bluuebunny/crossref_metadata_2025 huggingface dataset:
Rehabilitation for Chronic Constipation: Integrative Approaches to Diagnosis and Treatment
Authors: Alexandrescu Luana , Iordache Ionut Eduard , Stanigut Alina Mihaela , Condur Laura Maria , Tofolean Doina Ecaterina , Popescu Razvan Catalin , Nelson Twakor Andreea , Dumitru Eugen , Dumitru Andrei , Tocia Cristina , Herlo Alexandra , Tofolean Ionut Tiberiu
Published: January 2025

Background: Chronic constipation is a well-recognized complication which is caused by hard and/or infrequent defecation. According to estimates, constipation presents as a chronic illness affecting 16% of adults globally, who deal with insufficient bowel movements that cause discomfort, bloating, or a sensation of incomplete bowel. Objectives: This review looks at the many local and systemic factors that contribute to the pathogenesis of the causative, including dietary habits, genetic factors, colon function and absorption, social and economic factors, lifestyle, and biological and drug factors. Results: Appropriate diagnostic and management modalities are the cornerstone in the management of patients with chronic constipation. However, there are still controversies regarding the timing of these diagnostic and management approaches. This condition is common and reduces the quality of life of patients and represents a burden on any healthcare system. In clinical practice, it remains problematic, as physicians are most of the time indecisive on which therapy to administer and at what time. Conclusions: Constipation management is a new topic that was introduced over a decade ago and the purpose of this study is to shed some light onto the practice, problems and modern day techniques that can be used to treat constipation in patients, primarily through behavioural, conservative, medical, and surgical means. Additionally, this particular management is to be used in conjunction with an algorithm designed to enhance and support clinical practice.
Ice and Snow Scholarship: Challenges and Opportunities
Authors: Fassnacht Steven R.
Published: January 2025

The issues that ice and snow scholars are defining and addressing are becoming more urgent, coupled with the increasing scope of such issues [...]
Exploring Technology Integration in Health and Safety Routines in a Shanghai Kindergarten
Authors: Luo Wenwei , Wu Xiaoyu , Berson Ilene R. , Berson Michael J. , He Huihua , Gao Minqi
Published: January 2025

Background: Digital technology is increasingly being used in early childhood education; however, there is a significant gap in understanding how these technologies are practiced in health and safety routines. Objective: This study aims to understand the role of technologies in daily health and safety checks and identify the issues arising from their use in a Shanghai kindergarten. Method: A qualitative approach was employed; the study involved video analysis and semi-structured interviews with 8 teachers, 18 parents, 11 children, and 3 principals from a leading kindergarten in Shanghai. Data were analyzed using NVivo 12 to uncover themes related to technology use, human–technology interactions, and operational challenges. Results: The findings show that digital technologies enhance operational efficiency, but they also present challenges like usability issues and technical limitations. The study underscores the critical need for more child-friendly and educator-accessible designs to maximize the potential of these technologies. Conclusions: This study highlights the transformative potential of digital technologies in kindergarten health and safety routines. This insight contributes to a broader discourse on the benefits and complexities of digital transformation in early childhood education. Future research should focus on scalable, inclusive solutions and enhanced data governance to maximize the benefits of those tools in diverse educational settings.
Mental Health Challenges and Barriers to Veterans’ Adjustment to Civilian Life on the U.S.–Mexico Border
Authors: Paat Yok-Fong , Dorado Angela V. , Myers Nathan W. , Martinez Andie , Scully Shawna
Published: January 2025

Background: Seeking mental health care is crucial for supporting effective reintegration among veterans. The U.S.–Mexico border presents a compelling and urgent case for study due to its proximity to economically marginalized and medically underserved areas, where the availability and accessibility of services are often limited. Objective: This study explored veterans’ mental health challenges and factors that hindered their adjustment to civilian life on the U.S.–Mexico border. Methods: A total of 36 veterans were recruited using purposive sampling from a mental health agency located in Southwestern Texas on the U.S.–Mexico border between November 2023 and May 2024 to complete an in-depth semi-structured interview and a brief survey. Results: Using thematic analysis, we found six themes associated with our study: (1) mental health struggles, (2) enduring military-influenced mindset, (3) adjustment to civilian life, (4) strained family relationships, (5) past victimization and discrimination, and (6) barriers to opportunities and mental health care. Conclusion: Understanding veterans’ mental health well-being and their prospects for integration into the civilian world is critical for identifying risk and protective factors that can inform the development of targeted health promotion initiatives, strengthen the implementation of equitable health care efforts, and support strategies for enhancing treatment access that address the unique needs of veterans in the border region. Policy and practice implications are discussed.
Perceptions of Endocrine Clinicians Regarding Climate Change and Health
Authors: Steinmetz-Wood Samantha , Kennedy Amanda G. , Hitt Juvena R. , Barrett Kaitlyn , Gilbert Matthew P.
Published: January 2025

The effects of climate change on the endocrine system are increasingly recognized. We aimed to evaluate endocrine clinicians’ perspectives on climate change awareness and knowledge, motivation for action, and the need for climate health curricula. We designed an online questionnaire with endocrine-specific questions about climate change, which was shared through social media and email. Study data were collected between 9/2022 and 11/2022. Analyses were primarily descriptive. There were 164 responses; 98% were physicians, with a median age of 41 years. The majority (95%) reported that climate change is happening; 52% reported that they are very worried. Knowledge about climate change and health was variable (6.7% very, 40% moderately, 35% modestly, 17.7% not at all), with variable concerns regarding patient effects. The top endocrine climate–health concerns were reduced exercise, malnutrition, and weather-related disruptions. Most respondents agreed that climate change and health topics should be integrated into medical education (72.8% strongly agree or agree). The three resources perceived as most helpful were continuing medical education, patient resources, and policy statements. Endocrine clinicians are aware of and worried about climate change, with varying levels of knowledge and concern about climate change and health effects. We also exposed an untapped interest in developing endocrine-specific climate and health curricula.
Noninversion Variants in Sporadic Hemophilia A Originate Mostly from Females
Authors: Chen Ming , Shen Ming-Ching , Chang Shun-Ping , Ma Gwo-Chin , Lee Dong-Jay , Yan Adeline
Published: January 2025

F8 gene inversion variants originate in male germ cells during spermatogenesis. Our recent study revealed that de novo variants (DNVs) caused F8 noninversion variants (NIVs) in sporadic hemophilia A (HA). Here, we conducted a direct clinical determination of sex differences in the origin of sporadic HA-NIV according to the data of two new HA-NIV families, as well as of the families demonstrated in the previous study. Of the 126 registered families with HA, 23 were eligible for inclusion. We conducted a linkage analysis with F8 gene markers and an amplification refractory mutation system–quantitative polymerase chain reaction to confirm the origin of the sporadic NIVs (~0% mutant cells) or the presence of a mosaic variant, requiring further confirmation of the origin in the parent. Two sporadic DNV events were determined. One event occurred in grandparents, consisting of five maternal grandmothers and seven maternal grandfathers, who were the origins; their respective daughters became carrier mothers who gave birth to probands. The other event included 11 mothers, who were the origins exclusively; their respective sons became probands. In this study, we found that sporadic HA-NIVs originate mostly from females (16 out of 23). Our study contributes to a better understanding of the genetic pathogenesis of HA.
Endoplasmic Reticulum-Mitochondria Crosstalk in Fuchs Endothelial Corneal Dystrophy: Current Status and Future Prospects
Authors: Kasi Anisha , Steidl William , Kumar Varun
Published: January 2025

Fuchs endothelial corneal dystrophy (FECD) is a progressive and debilitating disorder of the corneal endothelium (CE) that affects approximately 4% of individuals over the age of 40. Despite the burden of the disease, the pathogenesis of FECD remains poorly understood, and treatment options are limited, highlighting the need for deeper investigation into its underlying molecular mechanisms. Over the past decade, studies have indicated independent contributions of endoplasmic reticulum (ER) and mitochondrial stress to the pathogenesis of FECD. However, there are limited studies suggesting ER-mitochondria crosstalk in FECD. Recently, our lab established the role of chronic ER stress in inducing mitochondrial dysfunction for corneal endothelial cells (CEnCs), indicating the existence of ER-mitochondria crosstalk in FECD. This paper aims to provide a comprehensive overview of the current understanding of how ER and mitochondrial stress contribute to FECD pathogenesis. The paper also reviews the literature on the mechanisms of ER-mitochondria crosstalk in other diseases relevant to FECD.
Circulating Cell-Free DNA Integrity for Breast and Prostate Cancer: What Is the Landscape for Clinical Management of the Most Common Cancers in Women and Men?
Authors: Sobhani Navid , Tierno Domenico , Pavan Nicola , Generali Daniele , Grassi Gabriele , Zanconati Fabrizio , Scaggiante Bruna
Published: January 2025

Breast cancer (BC) and prostate cancer (PCa) are major health problems for women and men worldwide. Although therapeutic approaches have increased, the complexity associated with their heterogeneity and progression requires better ways to monitor them over time. Cell-free DNA integrity (cfDI) represents a viable alternative to needle biopsy and has the potential to be representative of cancer at all stages. In addition to the advantages of liquid biopsy in terms of cost and reduced invasiveness, cfDI can be used to detect repetitive DNA elements (e.g., ALU and LINE1), which could circumvent the problem of mutational heterogeneity in BC and PCa. In this review, we summarise the latest findings on cfDI studies in BC and PCa. The results show that cfDI has the potential to improve early detection, metastasis, and recurrence of BC, while limited studies prevent its clinical value in PCa from being fully defined. However, it is expected that further studies in the near future will help to introduce the use of cfDI as another biomarker for the clinical monitoring of BC and PCa patients.
Preeclampsia as a Study Model for Aging: The Klotho Gene Paradigm
Authors: Cecati Monia , Fumarola Stefania , Vaiasicca Salvatore , Cianfruglia Laura , Vignini Arianna , Giannubilo Stefano Raffaele , Emanuelli Monica , Ciavattini Andrea
Published: January 2025

Aging and pregnancy are often considered opposites in a woman’s biological timeline. Aging is defined by a gradual decline in the functional capabilities of an organism over its lifetime, while pregnancy is characterized by the presence of the transient placenta, which fosters the cellular fitness necessary to support fetal growth. However, in the context of preeclampsia, pregnancy and aging share common hallmarks, including clinical complications, altered cellular phenotypes, and heightened oxidative stress. Furthermore, women with pregnancies complicated by preeclampsia tend to experience age-related disorders earlier than those with healthy pregnancies. Klotho, a gene discovered fortuitously in 1997 by researchers studying aging mechanisms, is primarily expressed in the kidneys but also to a lesser extent in several other tissues, including the placenta. The Klotho protein is a membrane-bound protein that, upon cleavage by ADAM10/17, is released into the circulation as soluble Klotho (sKlotho) where it plays a role in modulating oxidative stress. This review focuses on the involvement of sKlotho in the development of preeclampsia and age-related disorders, as well as the expression of the recently discovered Mytho gene, which has been associated with skeletal muscle atrophy.
Polychlorinated Biphenyls Induce Cytotoxicity and Inflammation in an In Vitro Model of an Ocular Barrier
Authors: Cosentino Alessia , Agafonova Aleksandra , Cavallaro Luca , Musumeci Rosaria Ester , Prinzi Chiara , Lombardo Cinzia , Cambria Maria Teresa , Anfuso Carmelina Daniela , Lupo Gabriella
Published: January 2025

Polychlorinated biphenyls (PCBs) are heterogeneous, synthetic, and widespread organochlorine compounds, and are one of the persistent organic pollutants present in improperly dumped waste and electronic equipment (e-waste), with a high bioaccumulation potential. In this study, the toxicity of Aroclor 1254 (a mixture of commercial PCBs) in human corneal epithelial cells (HCEpiCs), in an in vitro model of an ocular barrier, was evaluated. Aroclor 1254 (0.1–10 μg/mL) reduced cell viability, trans-endothelial electric resistance (TEER) and cell migration. Moreover, it induced an inflammatory response, as indicated by the increase in cPLA2 activity, PGE2 production, phosphorylation of ERK 1/2 and p-38, and release of inflammatory cytokines. Aroclor 1254 can damage corneal cells, compromising the integrity of the eye’s outermost barrier. This damage may facilitate the occurrence of infectious processes that are physiologically prevented by the corneal barrier.
Review of Nondestructive Testing (NDT) Techniques for Timber Structures
Authors: Azzi Ziad , Al Sayegh Houssam , Metwally Omar , Eissa Mohamed
Published: January 2025

The widespread adoption of wood in construction is driven by its sustainability, cost-effectiveness, and esthetic appeal. The construction of wood buildings often requires minimal specialized equipment, contributing to affordability and higher demand for wood-frame structures. Wood is considered more sustainable than other building materials, such as steel or concrete, for several reasons, including its renewable nature, low embodied energy, carbon sequestration, energy efficiency, and biodegradability, among others. In the United States, wood is the most common material used in building construction. While many of the structures are single-family homes, wood framing is also prevalent in larger apartment complexes, as well as commercial and industrial buildings. Timber has also been traditionally used for bridge construction, and recently, it has been considered again for the construction of new bridges. Over time, wood-frame construction has developed from a basic method for primitive shelters into a sophisticated field of structural design. As an eco-friendly resource, wood is crucial for promoting sustainable building practices. However, ensuring the long-term performance and safety of timber structures is essential. Regular inspections and testing of wooden structures are important to identify signs of wear, damage, or decay. One type of testing which is gaining popularity is nondestructive testing (NDT). NDT techniques have become invaluable for assessing the condition of timber components because such techniques are non-invasive in nature and do not cause damage, ensuring that structures remain functional with minimal disruptions. These methods provide critical insights into the structural integrity and operational efficiency of wood under sustained loads and in inclement environments. This article examines various NDT techniques used to evaluate timber structures, highlighting their capabilities, as well as advantages and limitations. It also discusses the importance of wood in advancing sustainability within the construction industry and emphasizes the need for accurate and reliable assessment methods to enhance the use of timber as an environmentally friendly building material. By incorporating NDT practices into regular inspection and maintenance protocols for buildings, bridges, and other structures, various stakeholders can ensure the durability, longevity, and safety of timber structures, thereby contributing to the progress and advancement of sustainable construction practices worldwide.
Diet Diversification in Bombyx mori Larvae: The Impact of Dandelion on Nutritional and Bioactive Profiles for Targeted Farming Goals
Authors: Trajković Aleksandra , Dragojlović Danka , Stojanović Gordana , Zlatanović Đaić Ivana , Ristić Milenko , Milošević Marijana Ilić , Stanković Saša S. , Žikić Vladimir , Joković Nataša
Published: January 2025

The domesticated silkworm, Bombyx mori, reared for sericulture, has gained attention as a promising, sustainable protein source. While studies have focused on pupal powders obtained through natural or artificial mulberry-based diets, this research builds on ethnoentomological knowledge of the use of dandelion as a short-term mulberry substitute, in a mixed mulberry–dandelion diet throughout larval development. Through proximate analyses, amino acid and fatty acid profiling, mineral and carbohydrate composition, as well as antioxidant activity assays, we investigated how dietary variation affects B. mori larvae. The mixed diet achieved a distinct nutritional profile, increasing total amino acids to 38.40 g/100 g compared to 32.37 g/100 g in the mulberry-only group, with differences in the content of essential amino acids like isoleucine (2.24 vs. 1.42 g/100 g) and phenylalanine (3.34 vs. 2.82 g/100 g). It also elevated linolenic acid to 74.33% of total fatty acids and introduced sorbitol (13.35 mg/g). Those two compounds were not detected in the larvae reared on a single-plant diet. HPLC-DAD analysis revealed phenolic acids, flavonoids, and riboflavin in both groups, which may serve as potential carriers of antioxidant activity. These preliminary findings demonstrate how dietary modifications can change nutritional profiles and antioxidant properties of B. mori. At the same time, they lay the foundation for further research to fully understand diet-induced effects in edible insects.
Design of On-Site Calibration Device for Electricity Meter Based on Pulse Detection
Authors: Wang Yingchun , Yu Wenjing , Zhang Cheng , Ye Li , Wei Wei , Yang Zhixin
Published: January 2025

At present, the error calibration of electricity meters in operation generally adopts an off-site method; that is, the electricity meter is taken out of operation and then calibrated in the laboratory. Off-site calibration, while beneficial, may not fully capture the operational error of the electricity meter due to potential differences in environmental conditions. An on-site calibration device for electricity meters based on pulse detection is designed, which obtains the error of the electricity meter under calibration by comparing the energy pulses of the standard electricity meter with those of the electricity meter under calibration. High-precision voltage and current sampling channels are designed, with a voltage measurement error of less than 0.02% and a current measurement error of less than 0.03%. In response to the non-synchronous sampling problem caused by frequency fluctuations in the on-site verification environment, a fast optimal frequency estimation algorithm is applied to accurately calculate the signal frequency within two cycles. The sampling time interval is adjusted to achieve lock-frequency synchronous sampling, and ensure the accurate calculation of electrical parameters. In order to reduce the complexity of the device circuit structure and equipment cost, a standard electric energy pulses generation method based on digital integration-to-frequency is proposed, which uses software to generate electric energy pulses, with a maximum output frequency of up to 10 kHz. Tests conducted in the laboratory on the developed on-site calibration device for electricity meters show that its accuracy is better than the 0.05 accuracy class, meeting the application requirements for on-site verification of electricity energy meters.
Sexual Dysfunctions in Breastfeeding Females: Systematic Review and Meta-Analysis
Authors: Smetanina Darya , Alnuaimi Shouq , Alkaabi Afra , Alketbi Meera , Hamam Elshimaa , Alkindi Hanin , Almheiri Mahra , Albasti Rouda , Almansoori Hajar , Alshehhi Mahra , Al Awar Shamsa , Statsenko Yauhen , Zaręba Kornelia
Published: January 2025

Background: The prevalence of sexual dysfunctions varies from 35.5% to over 80% among postpartum women. Controversy exists regarding the risk factors for female sexual dysfunction (FSD) in the postpartum period. It remains unclear whether breastfeeding types contribute to the development of FSDs differently. Aims: The primary goal of this meta-analysis was to explore the role of baby feeding practices in developing sexual dysfunctions in women. Methods: We conducted a systematic literature search using the biomedical databases Scopus, CINAHL, Embase, the Web of Science, and PubMed/Medline. We looked for peer-reviewed, original studies written in English, Polish, and Arabic and published between January 2000 and June 2023. We included publications that reported scores in sexuality domains assessed with the Female Sexual Dysfunction Index (FSFI) and any sexuality-related issues during postpartum. The FSFI scores were combined in a meta-analysis using the random-effects inverse-variance model. Other findings were synthesized with a narrative review. Results: Eighteen articles met the eligibility criteria for the systematic review and meta-analysis. Sexual dysfunctions were detected in all the women, irrespective of the feeding type. Better overall sexual functioning was reported among women using complementary feeding than among those who breastfed exclusively or used baby bottles: 22.16, 95% CI [21.68; 22.65]; 21.61, 95% CI [20.27; 22.95]; and 20.18, 95% CI: [20.93; 61.30], respectively. Slightly lower scores were reported in all the FSFI subscales in exclusively breastfeeding women compared to those using the complementary method. Conclusions: Breastfeeding females experience difficulties in sexual life during the postpartum period, irrespective of the feeding type. These findings can help in designing preventive measures for tackling postpartum sexual dysfunctions in women.
Percutaneous Revascularization of Thrombotic and Calcified Coronary Lesions
Authors: Milzi Andrea , Simonetto Federico , Landi Antonio
Published: January 2025

Percutaneous coronary intervention (PCI) for thrombotic and heavily calcified coronary artery lesions and occlusions is often hampered by difficulty in wiring the occlusions, restoring antegrade flow, and proceeding to successful stent implantation. Characterization of dynamic anatomical features such as thrombi and the calcium distribution is key to prevent periprocedural complications and long-term adverse events, which are mainly driven by stent underexpansion and malapposition and may prompt in-stent restenosis or stent thrombosis. Therefore, multimodal imaging is a critical step during PCI to better characterize these high-risk lesions and select those in which careful preparation with debulking devices is needed or to guide stent optimization with the aim of improving procedural and long-term clinical outcomes. Hence, obtaining a better understanding of the underlying cause of thrombus formation, imaging the calcium distribution, and thorough planning remain crucial steps in selecting the optimal revascularization strategy for an individual patient. In this review, we summarize current evidence about the prevalence, predictors, and clinical outcomes of “hard-rock” thrombotic lesions treated by PCI, focusing on the value of imaging and physiological assessments performed to guide interventions. Furthermore, we provide an overview of cutting-edge technologies with the aim of facilitating the use of such devices according to specific procedural features.
Electrographic Flow Mapping Provides Prognosis for AF Ablation Outcomes Across Two Independent Prospective Patient Cohorts
Authors: Nilsson Kent R. , Anerao Amitesh , Kong Melissa H. , Derejko Pawel , Szili-Török Tamás , Goyal Sandeep , Turagam Mohit , Verma Atul , Castellano Steven
Published: January 2025

Background/Objectives: Electrographic flow (EGF) mapping allows for the visualization and quantification of atrial fibrillation (AF) wavefront propagation patterns. EGF-identified sources were shown in the randomized controlled FLOW-AF trial to significantly increase the likelihood of AF recurrence within 1 year if left unablated. Electrographic flow consistency (EGFC) additionally measures the stability of observed wavefront patterns, such that patients with more organization have a healthier substrate and lower recurrence. Source presence and EGFC can be used collectively to assign mechanistic phenotypes to AF patients. Methods: The patient phenotypes, treatment modalities, and outcomes in FLOW-AF were compared with those of patients in the ensuing AF-FLOW Global Registry, which was conducted by separate physicians at discrete clinical centers. Results: Patients with low EGFC (≤0.62) had a 12-month freedom from AF (FFAF) of 46%, while those with a high mean EGFC (>0.62) had a FFAF of 81%. Right atrial EGFC was correlated with left atrial EGFC, and the highest recurrence occurred in those with biatrial low EGFC. Source presence also affected the recurrence rates in both trials, such that the presence of EGF-identified sources in PVI-only patients lowered the FFAF from 65% to 36%, but the elimination of sources produced a 30% absolute increase in FFAF from 36% to 66%. Conclusions: Patient outcomes by EGF-based AF phenotype were consistent across two cohorts of patients from separate clinical trials at distinct centers. Patients with a high EGFC and no sources post-procedure had the best outcomes. EGF mapping provides insights into underlying disease pathophysiology and may be employed prospectively to predict recurrence.
Multicenter Prospective Pilot Study Identifying Thrombomodulin as a Potential Biomarker for Neurocognitive Outcomes in Immune Thrombotic Thrombocytopenic Purpura
Authors: Boothby Aaron B. , Evans Michael D. , Yang Shangbin , Sukumar Senthil , Scott James G. , Terrell Deirdra R. , Cataland Spero , Mazepa Marshall
Published: January 2025

Background/Objectives: Immune thrombotic thrombocytopenic purpura (iTTP) is a rare, chronically relapsing disorder that causes life-threatening thrombotic microangiopathy. Many survivors in clinical remission show evidence of ongoing silent cerebral infarction and neurocognitive deficits. Prospective longitudinal studies of this population are needed to acquire a complete understanding of the mechanism behind this ongoing neurologic injury. We aimed to assess the feasibility of a multicenter prospective study of neuropsychological and cognitive function in iTTP survivors in remission and examine novel biomarkers. Methods: We aimed to enroll 50 iTTP patients across three USTMA consortium sites between 2019 and 2022 in a 24-month longitudinal study. Clinical, cognitive, and biomarker assessments, including ADAMTS13 activity, were performed. Results: Despite the COVID-19 pandemic, we enrolled 38 subjects, and 31 (81.6%) completed closeout evaluations at 24 months. Upon the participants’ enrollment in the study, we confirmed previous findings, including high rates of moderate to severe neurocognitive and psychiatric sequelae (anxiety, 47%; depression, 45%; and headaches, 55%). Changes in cognitive function were measurable and included decreased immediate memory and visuospatial abilities. Over this two-year study, we did not see a significant change in neurocognitive findings. There was no association between cognitive function and ADAMTS13 activity; however, we found that the level of soluble thrombomodulin (CD141) was significantly correlated with cognitive impairment. Conclusions: We conclude that a more extensive study is feasible, and at least 5–10 years may be required to detect trends in neurocognitive function. Soluble thrombomodulin is a promising biomarker for cognitive impairment in survivors of iTTP, and it is worthy of additional study.
The Debilitating Physical and Emotional Effects of Limb Deformity: A Tertiary Center Observational Study Utilizing the Limb Deformity-Modified Scoliosis Research Society Score (LD-SRS)
Authors: Addar Abdullah , Alhabib Fayez A. , AbuDujain Nasser M. , Alghamdi Hani A. , Alshalan Mohammed H. , Alrabai Hamza M. , Alhuzaimi Fahad
Published: January 2025

Background: Limb deformity describes a condition where a limb has an abnormal shape or length, resulting from an acquired or a congenital case. This condition can impair the normal function of patients’ lives, leading to adverse psychological impacts. The limb deformity-modified Scoliosis Research Society (LD-SRS) score is a frequently used tool to assess quality of life. This observational study aimed to investigate the quality of life of patients with debilitating limb deformities in Saudi Arabia using the LD-SRS score. Methods: This is an observational analytical cross-sectional study conducted at the orthopedic clinic at King Saud University Medical City between March and May 2024. Patients diagnosed with any type of limb deformity (of different ages) were included in this study. Patients completed the LD-SRS score in the clinic and were divided into two groups based on whether they had undergone surgery for limb deformity. Results: This study included 152 participants, with the majority of participants in the 13–18-year age group and predominantly male (59.87%). Most participants were assessed before treatment, with significant differences observed in total scores based on the examination time (p < 0.001). Post-surgery scores showed marked improvement, with the overall total mean score for the surgery group being significantly higher than that of the non-surgery group (p < 0.001). Domain-specific scores revealed higher satisfaction in self-image/appearance for the surgery group, while the non-surgery group had lower scores in function/activity and mental health domains. No significant differences were found across age, gender, side of the body affected, or affected site. Conclusions: Preoperative patients had lower QoL scores as a whole group compared to those who had undergone surgery. The longer the duration postoperatively, the better the QoL score; those measured at three months had better QoL than preoperative patients, and those assessed at one and two years scored even higher. Self-image/appearance was a key factor, with the surgery group scoring higher in this domain than the non-surgery group. Future research should explore broader patient perspectives, including those related to mental and social well-being.
Development and Validation of a Quantitative Score for the Criteria Clinical Control in Stable COPD Proposed in the Spanish COPD Guidelines (GesEPOC): Results of the EPOCONSUL Audit
Authors: Calle Rubio Myriam , Cataluña Juan José Soler , Miravitlles Marc , Navarrete Bernardino Alcázar , López-Campos José Luis , Ferrer Manuel E. Fuentes , Rodríguez Hermosa Juan Luis
Published: January 2025

Introduction/Objective: the concept of clinical control of COPD is a measure proposed in the Spanish COPD Guidelines (GesEPOC), which aims to help clinicians assess the clinical status in order to adapt the treatment plan at follow-up. However, studies that have evaluated clinical practice reveal that the degree of control of COPD is not always assessed, which underlines the need to promote its assessment through a scoring system. To develop a scoring system that quantitatively assesses the validated criteria defining the degree of COPD control. Methods: this study used data from the EPOCONSUL audit in respiratory clinics across Spain. We included in this analysis all patients with a COPD clinical control grade estimated and reported by the physician at the visit, who had registered the criteria necessary to define the degree of clinical control validated and established in GesEPOC. Patients were randomly assigned to either the development or validation cohorts. The development cohort included 485 patients and the validation cohort included 341 patients. Score modelling was conducted using a multivariate logistic regression model, and calibration of the model and score was assessed using the Hosmer-Lemeshow goodness-of-fit test and GiViTi Calibration belts. The model and generated score’s discrimination capacity were analyzed by calculating the Area Under the Curve (AUC). Results: the scoring system was developed using four criteria as predictors of poor clinical control of COPD reported by the treating physician:adjusted dyspnoea severity, use of rescue inhaler more than three times per week, walking less than 30 min per day, and COPD exacerbations in the last three months. The scoring system attributed scores from 0 to 8. Calibration was satisfactory in both development and validation cohorts, and the score’s discrimination power, as indicated by the AUC, was 0.892. Conclusions: this scoring system provides an easy-to-use quantitative assessment of clinical control of COPD that we believe will help to measure COPD control and its evolution during patient follow-up. Future research will be needed to prospectively evaluate this score as a predictor of outcome.
Brain Imaging in Patients with Non-Small Cell Lung Cancer—A Systematic Review
Authors: Mayer Nora , Boschetti Laura , Scarci Marco , Cioffi Ugo , De Simone Matilde , Schnider Marlène , Kestenholz Peter , Minervini Fabrizio
Published: January 2025

Background: Lung cancer frequently metastasizes to the brain, liver, and adrenal glands with a significant negative prognostic impact on overall survival and quality of life (QoL). To optimize treatment and prognosis, adequate staging with the detection of distant metastases is crucial. The incidence of brain metastases in potentially resectable early-stage non-small cell lung cancer (NSCLC) is as low as 3%; hence, the need for preoperative brain imaging has been a constant matter of debate, especially in stage II. In stages III and IV NSCLC, neuroimaging is an essential part of staging. Methods: A systematic literature search was performed. Publications from 1999 to 2024, focusing on preoperative brain imaging (BI) in the staging of stages I–IV NSCLC, were included. Data extraction included study population characteristics, the modality of BI, the incidence of brain metastases (BMs), and the main outcomes of the studies. The final included studies were selected according to the PRISMA criteria. In the second step, guidelines on BI in NSCLC staging of major importance were identified and compared. Results: A total of 530 articles were identified, of which 25 articles were selected. Four prospective studies and 21 retrospective investigations were included. Most of the investigations focused on BI in the early stages. The main imaging modality for BI was magnetic resonance imaging (MRI), followed by computed tomography (CT). Besides the identified 25 studies, the most important internationally applied guidelines on brain imaging in the staging of NSCLC were reviewed. While some guidelines agree on preoperative BI in NSCLC stage III (Union for International Cancer Control—UICC eighth edition) patients, other guidelines recommend earlier BI starting from clinical stage II. All mentioned guidelines homogenously recommend BI in patients with symptoms suggestive of brain pathologies. Conclusions: BI in NSCLC staging is recommended in neurologically symptomatic patients suggestive of brain metastases as well as NSCLC patients with stage III disease. Neuroimaging in stage IA patients, as well as in pure GGO (Ground-Glass Opacity) lesions, was considered unnecessary. The predominantly applied imaging modality was ce-MRI (contrast-enhanced magnetic resonance imaging). Inconsistency exists concerning BI in stage II. The identification of prognostic factors for developing BM in patients with early-stage NSCLC could help to clarify which subgroup might benefit from preoperative BI.
Study on the Multi-Equipment Integrated Scheduling Problem of a U-Shaped Automated Container Terminal Based on Graph Neural Network and Deep Reinforcement Learning
Authors: Zhang Qinglei , Zhu Yi , Qin Jiyun , Duan Jianguo , Zhou Ying , Shi Huaixia , Nie Liang
Published: January 2025

Intelligent Guided Vehicles (IGVs) in U-shaped automated container terminals (ACTs) have longer travel paths than those in conventional vertical layout ACTs, and their interactions with double trolley quay cranes (DTQCs) and double cantilever rail cranes (DCRCs) are more frequent and complex, so the scheduling strategy of a traditional ACT cannot easily be applied to a U-shaped ACT. With the aim of minimizing the maximum task completion times within a U-shaped ACT, this study investigates the integrated scheduling problem of DTQCs, IGVs and DCRCs under the hybrid “loading and unloading” mode, expresses the problem as a Markovian decision-making process, and establishes a disjunctive graph model. A deep reinforcement learning algorithm based on a graph neural network combined with a proximal policy optimization algorithm is proposed. To verify the superiority of the proposed models and algorithms, instances of different scales were stochastically generated to compare the proposed method with several heuristic algorithms. This study also analyses the idle time of the equipment under two loading and unloading modes, and the results show that the hybrid mode can enhance the operational effectiveness. of the U-shaped ACT.
Climatological Annual Mean and Seasonal Variations in Spatial Energy Spectra of Satellite-Observed Sea-Surface Chlorophyll-a Concentration in the East China Sea
Authors: Huang Bo , Gu Yanzhen , Liu Cong , Zhai Fangguo , He Shuangyan , Song Dan , Li Peiliang
Published: January 2025

The hourly L2-level chlorophyll-a (CHL-a) concentration spatial energy spectra of GOCI-II from 2021 to 2023 are employed to investigate the characteristics of the CHL-a spatial energy spectrum slopes in three regions of the East China Sea, namely nearshore, offshore, and open ocean. The seasonal trends of the spatial energy spectrum slopes are also examined for the nearshore and offshore regions. It is observed that the slopes of the CHL-a spatial energy spectrum are −2 at scales larger than 5 km, whereas at smaller scales, they are −5/3, −1, and −0.3 from the nearshore region to the open sea, respectively. On the larger scales, the spatial energy spectrum slopes are consistent with surface quasi-geostrophic (sQG) theory, but this is not the case on smaller scales. An insufficient regional CHL-a concentration leads to a flattening of the slope at the smaller scales. On the submesoscale, the slope of the nearshore CHL-a concentration spatial energy spectrum is steeper in summer and flatter in winter, a pattern that contrasts with changes observed offshore. This seasonal variation is attributed to the southward flow of ZheMin Coastal Current (ZMCC) during winter, which carries freshwater and enhances the horizontal buoyancy gradient in the nearshore region.
Ganoderma lucidum Immobilized on Wood Demonstrates High Persistence During the Removal of OPFRs in a Trickle-Bed Bioreactor
Authors: Tayar Shamim , Villagra Javier , Gaju Núria , Martínez-Alonso Maira , Beltrán-Flores Eduardo , Sarrà Montserrat
Published: January 2025

Emerging pollutants such as organophosphate flame retardants (OPFRs) pose a critical threat to environmental and human health, while conventional wastewater treatments often fail to remove them. This study addresses this issue by evaluating the bioremediation potential of white-rot fungi for the removal of two OPFRs: tris(2-chloroethyl) phosphate (TCEP) and tributyl phosphate (TBP). Three fungal species—Ganoderma lucidum, Trametes versicolor, and Phanerochaete velutina—were screened for their degradation capabilities. Among these, G. lucidum and T. versicolor demonstrated removal efficiencies exceeding 99% for TBP, while removal rates for TCEP were significantly lower, with a maximum of 30%. The exploration of the enzyme role showed that cytochrome P450 is involved in the degradation while the extracellular laccase is not involved. Continuous batch experiments were performed using a trickle-bed reactor (TBR) operating under non-sterile conditions, a setting that closely resembles real-world wastewater treatment environments. G. lucidum was immobilized on oak wood chips, and the removal efficiencies were measured to be 85.3% and 54.8% for TBP and TCEP, respectively, over 10 cycles. Microbial community analysis showed that G. lucidum remained the dominant species in the reactor. These findings demonstrate the efficacy of fungal-based trickle-bed bioreactors, offering a sustainable and efficient alternative for addressing environmental pollution caused by highly recalcitrant pollutants.
Business Strategy and Auditor Report Lag: Do Board Characteristics Matter? Evidence from an Emerging Market
Authors: Eissa Aref M. , Diab Ahmed , Hamdy Arafat
Published: January 2025

This study investigates the association between business strategy and audit report lag (ARL). In addition, it reveals the moderating influence of board characteristics on this relationship. We used data collected from Egyptian firms listed on EGX100 during the period from 2014 to 2019, which were analyzed using ordinary least squares and binary logistic regression models. Our study revealed a decrease in ARL for firms adopting cost leadership or differentiation strategies. In addition, we found that ARL decreased for cost leadership firms with a higher percentage of non-executive director and board meetings. Moreover, ARL decreased for firms adopting a differentiation strategy with a higher percentage of non-executive directors. This study contributes to the literature on the potential factors affecting the link between business strategy and the quality of financial reporting by focusing on ARL, which is rarely examined in the literature, especially in emerging markets such as Egypt. The findings of this study are valuable to investors, auditors, corporate management, and other stakeholders, who should consider particular board attributes to better predict ARL and ensure the effective adoption and implementation of business strategies.
Modeling and Forecasting the Probability of Crypto-Exchange Closures: A Forecast Combination Approach
Authors: Magomedov Said , Fantazzini Dean
Published: January 2025

The popularity of cryptocurrency exchanges has surged in recent years, accompanied by the proliferation of new digital platforms and tokens. However, the issue of credit risk and the reliability of crypto exchanges remain critical, highlighting the need for indicators to assess the safety of investing through these platforms. This study examines a unique, hand-collected dataset of 228 cryptocurrency exchanges operating between April 2011 and May 2024. Using various machine learning algorithms, we identify the key factors contributing to exchange shutdowns, with trading volume, exchange lifespan, and cybersecurity scores emerging as the most significant predictors. Since individual machine learning models often capture distinct data characteristics and exhibit varying error patterns, we employ a forecast combination approach by aggregating multiple predictive distributions. Specifically, we evaluate several specifications of the generalized linear pool (GLP), beta-transformed linear pool (BLP), and beta-mixture combination (BMC). Our findings reveal that the beta-transformed linear pool and the beta-mixture combination achieve the best performances, improving forecast accuracy by approximately 4.1% based on a robust H-measure, which effectively addresses the challenges of misclassification in imbalanced datasets.
Federated Learning for IoT: A Survey of Techniques, Challenges, and Applications
Authors: Dritsas Elias , Trigka Maria
Published: January 2025

Federated Learning (FL) has emerged as a pivotal approach for decentralized Machine Learning (ML), addressing the unique demands of the Internet of Things (IoT) environments where data privacy, bandwidth constraints, and device heterogeneity are paramount. This survey provides a comprehensive overview of FL, focusing on its integration with the IoT. We delve into the motivations behind adopting FL for IoT, the underlying techniques that facilitate this integration, the unique challenges posed by IoT environments, and the diverse range of applications where FL is making an impact. Finally, this submission also outlines future research directions and open issues, aiming to provide a detailed roadmap for advancing FL in IoT settings.
Is Artificial Intelligence a Game-Changer in Steering E-Business into the Future? Uncovering Latent Topics with Probabilistic Generative Models
Authors: Oprea Simona-Vasilica , Bâra Adela
Published: January 2025

Academic publications from the Web of Science Core Collection on “e-business” and “artificial intelligence” (AI) are investigated to reveal the role of AI, extract latent themes and identify potential research topics. The proposed methodology includes relevant graphical representations (trends, co-occurrence networks, Sankey diagrams), sentiment analyses and latent topics identification. A renewed interest in these publications is evident post-2018, with a sharp increase in publications around 2020 that can be attributed to the COVID-19 pandemic. Chinese institutions dominate the collaboration network in e-business and AI. Keywords such as “business transformation”, “business value” and “e-business strategy” are prominent, contributing significantly to areas like “Operations Research & Management Science”. Additionally, the keyword “e-agribusiness” recently appears connected to “Environmental Sciences & Ecology”, indicating the application of e-business principles in sustainable practices. Although three sentiment analysis methods broadly agree on key trends, such as the rise in positive sentiment over time and the dominance of neutral sentiment, they differ in detail and focus. Custom analysis reveals more pronounced fluctuations, whereas VADER and TextBlob present steadier and more subdued patterns. Four well-balanced topics are identified with a coherence score of 0.66 using Latent Dirichlet Allocation, which is a probabilistic generative model designed to uncover hidden topics in large text corpora: Topic 1 (29.8%) highlights data-driven decision-making in e-business, focusing on AI, information sharing and technology-enabled business processes. Topic 2 (28.1%) explores AI and Machine Learning (ML) in web-based business, emphasizing customer service, innovation and workflow optimization. Topic 3 (23.6%) focuses on analytical methods for decision-making, using data modeling to enhance strategies, processes and sustainability. Topic 4 (18.5%) examines the semantic web, leveraging ontologies and knowledge systems to improve intelligent systems and web platforms. New pathways such as voice assistance, augmented reality and dynamic marketplaces could further enhance e-business strategies.