the vane height is reduced, the high-pressure gradient is improved, and the small-scale vortex vanishes. The influence area of the large-scale vortex in the volute outlet pipe decreases, leading to a weakening of the deflection of the main flow and ultimately resulting in reduced hydraulic loss.
The Optimum Interval Time of Layered Cement Composites with the Incorporation of Edge-Oxidized Graphene Oxide
Authors: Khawaji Mohammad , Alamri Mohammed
Published: July 2024

The current research focuses on the effect of incorporating edge-oxidized graphene oxide (EOGO) on the performance of layered cement composites cast at different times. The feature of producing flower-shaped hydrated cement products is exploited to enhance the contact surface of two different cement composites. In the current study, the interval time of casting cement composites is the crucial parameter investigated. Consequently, a layer of cement paste with EOGO is cast above a layer of cement mortar where the amount of EOGO of 0.10% by the cement weight is fixed for all mixtures. Also, four different interval times based on cement setting time are considered, namely immediately, 6 h, 12 h, and 1 day. Similar mixtures are prepared but without adding EOGO for comparison purposes. The results show that EOGO is capable of enhancing the contact surface of layered cement composites by strengthening the split strength of two different layers (between 12 and 29%). Moreover, casting the paste layer containing EOGO after 6 h of mortar layer seems to be the optimum interval time among others by improving compressive strength (by 29%) and residual strength (by 34%) and not affecting flexural strength and porosity percentage.
Sleep Quality, but Not Personality Traits, Mediates the Relationship between Chronotype and Life Satisfaction: A Study in Young Adults
Authors: Lan Anat , Stukalin Yelena , Einat Haim
Published: July 2024

Chronotype reflects the morningness–eveningness preference over a 24 h period. Significant data indicate meaningful differences between evening types (ETs) and morning types (MTs) in behavior, personality traits, health, and well-being. This study explores the interactions between chronotype, sleep, personality, and life satisfaction among 254 undergraduate college students (mean age 23.79 ± 1.85). Using online questionnaires, the participants provided demographic information and completed assessments, including the Morningness–Eveningness Questionnaire (MEQ), the Pittsburg Sleep Quality Index (PSQI), a shortened version of the Big Five Inventory (BFI-10), and a life satisfaction uniscale measure. The results revealed a significant association between chronotype and both life satisfaction and sleep quality, where ETs exhibited poorer outcomes compared to MTs. Additionally, the chronotype correlated with agreeableness and conscientiousness, with later chronotypes linked to reduced scores in these personality traits. A key finding in this study was revealed in a mediation analysis in which sleep quality was found to mediate the relationship between chronotype and life satisfaction. The mediation analysis highlighted sleep quality as a crucial process connecting chronotype to life satisfaction. The findings emphasize the importance of addressing sleep quality in interventions aimed at enhancing life satisfaction and overall well-being among ETs. Overall, our results provide valuable insights into the intricate relationships between chronotype, personality, sleep quality, and subjective well-being.
Unwanted Skin Reactions to Acrylates: An Update
Authors: Lugović-Mihić Liborija , Filija Eva , Varga Vanja , Premuž Lana , Parać Ena , Tomašević Renata , Barac Ema , Špiljak Bruno
Published: July 2024

Acrylates and methacrylates, though common in a wide variety of products, especially in the dental industry, can cause adverse skin reactions. These compounds, including 2-hydroxyethyl methacrylate, triethylene glycol dimethacrylate, and bisphenol A-glycidyl methacrylate, are strong contact irritants or allergens. Found in dental prostheses, composite resins, dentin bonding materials, and glass ionomers, they pose a higher risk of exposure for dental personnel. Clinically, acrylate allergies manifest as facial rashes, eczema with cracked skin on fingers (pulpitis), nail dystrophy, and periungual dermatitis. Recently, however, the highest frequency of allergic reactions to acrylates has been observed in the beauty industry due to increased use in artificial nails, eyelashes, and hair extensions. This has led to greater sensitization. Acrylates are also used in medical applications such as bone cement for orthopedic endoprostheses, soft contact lenses, hearing aids, histological preparations, and wound dressings, which can also cause allergic reactions. For example, acrylates in surgical glue can cause severe dermatitis, and diabetic medical devices are also potential sources of allergic contact dermatitis. Given the extensive use and prolonged skin contact of products containing acrylates and methacrylates, this review aims to present current knowledge from the literature on reactions to these compounds across different industries.
Integrated Low Electromagnetic Interference Design Method for Small, Fixed-Wing UAVs for Magnetic Anomaly Detection
Authors: Ge Jiahao , Xiang Jinwu , Li Daochun
Published: July 2024

Unmanned aerial vehicles (UAVs) equipped with magnetic airborne detectors (MADs) represent a new combination for underground or undersea magnetic anomaly detection. The electromagnetic interference (EMI) generated by a UAV platform affects the acquisition of weak magnetic signals by the MADs, which brings unique conceptual design difficulties. This paper proposes a systematic and integrated low-EMI design method for small, fixed-wing UAVs. First, the EMI at the MAD is analyzed. Second, sensor layout optimization for a single UAV is carried out, and the criteria for the sensor layout are given. To enhance UAV stability and resist atmospheric disturbances at sea, the configuration is optimized using an improved genetic algorithm. Then, three typical multi-UAV formations are analyzed. Finally, the trajectory is designed based on an analysis of its influence on EMI at the MAD. The simulation results show that the low-EMI design can keep MADs away from the EMI sources of UAVs and maintain flight stability. The thread-like formation is the best choice in terms of mutual interference and search width. The results also reveal the close relationship between the low-EMI design and flight trajectory. This research can provide a reference for the conceptual design and trajectory optimization of small, fixed-wing UAVs for magnetic anomaly detection.
Teaching Experience as a Key Factor in Dealing with Digital Teaching Stress
Authors: Fernández-Arias Pablo , Antón-Sancho Álvaro , Sánchez-Calvo María , Vergara Diego
Published: July 2024

Digital pandemic stress among university faculty has become a key issue in the contemporary era, marked by the rapid transition to online teaching. This study conducts a quantitative investigation into the teaching experience as a key explanatory variable in explaining the levels of such stress. For this purpose, a validated instrument has been used, which has been answered by a sample of 1240 university professors. The results show that, although the participating professors do not express high self-concepts of their digital competence or professional aspects, they do not express high levels of digital stress due to the pandemic. However, strong divergences have been identified between the levels of digital pandemic stress of more experienced professors and those of younger professors. Specifically, more experienced professors report lower levels of stress than younger professors, although there are no significant differences in their respective digital competencies. Consequently, the results suggest that teaching experience mitigates teaching digital stress, even when this greater experience does not concur with greater digital competence. It has also been found that the evolution of ratings with teaching experience depends on whether the professor is a specialist in scientific–technical or humanistic–social areas. Specifically, professors in scientific–technical areas with 15 to 25 years of experience are those who suffer more digital stress. Moreover, the digital stress of professors in scientific–technical areas increases between 10 and 25 years of experience, while it decreases among professors with less than 10 years of experience. In contrast, among professors in humanistic–social areas, the trend in the evolution of digital stress is the opposite: it increases among those with less than 10 years of experience and decreases among those with more than 10 years of experience.
Security-Aware Task Offloading Using Deep Reinforcement Learning in Mobile Edge Computing Systems
Authors: Lu Haodong , He Xiaoming , Zhang Dengyin
Published: July 2024

With the proliferation of intelligent applications, mobile devices are increasingly handling computation-intensive tasks but often struggle with limited computing power and energy resources. Mobile Edge Computing (MEC) offers a solution by enabling these devices to offload computation-intensive tasks to resource-rich edge servers, thus reducing processing latency and energy consumption. However, existing task-offloading strategies often neglect critical security concerns. In this paper, we propose a security-aware task-offloading framework that utilizes Deep Reinforcement Learning (DRL) to solve these challenges. Our framework is designed to minimize the latency of task accomplishment and energy consumption while ensuring data security. We model system utility as a Markov Decision Process (MDP) and design a Proximal Policy Optimization (PPO)-based algorithm to derive optimal offloading strategies. Experimental results demonstrate that the proposed algorithm outperforms traditional methods regarding task execution latency and energy consumption.
Incidence of Surgical Site Infection Following Cesarean Section and Its Associated Factors in a Hospital of the Eastern Region, Saudi Arabia: A Retrospective Cohort Study
Authors: Albaharnah Sukinah F. , Rashed Sara A. , Almuhaimeed Rahaf S. , Abohelaika Salah
Published: July 2024

Background: Surgical site infections (SSIs) following cesarean sections (CS) pose significant challenges in healthcare settings, prompting this five-year investigation in a Qatif Area general hospital. The study aimed to delineate nuances in SSI occurrences, assess yearly variations, and identify associated risk factors impacting SSI rates among CS patients. Methods: A retrospective analysis of 1584 cesarean sections conducted over five years was undertaken, and the reported SSI cases were examined to calculate the overall and yearly SSI rates. The impact of potential risk factors such as diabetes mellitus, hypertension, and postoperative antibiotic courses on SSI occurrence was examined. Results: The study revealed an overall SC rate of 15.4%. The SSI rate following CS was 4.7% (N = 74), with variations across years ranging from 2.2% in 2020 to a peak of 6.7% in 2022. Notably, 2021 and 2022 demonstrated increased SSI rates compared to prior years. Diabetes mellitus and a surgery duration of more than one hour exhibited a substantial association with SSI occurrence, (OR = 10.76, p = 0.038) and (OR = 3.54, p = 0.002), respectively, signifying independent risk factors. Conclusions: The study underscores the dynamic nature of SSI rates following CS, highlighting an increasing trend in recent years. All cases were managed with the optimal hospital care. Diabetes mellitus and a surgery duration of more than one hour emerged as prominent independent risk factors for SSI, warranting heightened vigilance and tailored preventive measures in this subset of patients.
Manifestation and Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease in a Predominately African American Population at a Multi-Specialty Healthcare Organization
Authors: Saini Astha , Rutledge Brian , Damughatla Anirudh R. , Rasheed Mina , Naylor Paul , Mutchnick Milton
Published: July 2024

African Americans (AA) have a high incidence of risk factors associated with MASLD (metabolic dysfunction-associated steatotic liver disease); the AA population has a lower incidence of MASLD and MASH (metabolic-associated steatotic hepatitis) than Caucasian and Hispanic Americans (non-AA). We investigated if underlying risk factor variation between AA and non-AA individuals could provide a rationale for the racial diversity seen in MASLD/MASH. Using ICD-10 codes, patients from 2017 to 2020 with MASLD/MASH were identified and confirmed to have either MASLD or MASH. Despite the large (>80%) AA population in our clinics, only 54% of the MASLD/MASH patients were African American. When the non-invasive NAFLD Fibrosis Scores (NFS) evaluated at early diagnosis were compared to the most recent values, the only increase in fibrosis score by NFS over time was in non-AA MASH patients. The increase in fibrosis only in non-AA MASLD patients is consistent with racial disparity in the disease progression in non-AA as compared to AA patients. Even with the large proportion of AA patients in our study, there was no significant racial disparity in the earliest assessment of either risk factors, laboratory values, or fibrosis scores that would account for racial disparity in the development and progression of MASLD.
From Settlement Abandonment to Valorisation and Enjoyment Strategies: Insights through EU (Portuguese, Italian) and Non-EU (Albanian) ‘Ghost Towns’
Authors: Gizzi Fabrizio Terenzio , Antunes Isabel Margarida Horta Ribeiro , Reis Amélia Paula Marinho , Giano Salvatore Ivo , Masini Nicola , Muceku Ylber , Pescatore Eva , Potenza Maria Rosaria , Corbalán Andreu Carmen , Sannazzaro Annarita , Palladino Giuseppe , Bentivenga Mario
Published: July 2024

The abandonment of inhabited places is a phenomenon widespread on a global scale that has spanned centuries. It has led to the birth of the so-called ‘ghost towns’. These lifeless sites dot the internal Mediterranean and European areas, testifying to the changeability of the human settlements. Through a vision that reverses the paradigm that epitomises the ‘ghost towns’, these places can be transformed from a problem into an opportunity for the development of the territories that host them. The main topic of this article is to present and update investigations performed on three abandoned settlements sited in Portugal, Italy, and Albania in view of their tourist exploitation, considering three different tailored strategies: underwater tourism, dark tourism, and heritage tourism. For each site, we analysed the site history, the abandonment causes, and the territorial-geological features, thus arguing for the possible valorisation and enjoyment approaches with special attention to digital technologies, which are highly underexploited in the sector. This study, which is part of an international research landscape still in the initial stages, falls within the BEGIN project (aBandonment vErsus reGeneratIoN), which aims to develop a multilevel methodological–operational protocol useful in regional, national, EU, and non-EU contexts for the dissemination of knowledge, conservation, regeneration, valorisation, management, and fruition of areas classified as a ‘ghost town’. The research findings can be useful for scholars, practitioners, and local entities entrusted to manage the abandoned towns. Furthermore, the methodological approach followed in this research can supply useful insights into aims to valorise and enjoy worldwide ‘ghost towns’.
Measuring Reliable Accessibility to High-Speed Railway Stations by Integrating the Utility-Based Model and Multimodal Space–Time Prism under Travel Time Uncertainty
Authors: Zhang Yongsheng , Liang Kangyu , Yao Enjian , Gu Mingyi
Published: July 2024

Measuring the accessibility of each traffic zone to high-speed railway stations can evaluate the ease of the transportation hub in the transportation system. The utility-based model, which captures individual travel behavior and subjective perception, is often used to quantify the travel impedance on accessibility for a given origin–destination pair. However, existing studies neglect the impacts of travel time uncertainty on utility and possible choice set when measuring accessibility, especially in high-timeliness travel (e.g., railway stations or airports). This study proposes a novel integration of the utility-based model and multimodal space–time prism under travel time uncertainty to measure reliable accessibility to high-speed railway stations. First, the reliable multimodal space–time prism is developed to generate a reliable travel mode choice set constrained by travel time budgets. Then, the reliable choice set is integrated into the utility-based model with the utility function derived from a proposed mean–standard deviation logit-based mode choice model. Finally, this study contributes to measuring reliable accessibility within areas from Beijing’s 5th Ring Road to the Beijing South Railway Station. Based on the results, policymakers can effectively evaluate the distribution of transportation resources and urban planning.
Vascular Endothelial Growth Factor Receptor 2 (VEGFR2) rs2071559 Gene Polymorphism and the Risk of Gliomas: A Systematic Review and Meta-Analysis
Authors: Prasetiyo Patricia Diana , Wahjoepramono Eka Julianta
Published: July 2024

Background: A glioma is a form of tumor that is abundant in blood vessels. Vascular endothelial growth factor receptor (VEGFR) and its receptor 2 (VEGFR2) are important in the process of angiogenesis. The relationship between VEGFR2 rs2071559 and glioma development is currently uncertain. The present study aims to analyze the correlation between VEGFR2 rs2071559 gene polymorphism and the susceptibility to gliomas. Methods: A thorough search was carried out in the Cochrane Library, Scopus, and Medline databases from inception until 20 February 2024 using a mix of pertinent keywords. We used random-effects models to examine the odds ratio (OR) and reported the results together with their respective 95% confidence intervals (CIs). Results: A total of six studies were incorporated. The results of our meta-analysis indicated that all genetic models of VEGFR2 rs2071559 gene polymorphism, starting from dominant (OR 1.40; p < 0.00001), recessive (OR 1.52; p < 0.0001), CC genotype (OR 1.78; p < 0.00001), CT genotype (OR 1.30; p < 0.0001), and C allele (OR 1.41; p < 0.00001), were associated with a higher risk of developing gliomas. The subgroup analysis revealed a higher OR for studies with a sample size of ≥500, originated from Asia, with a mean age of ≥42.3 years, and a male prevalence of <57%. Conclusions: This study suggests that VEGFR2 rs2071559 gene polymorphism is associated with a higher risk of gliomas.
A Critical Examination of Academic Hospital Practices—Paving the Way for Standardized Structured Reports in Neuroimaging
Authors: Alruwaili Ashwag Rafea , Jamea Abdullah Abu , Alayed Reema N. , Alebrah Alhatoun Y. , Alshowaiman Reem Y. , Almugbel Loulwah A. , Heikal Ataf G. , Alkhanbashi Ahad S. , Maflahi Anwar A.
Published: July 2024

Background/Objectives: Imaging studies are often an integral part of patient evaluation and serve as the primary means of communication between radiologists and referring physicians. This study aimed to evaluate brain Magnetic Resonance Imaging (MRI) reports and to determine whether these reports follow a standardized or narrative format. Methods: A series of 466 anonymized MRI reports from an academic hospital were downloaded from the Picture Archiving and Communication System (PACS) in portable document format (pdf) for the period between August 2017 and March 2018. Two hundred brain MRI reports, written by four radiologists, were compared to a structured report template from the Radiology Society of North America (RSNA) and were included, whereas MR-modified techniques, such as MRI orbits and MR venography reports, were excluded (n = 266). All statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS) statistical software (version 16.4.1, MedCalc Software). Results: None of the included studies used the RSNA template for structured reports (SRs). The highest number of brain-reported pathologies was for vascular disease (24%), while the lowest was for infections (3.5%) and motor dysfunction (5.5%). Radiologists specified the Technique (n = 170, 85%), Clinical Information (n = 187, 93.5%), and Impression (n = 197, 98.5%) in almost all reports. However, information in the Findings section was often missing. As hypothesized, radiologists with less experience showed a greater commitment to reporting additional elements than those with more experience. Conclusions: The SR template for medical imaging has been accessible online for over a decade. However, many hospitals and radiologists still use the free-text style for reporting. Our study was conducted in an academic hospital with a fellowship program, and we found that structured reporting had not yet been implemented. As the health system transitions towards teleservices and teleradiology, more efforts need to be put into advocating standardized reporting in medical imaging.
Self-Management among Stroke Survivors in the United States, 2016 to 2021
Authors: Vemuri Ajith Kumar , Hejazian Seyyed Sina , Vafaei Sadr Alireza , Zhou Shouhao , Decker Keith , Hakun Jonathan , Abedi Vida , Zand Ramin
Published: July 2024

Background: Self-management among stroke survivors is effective in mitigating the risk of a recurrent stroke. This study aims to determine the prevalence of self-management and its associated factors among stroke survivors in the United States. Methods: We analyzed the Behavioral Risk Factor Surveillance System (BRFSS) data from 2016 to 2021, a nationally representative health survey. A new outcome variable, stroke self-management (SSM = low or SSM = high), was defined based on five AHA guideline-recommended self-management practices, including regular physical activity, maintaining body mass index, regular doctor checkups, smoking cessation, and limiting alcohol consumption. A low level of self-management was defined as adherence to three or fewer practices. Results: Among 95,645 American stroke survivors, 46.7% have low self-management. Stroke survivors aged less than 65 are less likely to self-manage (low SSM: 56.8% vs. 42.3%; p < 0.0001). Blacks are less likely to self-manage than non-Hispanic Whites (low SSM: 52.0% vs. 48.6%; p < 0.0001); however, when adjusted for demographic and clinical factors, the difference was dissipated. Higher education and income levels are associated with better self-management (OR: 2.49, [95%CI: 2.16–2.88] and OR: 1.45, [95%CI: 1.26–1.67], respectively). Further sub-analysis revealed that women are less likely to be physically active (OR: 0.88, [95%CI: 0.81–0.95]) but more likely to manage their alcohol consumption (OR: 1.57, [95%CI: 1.29–1.92]). Stroke survivors residing in the Stroke Belt did not self-manage as well as their counterparts (low-SSM: 53.1% vs. 48.0%; p < 0.001). Conclusions: The substantial diversity in self-management practices emphasizes the need for tailored interventions. Particularly, multi-modal interventions should be targeted toward specific populations, including younger stroke survivors with lower education and income.
Prevalence and Correlates of High Stress and Low Resilience among Teachers in Three Canadian Provinces
Authors: Agyapong Belinda , Dias Raquel da Luz , Wei Yifeng , Agyapong Vincent Israel Opoku
Published: July 2024

Objective: High stress levels can be problematic for teachers and indirectly affect students. Resilience may be a protective factor for overcoming stress. Knowledge about the prevalence and correlates of high stress and low resilience will provide information about the extent of the problem among teachers in Canada. Methods: This is a cross-sectional study among teachers in Alberta, Nova Scotia, and Newfoundland and Labrador in Canada. Participants self-subscribed to the Wellness4Teachers supportive text messaging program and completed the online survey on enrollment. Baseline data collection occurred from 1 September 2022 to 30 August 2023. Resilience and stress were, respectively, assessed using the Brief Resilience Scale (BRS) and the Perceived Stress Scale (PSS-10). The data were analyzed with SPSS version 28 using chi-squared tests and binary logistic regression analysis. Results: A total of 1912 teachers subscribed to the Wellness4Teachers program, and 810 completed the baseline survey, yielding a response rate of 42.40%. Most of the participants, 87.8%, were female, and 12.2% were aged 18 to 61 and above. The prevalence of low resilience was 40.1%, and high stress had a prevalence of 26.3%. After controlling for all the other variables in the logistic regression model, participants with low resilience were 3.10 times more likely to experience high-stress symptoms than those with normal to high resilience (OR = 3.10; 95% CI: 2.18–4.41). Conversely, participants who reported high stress were 3.13 times more likely to have low resilience than those with low to moderate stress (OR = 3.13; 95% CI: 2.20–4.44). Additionally, junior and senior high school teachers were, respectively, 2.30 times (OR = 2.30; 95% CI: 1.25–4.23) and 2.12 times (OR = 2,12; 95% CI: 1.08–4.18) more likely to have low resilience compared to elementary school teachers. Conclusions: Our study findings suggest a high prevalence of stress and low resilience among teachers in the three Canadian provinces. Administrators, policymakers in the educational field, school boards, and governments should integrate stress management and resilience-building strategies into teachers’ training and continuing professional development programs.
Role of Endoscopic Techniques in the Diagnosis of Complications of Allogeneic Hematopoietic Stem Cell Transplantation: A Review of the Literature
Authors: Bangolo Ayrton , Dey Shraboni , Nagesh Vignesh Krishnan , Gumer Kabir , Avetisyan Lida , Islam Saima , Sahotra Monika , Millett Melissa , Alqinai Budoor , Pender Silvanna , Dunraj Yazmika , Syeda Habiba , Tasneem Beegum , Duran Mikel , Deugd Nicoleta De , Thakur Prasad , Weissman Simcha , Cho Christina
Published: July 2024

Allogeneic stem cell transplantation (Allo-SCT) implies that a donor and a recipient are not genetically identical. Allo-SCT is used to cure a variety of conditions, including hematologic malignancies using the graft versus tumor effect, nonmalignant hematologic, immune deficiencies, and, more recently, genetic disorders and inborn errors of metabolism. Given the immunosuppressive and myeloablative nature of some of the conditioning chemotherapy regimens used during the Allo-SCT, patients are often at high risk of infection, including viral infections affecting the gastrointestinal tract, following the transplant. Furthermore, other complications such as hepatic sinusoidal obstruction syndrome (SOS) or graft-versus-host disease may occur post-transplant and may require endoscopy to assist in the diagnosis. This review will provide newer insights into the importance of endoscopic techniques in the diagnosis of post-Allo-SCT complications with a focus on safety and timing.
Cardiac Sarcoma Mimicking Libman–Sacks Endocarditis in a Patient with Systemic Lupus Erythematosus (SLE): A Case Report and Literature Review
Authors: Ritter Einat , Itach Tamar , Paran Daphna , Gaskin Aleksandr , Havakuk Ofer , Ablin Jacob Nadav
Published: July 2024

We present the case of a 39-year-old woman who was diagnosed with SLE and antiphospholipid antibodies 8 years ago. The chief manifestations of her disease included low-grade fever and polyarthritis. Eight months before presentation, she experienced symptoms attributed to a flare of SLE, leading to an increase in immunomodulatory treatment with no improvement. She presented to the emergency room with acute onset of dyspnea. Clubbing of her fingers and toes was noted. When questioned, she reported the onset of clubbing 5 months earlier. A CTA was performed to rule out pulmonary embolism, which was excluded, although it revealed a severely damaged mitral valve with severe insufficiency and a large mass on the valve, protruding into the left atrium. Antibiotics were started, with a working diagnosis of infectious endocarditis; however, the severe mitral valve dysfunction lead to emergency mitral valve replacement, revealing an organized thrombus. She was treated with anticoagulation, with a working diagnosis of Libman–Sacks endocarditis, with no improvement. Additional immunosuppression failed to improve her symptoms. Enlargement of the thrombotic mass and an increased gradient across the prosthetic mitral valve led to repeat surgery, culminating in a diagnosis of high-grade sarcoma within the left atrial mass. We further discuss cardiac sarcoma and describe the occurrence of clubbing in patients with sarcoma. This case highlights the importance of interdisciplinary collaboration and the need for vigilant monitoring in refractory cases, particularly when atypical presentations arise.
Ultrasound and Intrapleural Enzymatic Therapy for Complicated Pleural Effusion: A Case Series with a Literature Review
Authors: Inchingolo Riccardo , Ielo Simone , Barone Roberto , Whalen Matteo Bernard , Carriera Lorenzo , Smargiassi Andrea , Sorino Claudio , Lococo Filippo , Feller-Kopman David
Published: July 2024

Pleural effusion is the most common manifestation of pleural disease, and chest ultrasound is crucial for diagnostic workup and post-treatment monitoring. Ultrasound helps distinguish the various types of pleural effusion and enables the detection of typical manifestations of empyema, which presents as a complicated, septated effusion. This may benefit from drainage and the use of intrapleural enzyme therapy or may require more invasive approaches, such as medical or surgical thoracoscopy. The mechanism of action of intrapleural enzymatic therapy (IPET) is the activation of plasminogen to plasmin, which breaks down fibrin clots that form septa or the loculation of effusions and promotes their removal. In addition, IPET has anti-inflammatory properties and can modulate the immune response in the pleural space, resulting in reduced pleural inflammation and improved fluid reabsorption. In this article, we briefly review the literature on the efficacy of IPET and describe a case series in which most practical applications of IPET are demonstrated, i.e., as a curative treatment but also as an alternative, propaedeutic, or subsequent treatment to surgery.
Understanding the Role of Sex Hormones in Cardiovascular Kidney Metabolic Syndrome: Toward Personalized Therapeutic Approaches
Authors: Guldan Mustafa , Unlu Selen , Abdel-Rahman Sama Mahmoud , Ozbek Laşin , Gaipov Abduzhappar , Covic Andreea , Soler Maria José , Covic Adrian , Kanbay Mehmet
Published: July 2024

Cardiovascular kidney metabolic (CKM) syndrome represents a complex interplay of cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic comorbidities, posing a significant public health challenge. Gender exerts a critical influence on CKM syndrome, affecting the disease severity and onset through intricate interactions involving sex hormones and key physiological pathways such as the renin–angiotensin system, oxidative stress, inflammation, vascular disease and insulin resistance. It is widely known that beyond the contribution of traditional risk factors, men and women exhibit significant differences in CKM syndrome and its components, with distinct patterns observed in premenopausal women and postmenopausal women compared to men. Despite women generally experiencing a lower incidence of CVD, their outcomes following cardiovascular events are often worse compared to men. The disparities also extend to the treatment approaches for kidney failure, with a higher prevalence of dialysis among men despite women exhibiting higher rates of CKD. The impact of endogenous sex hormones, the correlations between CKM and its components, as well as the long-term effects of treatment modalities using sex hormones, including hormone replacement therapies and gender-affirming therapies, have drawn attention to this topic. Current research on CKM syndrome is hindered by the scarcity of large-scale studies and insufficient integration of gender-specific considerations into treatment strategies. The underlying mechanisms driving the gender disparities in the pathogenesis of CKM syndrome, including the roles of estrogen, progesterone and testosterone derivatives, remain poorly understood, thus limiting their application in personalized therapeutic interventions. This review synthesizes existing knowledge to clarify the intricate relationship between sex hormones, gender disparities, and the progression of CVD within CKM syndrome. By addressing these knowledge gaps, this study aims to guide future research efforts and promote tailored approaches for effectively managing CKD syndrome.
Implementation of a Partial-Order Data Security Model for the Internet of Things (IoT) Using Software-Defined Networking (SDN)
Authors: Stambouli Abdelouadoud , Logrippo Luigi
Published: July 2024

Data security on the Internet of Things (IoT) is usually implemented through encryption. This paper presents a solution based on routing, in which data are forwarded only to entities that are intended to receive them according to security requirements of secrecy (also called confidentiality), integrity, and conflicts. Our solution is generic in the sense that it can be used in any network, together with encryption as appropriate. We use the fact that, in any network, security requirements generate a partial order of equivalence classes of entities, and each entity can be labeled according to the position of its equivalence class in the partial order. Routing tables among entities can be compiled using the labels. The method is demonstrated in this paper for software-defined networking (SDN) routers and controllers. We propose a centralized IoT architecture with a cloud structure using SDN as networking infrastructure, where storage entities (i.e., cloud servers) are associated with application entities. A small ‘hospital’ example is shown for illustration. Procedures for network reconfigurations are presented. We also demonstrate the method for the normal case where different partial orders, representing distinct but concurrent security requirements, coexist among a set of entities. The method proposed does not impose an overhead on the normal functioning of SDN networks since it requires calculations only when the network must be reconfigured because of administrative intervention or policies. These occasional updates can be done efficiently and offline.
Recent Data on Nematode Infestation of Anchovy (Engraulis encrasicolus) on the Romanian Black Sea Coast
Authors: Țoțoiu Aurelia , Nenciu Magda , Niță Victor
Published: July 2024

Marine fish populations can be affected by various infectious and parasitic diseases. The species investigated during 2021–2023 along the Romanian coast was European anchovy [Engraulis encrasicolus (Linnaeus, 1758)], a small pelagic fish with both economic and ecological value. Four species of endoparasites (nematodes) were identified, namely: Hysterothylacium sp. Ward & Magath, 1917, Contracaecum sp. Railliet & Henry, 1912, Porrocaecum sp. Railet & Henry, 1912, and Anisakis sp. Dujardin, 1845. Nematode worms were found as larvae and infested the abdominal cavity, both in the free state and enclosed in internal organs. The parameters analyzed included abundance, prevalence, and average intensity. Abundance results indicated 14 parasites/fish in length classes ranging from 11–12 cm. A prevalence of 100% was reported in the anchovy population sampled from several stations. A high level of infestation intensity was recorded in 11 cm long specimens (15 nematode worms/host). In this study, the accumulation of nematode worms was observed in large mature specimens, with a negative impact on the host organism through the presence of internal lesions, slowing of growth rate, appetite reduction, and disturbance of the reproductive process. The potential risks to anchovy stock status, threats to human health, and control measures are also tackled.
Can China’s Cross-Regional Ecological Fiscal Transfers Help Improve the Ecological Environment?—Evidence from Hubei Province
Authors: Liu Mengba , Xiong Yanfei , Zhang Anlu
Published: July 2024

As an important incentive and constraint system to coordinate the contradiction between ecological resource protection and regional economic development, the ecological and environmental protection effect after its implementation deserves special attention, especially for China, which involves the widest scope of payment and the largest transfer and has become the largest governmental ecological compensation program in China and even in the world. Starting from the evolution of China’s eco-financial transfer system, this study conducts an empirical investigation of the ecological and environmental protection effect of the eco-financial transfer system. Such an undertaking is based on the theoretical exploration of the impact mechanism of the eco-financial transfer system to improve the ecological environment quality and based on the panel data of 40 counties in Hubei Province from 2010 to 2020. Results of the study show that the ecological financial transfer system can promote the improvement of regional ecological environment quality, but the promotion effect is insignificant. The financial funds reflect more of a financial compensation effect than a system incentive effect. The increase in the scale of ecological transfer payments is conducive to strengthening the incentive function of the system, promoting local governments to increase environmental protection expenditures and environmental regulation efforts to improve the quality of the ecological environment. Therefore, in the process of implementing ecological financial transfers from the province to the counties, the concept of ecological value contribution should be incorporated into the fund allocation process. In addition, the current ecological transfer payment fund allocation method should be reconstructed on the basis of the ecological value contribution to enhance the guiding role of “high quality and high price, more work and more gain.” The goal is to effectively stimulate the enthusiasm of local governments for ecological environmental protection. Findings have significant guidance for developing countries that are currently seeking to formulate and implement such policies.