bluuebunny/crossref_metadata_2025 huggingface dataset:
Air quality monitoring in the eastern Jiul Valley
Authors: Gaman Angelica-Nicoleta , Simion Alexandru , Simion Sorin
Published: January 2024

Jiu Valley is an area with a tradition in the field of mining. Over time, coal mining has been the main driver of the local economy. The decrease in the level of coal use also led to the closure of mining units in the Jiu Valley. Such transitional actions require calibration to climate, environmental and health responsibilities. Air pollution specific to the area has, perhaps, the most significant impact on the quality of population’s life in terms of affecting health. The paper presents the air quality monitoring in the Eastern Jiu Valley for a period of four months (one sampling campaign/month), between February and May 2023, in six monitoring points, with the help of the Mobile Environmental Laboratory which has the facility of simultaneously determining several samples for quick identification of polluted areas. The established monitoring program includes the monitoring points, monitoring frequency and duration, as well as the areas where the mobile laboratory was located. The analysed data highlight the air quality in the Eastern Jiu Valley to establish the medium and long-term objectives in each area where the mobile laboratory was located, as well as the level of exposure of resident population. The concentration levels found in different urban areas illustrate the average concentrations of dust, gases and ozone caused by both activities in the area and road traffic.
Comparison between measured and modelled data on occupational exposure to organic solvents in degreasing, varnishing and painting activities performed in a Romanian company
Authors: Chiurtu Elena-Ruxandra , Haiducu Maria , Scarlat Iuliana Pamela
Published: January 2024

This study aims to highlight the similarities and differences between occupational exposure measured (personal and static) and modelled data using the Tier 2 Advanced REACH Tool (ART 1.5) for some organic solvents used in degreasing, varnishing and painting activities. The measurements were performed between 2020 and 2022 in a Romanian company manufacturing metallic components for the energy industry. The conclusion of the study will allow identifying some of the uncertainties related to the use of modelled data versus measured data, and to decide on the adequate operational conditions (OCs) and risk management measures (RMMs) to implement in place, in accordance with the hierarchy of control principles.
Reducing the occurrence of occupational diseases in order to make the work of mining personnel more efficient
Authors: Marica Laura , Itu Razvan Bogdan
Published: January 2024

The objectives of the study focus on identifying the professional working conditions and the implementation of labor protection regulations in the mining field; identifying occupational diseases in the mining industry; identifying how these occupational diseases have been treated through various therapeutic forms. Through the questionnairebased survey, we collected both objective data (age, gender, marital status, etc.) and subjective data (opinions, aspirations, attitudes, beliefs, needs, etc.), considering this method appropriate for identifying and describing the aspects targeted by the research. The questionnaire was administered to a group of individuals with various levels of training (engineers, mining rescuers, miners, etc.) who work underground in harsh conditions, within mining enterprises in the Jiu Valley, Hunedoara County. It consisted of 22 questions structured around 4 important dimensions of analysis: professional data, conditions related to the workplace and the implementation of labor protection regulations, aspects related to occupational diseases in the mining industry, and personal data.The analyzed topic is important in the real world as the number of studies in this field is quite limited. The paper will also highlight and graphically present the results obtained from the subjects.
Quantification of uncontrolled oil pollution of the East Jiu
Authors: Vlad Lautaru , Izabella Kovacs
Published: January 2024

In the current global context, where drinking water sources are constantly diminishing, surface water pollution has become an environmental problem that requires rapid action to conserve drinking water sources and protect aquatic biodiversity. Water pollution has many causes and can be caused by nitrates, detergents, pesticides, heavy metals, petroleum products and many other harmful substances that come from different sources. In this paper we analyzed the pollution of surface waters, respectively of the water course - Jiul de Est, with petroleum products, considering that in its immediate vicinity there are several points of sale and storage of motor fuels, but also pollution with petroleum products that come from cars that transit the roads in the vicinity of East Jiu.In order to be able to quantify the degree of oil pollution of the Eastern Jiu, water samples were taken in order to analyze them with the Fourier Transform Infrared Spectrometer determination method. The purpose of the work is to determine whether the degree of oil pollution of the Eastern Jiu is an environmental problem that requires the intervention of the competent authorities in order to reduce the effects that this type of pollution can have.
Metabolic syndrome and the 10-year cardiovascular disease risk in urban public transport drivers in the context of occupational risks and workloads
Authors: Mihăilă Delia , Iordache Raluca Maria , Petreanu Viorica
Published: January 2024

The specific risks and workloads of urban public transport drivers create a net for the development of several health issues. It is worth mentioning the impact of the work regime on this type of workers’ metabolic and cardiovascular health. This paper represents a sequence from an ample study that has followed the effects of this professional activity on worker’s health and work capacity and has established prevention / reduction of identified risk factors measures. The health state analysis was realized through a prevalence study on three cohorts (bus, tram, trolleybus drivers). The prevalence of metabolic syndrome was the highest in the group of the bus drivers, 16.7%. The 10-year fatal cardiovascular disease risk in both the increased risk category and very increased risk category was the highest in the trolleybus drivers’ cohort, 29%, respectively 6%. Major contributing pathology, such as hypertension and type II diabetes, starts in the 36-45 years of age group regardless of gender in all three cohorts signalizing an early wear and is already important in the 46-55 years of age group.
Virtual Tool Used for Temperature Monitoring through I2C Protocol
Authors: Patrascoiu Nicolae
Published: January 2024

Temperature monitoring is very important both for large geographical and industrial environments, but equally for equipment or subassemblies in a technological process. Monitoring in all cases is important to prevent accidents or the occurrence of major defects. In this paper, a temperature monitoring solution is proposed for a number of up to 8 measurement points located at distances of up to 2 m by means of intelligent integrated sensors capable of transmitting information through the I2C industrial protocol. A flexible hardware structure and software development concept are presented to offer local information and to be integrated into a hierarchical temperature monitoring network.
Photovoltaic System Protection Against Lightning
Authors: Beiu Constantin , Buica Georgeta , Antonov Anca Elena , Risteiu Mircea
Published: January 2024

Lightning strikes pose a significant threat to photovoltaic (PV) systems, which are increasingly utilized for renewable energy generation. This paper presents a comprehensive overview of the potential risks associated with lightning strikes on PV systems and explores various protection measures to enhance their resilience. The study delves into the characteristics of lightning and its interaction with PV installations, identifies vulnerabilities within the system, and discusses the principles and techniques for effective lightning protection. The paper emphasizes the importance of comprehensive risk assessment, surge protection devices, grounding systems, and maintenance practices to mitigate the damaging effects of lightning strikes. By implementing appropriate protection strategies, PV system owners and designers can safeguard their installations and ensure the longevity and reliability of their renewable energy infrastructure.
Workers exposure to synthetic textiles microfibers
Authors: Scarlat Iuliana , Stepa Raluca , Haiducu Maria , Visileanu Emilia , Grosu Marian Cătălin
Published: January 2024

The textile industry is one of the most polluting sectors, its contribution to the growing contamination with microfibers being of recent interest. Microfibers are an important part of microplastics, a real problem in our society. Textiles are dominated by synthetic fibres, generating microfibres as environmental contaminants. Exposure may also occur in the workplace, but fewer studies address this topic. Although synthetic microfibres toxicity is not fully understood, is accepted that their dimensions can influence health effects. This study analysed the length and diameter of 201 airborne polyester fibres sampled in the working environment of a textile factory. Phase contrast microscopic analysis was performed using NIOSH method 7400. Three size categories were considered for the length: small (≤ 10 μm), medium (10 - 100 μm) and large (≥ 100 μm). Four diameter categories: thin (≤ 1 μm), medium (≤ 2 μm) and thick (≤ 3 μm) were defined. Diameters over 3 microns were considered elongated microplastics. Results show that most of the fibres (93%) were less than 100 μ long (20.1% being less than 10 μ) and the fibres with 1μ diameter were predominant (42.8%) Such fibres may reach into the bronchial tree and even further, where they may cause health problems.
Perioperatives Patient Blood Management im interprofessionellen Team
Authors: Christin Müller Marie , Beginn Florian
Published: January 2024

Im Fokus des Patient Blood Managements steht, Blutprodukte einzusparen, Blutverluste zu minimieren und Gerinnungsstörungen zu vermeiden. Dies wirkt sich positiv auf die Patientensicherheit und den Umgang mit Ressourcen aus. Allerdings ist Patient Blood Management kein starrer Behandlungspfad, sondern ein Konzept, das für jeden Patienten individuell angepasst wird, da er der Mittelpunkt sämtlicher Maßnahmen ist. Welchen wichtigen Beitrag Anästhesie-Pflegende und Anästhesietechnische Assistent*innen dabei leisten, erfahren Sie in unserem Schwerpunkt.
Die Rechtsfrage: Bleiben Arbeitsverträge bei Praxisübernahme gültig?
Authors: Schlegel Thomas
Published: January 2024

Ich übernehme eine Therapiepraxis mit einigen Angestellten. Darf ich bestehende Arbeitsverträge zum Beispiel in Bezug auf Urlaubstage oder den Umgang mit Überstunden verändern oder können die Angestellten auf ihrem alten Arbeitsvertrag bestehen?

Therapeutin aus Bayern
Robotische Pankreatoduodenektomie: Variationen der Pankreasanastomose in modifizierter Blumgart-Technik
Authors: Seeger Philipp , Distler Marius , Thomaschewski Michael , Zimmermann Markus , Heumann Asmus , Uzunoglu Faik Güntac , Grützmann Robert , Weber Georg F. , Brunner Maximilian , Kersting Stephan , Hackert Thilo , Keck Tobias , Nickel Felix
Published: January 2024

Die wichtigste Komplikation nach Pankreatoduodenektomie ist die klinisch relevante Pankreasfistel. Um die Rate an Komplikationen zu senken, ist eine routinierte und standardisierte Operationstechnik zur Anlage der Pankreatojejunostomie notwendig.

Die Pankreatoduodenektomie ist im multimodalen Setting der Goldstandard zur Behandlung des lokal begrenzten Pankreaskopfkarzinoms und weiterer Pathologien. Das robotische Verfahren bietet als innovatives minimalinvasives Verfahren Vorteile bez. Morbidität und Ergonomie.

Nach der Resektionsphase folgt die Rekonstruktion beginnend mit der Pankreatojejunostomie. Die aktuell meistverbreitete robotische Technik ist die Anastomose nach Blumgart: Dabei wird eine äußere Naht transpankreatisch zwischen Jejunalwand und dem gesamten Pankreasparenchym in ventrodorsaler Ausrichtung angelegt, die Spannungs- und Scherkräfte verteilt. Die innere Naht wird durch eine Duct-to-Mucosa-Naht des Pankreasganges mit einer kleinen Jejujunostomie erreicht. In diesem Manuskript werden verschiedene Varianten dieser Rekonstruktion in robotischer Technik gezeigt.

Hinsichtlich der wissenschaftlichen Evidenz zeigt keine Anastomosenvariante einen Vorteil. Das Outcome ist abhängig von der Expertise des Operateurs, entsprechend sollte diejenige Anastomosentechnik angewendet werden, für die am meisten Erfahrung verfügbar ist. Die in diesem Beitrag gezeigten Variationen sollen für Anwender den Fokus auf wichtige Details legen sowie Tipps und Tricks zur Durchführung geben.
Semont-Plus-Manöver – Neues Manöver beim gutartigen paroxysmalen Lagerungsschwindel
Authors: Kellerer Silvy , Dassel Alexander , Jahn Klaus
Published: January 2024

Das Semont-Plus-Manöver ist eine „erweiterte“ Therapie des gutartigen paroxysmalen Lagerungsschwindels des hinteren Bogengangs, kurz BPPV, bei dem der Kopf tiefer gelagert wird als beim bekannten Semont-Manöver. Neuesten Untersuchungen zufolge gilt es als erfolgreicher und schneller in Bezug auf die Dauer bis zur Beschwerdefreiheit. Beim Provokationsmanöver zur Testung bleibt hingegen alles beim Alten.
Alles eine Frage der Zeit? – Verlauf akuter lumbaler Rückenschmerzen
Authors: Pfeiffer Fabian
Published: January 2024

Immer mehr Forschungsarbeiten zeigen Grenzen der zeitlichen Einteilung lumbaler Rückenschmerzen in akut, subakut und chronisch auf. Auch ist die Vorhersage von chronischen Verläufen anhand vorliegender Risikofaktoren in Frage zu stellen. Eine lang angelegte Kohortenstudie der Zürcher Hochschule für Angewandte Wissenschaften beleuchtet eindrucksvoll, wie komplex und individuell Verläufe von akuten LBP tatsächlich sind.
Außerklinische Beatmung: Lebensqualität und Lebensende
Authors: Stanzel Sarah Bettina , Schönhofer Bernd
Published: January 2024

Die Erfassung der Health related quality of life (HRQL) hat in den letzten Jahren enorm an Bedeutung gewonnen. Für die respiratorische Insuffizienz stehen krankheitsspezifische Fragebögen zur Verfügung, die die Erhebung der gesundheitsbezogenen Lebensqualität ermöglichen. Der „Severe Respiratory Insufficiency“ (SRI)-Fragebogen, der speziell für Patient*innen mit respiratorischer Insuffizienz entwickelt wurde, eignet sich hervorragend zur Quantifizierung der Lebensqualität bei Patient*innen mit COPD und außerklinischer Beatmung. Basierend auf Untersuchungen mit dem SRI-Fragebogen ergab sich, dass die körperliche Funktionsfähigkeit bei Patient*innen mit chronischen Lungenerkrankungen unterschiedlicher Genese deutlich eingeschränkt ist, nicht selten jedoch ohne nennenswerte Einschränkungen des Wohlbefindens bleibt. Auch müssen Erkrankungsschwere und Lebensqualität nicht in Korrelation zueinander stehen.

Sowohl invasive als auch nichtinvasive Beatmung können zur Verbesserung der Lebensqualität führen. Hierbei müssen Erkrankungsschwere und Lebensqualität nicht miteinander korrelieren.

Komorbidität und v.a. fortgeschrittenes Alter haben den höchsten negativen prädiktiven Wert bzgl. Krankenhausmortalität und Weaning-Versagen und der Anteil der älter als 80-jährigen Patient*innen mit bleibender Abhängigkeit von außerklinischer invasiver Beatmung nach erfolglosem prolongiertem Weaning nimmt inzwischen deutlich zu. Hohe Abhängigkeit von invasiver außerklinischer Beatmung geht häufig mit Einbuße der Lebensqualität und Autonomie einher. Vor diesem Hintergrund werden ethische Aspekte von beatmeten Patient*innen am Lebensende zunehmend thematisiert.

Nach erfolgloser Respiratorentwöhnung sollte die Indikation zur außerklinischen Beatmung angesichts der oft stark reduzierten Lebensqualität und schlechter Prognose sowie unter Berücksichtigung des Willens der Patient*innen kritisch geprüft werden.

Sind im Verlauf einer invasiven außerklinischen Beatmung die zuvor konsentierten Therapieziele nicht mehr erreichbar, sollten Gespräche zur Therapiezieländerung im Behandlungsteam, mit den Patient*innen, deren Angehörigen und ggf. mit gesetzlichen Vertreter*innen (z.B. auch in Form einer Fall- oder Familienkonferenz) geführt werden.

Um Übertherapie und unnötiges Leiden von Patient*innen in der invasiven außerklinischen Beatmung zu vermeiden, sollten eine vorausschauende Versorgungsplanung („Advanced Care Planning“) möglichst frühzeitig beginnen und ggf. durch palliativmedizinische Maßnahmen begleitet werden.
Tumour stage and overall survival in patients with intrahepatic cholangiocarcinoma and primary sclerosing cholangitis – a retrospective cohort study
Authors: Schramm Christoph , Sapuk Ayaz , Hoyer Dieter , Radünz Sonia , Schmidt Hartmut
Published: January 2024

Background Patients with primary sclerosing cholangitis (PSC) carry increased risks for malignancy, among which cholangiocarcinoma (CCA) is the most frequent. We aimed to characterise a cohort of patients with PSC and intrahepatic CCA (iCCA) and to compare this cohort with CCA in different localisations.

Methods We performed a retrospective analysis of our medical database from 01.01.2007 to 30.06.2023 and differentiated CCA according to its localisation within the biliary tract into iCCA, perihilar CCA (pCCA), distal CCA (dCCA), and gallbladder carcinoma (GBC).

Results We identified 8 (28%) patients with iCCA, 14 (48%) patients with pCCA, 6 (21%) patients with GBC, and 1 (3%) patient with dCCA without significant differences in gender distribution and mean age. Mean time between diagnosis of PSC and CCA was 158±84 months for iCCA, 93±94 months for pCCA, and 77±69 months for GBC (p=0.230). At the time of CCA diagnosis, advanced-stage disease was present in 6 (75%) patients with iCCA, 13 (93%) patients with pCCA, and 2 (40%) patients with GBC (p=0.050). Only 5 (63%) patients with iCCA received curatively intended surgery, of whom 4 (80%) patients developed recurrence after a mean time of 38±31 months. Mean survival time in patients with iCCA (35±33 months) lay between patients with pCCA (14±8 months) and patients with GBC (57±58 months), but the difference was not statistically significant (p=0.131).

Conclusion Patients with PSC and iCCA showed an advanced tumour stage at diagnosis and limited long-time survival, which was classified between pCCA with worse prognosis and GBC with better prognosis.
Toxins in Botanical Drugs and Plant-derived Food and Feed – from Science to Regulation: A Workshop Review
Authors: Schrenk Dieter , Allemang Ashley , Fahrer Jörg , Harms Henrik , Li Xilin , Lin Ge , Mahony Catherine , Mulder Patrick , Peijnenburg Ad , Pfuhler Stefan , Punt Ans , Sievers Hartwig , Troutman John , Widjaja Frances
Published: January 2024

In September 2022, the 3rd International Workshop on pyrrolizidine alkaloids (PAs) and related phytotoxins was held on-line, entitled ʼToxins in botanical drugs and plant-derived food and
feed – from science to regulationʼ. The workshop focused on new findings about the occurrence, exposure, toxicity, and risk assessment of PAs. In addition, new scientific results related to
the risk assessment of alkenylbenzenes, a distinct class of herbal constituents, were presented. The presence of PAs and alkenylbenzenes in plant-derived food, feed, and herbal medicines has
raised health concerns with respect to their acute and chronic toxicity but mainly related to the genotoxic and carcinogenic properties of several congeners. The compounds are natural
constituents of a variety of plant families and species widely used in medicinal, food, and feed products. Their individual occurrence, levels, and toxic properties, together with the broad
range of congeners present in nature, represent a striking challenge to modern toxicology. This review tries to provide an overview of the current knowledge on these compounds and indicates
needs and perspectives for future research.
Laparoscopic Living donor liver transplantation in irresectable intrahepatic cholangiocarcinoma in primary sclerosing cholangitis associated liver cirrhosis
Authors: Bednarsch Jan , Lang Sven A. , Heise Daniel , Strnad Pavel , Neumann Ulf P. , Ulmer Tom F.
Published: January 2024

Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver tumor and usually associated with a poor oncological prognosis. The current gold standard is the surgical resection of the tumor with subsequent adjuvant therapy. However, in case of irresectability e.g. in case of liver cirrhosis, a palliative treatment regime is conducted.

This report demonstrates the case of an irresectable iCCA in liver cirrhosis due to primary sclerosing cholangitis (PSC) treated by living-donor liver transplantation (LDLT) facilitated by minimal invasive donor hepatectomy. No postoperative complications were observed in the donor and the donor was released on the 6th postoperative day. Further, after a follow-up of 1.5 years, no disease recurrence was detected in the recipient.

According to the recent international literature, liver transplantation can be evaluated in case of small solitary iCCA (< 3 cm) in cirrhosis. Less evidence is provided for transplantation in advanced tumors which are surgically not resectable due to advanced liver disease or infiltration of major vessels, however some reports display adequate long-term survival after strict patient selection. The selection criteria comprise the absence of distant metastases and locoregional lymph node metastases as well as partial remission or stable disease after neoadjuvant chemotherapy. Due to no established graft allocation for iCCA in Germany, LDLT is currently the best option to realize transplantation in these patients. Developments in the last decade indicate that LDLT should preferentially be performed in minimal invasive manner (laparoscopic or robotic) as this approach is associated with less overall complications and a shorter hospitalization.

The presented case illustrates the possibilities of modern surgery and the introduction of transplant oncology in the modern therapy of patients combining systemic therapy, surgical resection and transplantation to achieve optimal long-term results in patients which were initially indicated for palliative treatment.
Plastische und dilatative Tracheostomie – Technik und Fallstricke
Authors: Hess Carolin , Le Uyen-Thao , Schmid Severin
Published: January 2024

Die Anlage eines Tracheostomas ist meist aufgrund einer langfristigen maschinellen Beatmungspflichtigkeit oder eines komplizierten Weanings erforderlich. Weitere Indikationen sind u. a.
Schluckstörungen mit rezidivierenden Aspirationen bei neuromuskulären Erkrankungen und hochgradige subglottische Stenosen. Die Tracheostomie kann in Abhängigkeit von der Indikation und Anatomie
als dilatative oder plastische Tracheostomaanlage durchgeführt werden. Die Komplikationsrate ist hierbei gering, wobei intraoperative Komplikationen von postoperativen Früh- und
Spätkomplikationen unterschieden werden. In diesem Artikel sollen die Indikationen, Durchführung und Komplikationen sowohl der dilatativen als auch plastischen Tracheostomie vorgestellt und
insbesondere die Langzeitkomplikationen, wie die Trachealstenose und die Tracheomalazie, beleuchtet werden.
Impact of Psychiatric Symptoms on Nasal Perception in Septorhinoplasty Patients
Authors: Hohenberger Ralph , Baumann Ingo , Riedel Frank , Plinkert Peter K. , Bulut Olcay Cem
Published: January 2024

Psychological assessment plays a crucial role in the preoperative phase of septorhinoplasty (SRPL), exerting potential influence on both pre- and postoperative aspects of quality of life (QoL). In this prospective study, SRPL patients were systematically screened using two validated questionnaires for body dysmorphic disorder (BDD) and one each for anxiety, depression, and somatic symptom disorder (SSD). Nasal perception was evaluated utilizing two disease-specific, self-report instruments: The Rhinoplasty Outcomes Evaluation (ROE) and the Functional Rhinoplasty Outcome Inventory-17 (FROI-17). A total of 95 patients were enrolled. Positive screening rates were 40.4 and 28.3% for BDD, 37.3% for elevated anxiety, 16.4% for depression, and 22.4% for SSD. Mean scores on the ROE and FROI indicated lower QoL in all positive screening groups. Statistically significant differences were observed for anxiety (FROI total score: 47.1 ± 14.6 to 37.8 ± 16.2; p = 0.021) and BDD (ROE: 43.7 ± 15.7 to 32.5 ± 15.5; p = 0.003 and FROI total score: 47.4 ± 15.3 to 37.8 ± 17.1; p = 0.014). The Hospital Anxiety and Depression Scale exhibited a significant correlation with the preoperative FROI score (r = 0.34, p = 0.005). Patients with positive screenings for depression, anxiety, BDD, and SSD demonstrated compromised QoL during preoperative assessments compared with their negative counterparts, reflecting diminished nasal perception in both esthetic and functional dimensions. Surgeons must be cognizant of these psychological aspects during preoperative evaluations.
Pentacene to Octacene: The Limit of Fourfold TIPS-Ethynylation
Authors: Zeitter Nico , Hippchen Nikolai , Baur Philipp , Unterreiner Tamara V. , Rominger Frank , Freudenberg Jan , Bunz Uwe H. F.
Published: January 2024

Soluble acenes beyond hexacene are rare. Their sensitivity complicates isolation, purification and application in devices. To increase the stability of acenes, functionalization with trialkylsilylethynyl substituents prevents [4 + 4] dimerization and oxidation. At the same time, such acenes are soluble and processible. Here we present the modular synthesis of fourfold tri-iso-propylsilylethynyl-ethynylated pentacenes to octacenes and investigate their optical and redox properties, frontier orbital positions (CV, density functional theory calculations) as well as their stability in solution (UV/vis, NMR spectroscopy). We also investigated their magnetic properties as a function of acene length. Pentacene, hexacene and heptacene are sufficiently stable to serve as semiconductors in thin-film transistors – the octacene rapidly decays to its butterfly dimer evidence by time-dependent NMR spectroscopy and crystal structure analysis.
Iron-Catalyzed [2+1+2+1] Annulation of Amines and N,N-Dimethyl Enaminones using N,N-Dimethylaminoethanol as a One-Carbon Synthon for the Synthesis of 1,4-Dihydropyridines
Authors: Yuan Jianyong , Ma Wanqian , Kuang Qiulin , Li Suzhen , Guo Mengyi , Song Yibo , Cheng Luoteng
Published: January 2024

A simple and efficient method for the synthesis of 1,4-dihydropyridines from amines, N,N-dimethyl enaminone and N,N-dimethylaminoethanol in a four-component [2+1+2+1] annulation catalyzed by FeCl3 has been established, where N,N-dimethylaminoethanol was applied as a methine source. The procedure was executed smoothly, resulting in the synthesis of a wide range of 1,4-dihydropyridines with moderate to good yields. Additionally, these fluorophores exhibited good photophysical characteristics.
Stable Arterial Perforators Mapping in Lower Leg Using Color-Coded Doppler Sonography, Acoustic Doppler, and Thermal Imaging Camera in Patients Undergoing Digital Subtraction Angiography
Authors: Lovětínská Vanesa , Sukop Andrej , Sulženko Jakub , Hora Adam , Patzelt Matěj , Kožnar Boris , Kovačič Karol , Kamenistý Michal , Kučerák Jozef
Published: January 2024

Background Chronic defects in the lower leg present significant challenges in plastic surgery due to their diverse etiologies and association with impaired peripheral circulation. This study describes the localization of stable perforators and assesses their changing velocities after digital subtraction angiography (DSA) and alterations of flow characteristics.

Methods Ten patients with lower extremity defects requiring DSA had undergone examinations by using standard methods. The localization of 40 stable perforators originating from the anterior tibial artery, posterior tibial artery, fibular artery, and medial sural artery was performed before and after angiography. Where stenoses or occlusions were observed, percutaneous transluminal angioplasty (PTA) was conducted, and velocity changes following reperfusion were measured.

Results Angiographic abnormalities were observed in all of patients, thus necessitating PTA interventions. Prior to PTA, handheld acoustic Dopplers detected 37 out of 40 perforators (90%), whereas color-coded sonography detected 35 out of 40 perforators (87.5%). After PTA, these numbers increased to 38 out of 40 (95%) and 37 out of 40 (92.5%), respectively. The diameter of the perforators ranged between 1.14 and 1.16 mm. The mean flow characteristics included the peak systolic velocities (PSV) of 21.9 and 27.2, end-diastolic velocities (EDV) of 9.4 and 11.4, and resistance indexes (RI) of 0.63 and 0.71, respectively. In the postintervention period, 16 microvessels exhibited enlarged lumen diameters ranging from 1 to 3 mm, resulting in increased perfusion values for PSV in 85.2% (21.9/27.2) and EDV in 88.2% (9.4/11.4) of the patients. The RI increased from 0.63 to 0.71. However, two perforators showed decreases in flow velocity after PTA.

Conclusion In most patients with chronic lower leg wounds and other comorbidities, adequate perforators for reconstruction can be identified by using conventional methods. PTA interventions positively impact blood flow in perforators, although they are not necessarily required prior to reconstruction.
Meta-Analysis and Network Analysis Differentially Detect Various
Pro-Inflammatory Mediators and Risk Factors for Type 2 Diabetes in the
Elderly
Authors: Gu Linlin , Du Yue , Liang Fang
Published: January 2024

Type 2 diabetes (T2D) has a pathophysiological component that includes
inflammation. Inflammation-sensitive marker measurement may be helpful in
determining the risk of complications for both older T2D patients and the
public. This study aimed to investigate the association between blood
pro-inflammatory mediators and the characteristics of elderly patients with T2D
using meta and network analyses. The Web of Science, Scopus, PubMed, and
Cochrane Library databases were selected as study methodology. The Quality in
Prognosis Studies (QUIPS) tool in the meta-analysis assessed the
studies’ methodological quality. The selected studies were statistically
analyzed using the META-MAR tool based on the standardized mean difference
(SMD). The selected studies included nine examinations involving 6399 old people
[+>+55 years old, 65.9+±+4.09
(mean+±+SD)]. The meta-analysis showed that
pro-inflammatory mediators (SMD 0.82) and patient-related variables [risk
factors (SMD 0.71)] were significantly associated with T2D
(p+<+0.05). Subgroup analysis revealed that tumor
necrosis factor alpha (TNF-α; SMD 1.08), body mass index (SMD 0.64),
high-density lipoprotein (HDL; SMD –0.61), body weight (SMD 0.50), and
blood pressure (SMD 1.11) were factors significantly associated with T2D
(p+<+0.05). Network analysis revealed that among patient
characteristics, diastolic blood pressure and, among inflammatory mediators,
leptin were the most closely associated factors with T2D in older adults.
Moreover, network analysis showed that TNF-α and systolic blood pressure
were most closely associated with leptin. Overall, alternate techniques, such as
meta-analysis and network analysis, might identify different markers for T2D in
older people. A therapeutic decision-making process needs to consider these
differences in advance.
Hyperbaric Oxygen Therapy to Minimize Orthodontic Relapse in Rabbits
Authors: Akbar Yun Mukmin , Maskoen Ani Melani , Mardiati Endah , Wandawa Ganesha , Amaliya Amaliya , Narmada Ida Bagus , Djustiana Nina , Evangelina Ida Ayu , Rikmasari Rasmi , Anggun Mas Rizky
Published: January 2024

Objectives The purpose of the present study was to discover how hyperbaric oxygen therapy (HBOT) could reduce orthodontic relapse by altering the expressions of hypoxia-inducible factor (HIF)-1 messenger ribonucleic acid (mRNA), type I collagen (Col I), and matrix metalloproteinase-1 (MMP-1) in the gingival supracrestal fibers in rabbits.

Materials and Methods This study involved 44 male rabbits (Oryctolagus cuniculus) randomly divided into the normal group (K0), the orthodontic group without HBOT (K1), and the orthodontic group with HBOT (K2). Following orthodontic separation of the two upper central incisors, a retention phase and relapse assessment were performed. The HBOT was performed for a period of 2, 4, 6, 8, and 10 days after retention. HIF-1α transcription was assessed employing real-time polymerase chain reaction, whereas Col I and MMP-1 proteins were examined using immunohistochemistry. The orthodontic relapse was measured clinically using a digital caliper.

Statistical Analysis We used the one-way analysis of variance followed by Tukey's post hoc for multiple comparisons to measure differences between pairs of means; a p-value of 0.05 was considered statistically significant.

Results HBOT significantly increased the HIF-1α mRNA expression (p = 0.0140), increased Col I (p = 0.0043) and MMP-1 (p = 0.0068) on the tensioned and pressured side of the gingival supracrestal fibers, respectively, and clinically decreased the relapse (p = 3.75 × 10−40).

Conclusion HBOT minimizes orthodontic relapse by influencing HIF-1α expression, collagen synthesis (Col I), and degradation (MMP-1). This result suggests that HBOT has the potential to be used as an adjunctive method in the orthodontic retention phase.
Chronic Pulmonary Aspergillosis as a Considerable Complication in Post-Tuberculosis Lung Disease
Authors: Neuböck Matthias J. , Günther Gunar , Barac Aleksandra , Davidsen Jesper R. , Laursen Christian B. , Agarwal Ritesh , Sehgal Inderpaul S. , Lange Christoph , Salzer Helmut J.F. ,   for CPAnet
Published: January 2024

Post-tuberculosis lung disease (PTLD) has only recently been put in the spotlight as a medical entity. Recent data suggest that up to 50% of tuberculosis (TB) patients are left with PTLD-related impairment after completion of TB treatment. The presence of residual cavities in the lung is the largest risk factor for the development of chronic pulmonary aspergillosis (CPA) globally. Diagnosis of CPA is based on four criteria including a typical radiological pattern, evidence of Aspergillus species, exclusion of alternative diagnosis, and a chronic course of disease. In this manuscript, we provide a narrative review on CPA as a serious complication for patients with PTLD.
Nasal Breathing Assessment Using Computational Fluid Dynamics: An Update from the Rhinologic Perspective
Authors: Hildebrandt Thomas , Heppt Werner Johannes
Published: January 2024

An objective assessment of nasal breathing is currently insufficiently achievable. The application of computational fluid dynamics for this purpose is increasingly gaining attention. However, the suggested specific frameworks can differ considerably. To the best of our knowledge, there is not yet a widely accepted clinical usage of computational fluid dynamics. In this article, selected aspects are addressed that might be crucial for future development and possible implementation of computational fluid dynamics in rhinology.
Orchestration of Genetic Alterations in PSEN1 and PSEN2 Genes in Development of Alzheimer's Disease through Computational Analysis
Authors: Mir Asif , Kamran Zainab , Iqbal Wajid
Published: January 2024

Dementia is a syndrome that can cause a number of progressive illnesses that affect memory, thinking, and ability to perform everyday tasks. Alzheimer's disease (AD) is the most common cause of dementia and represents a major public health problem. AD is a progressive disease, where in early stages there is mild memory loss and in late-stage patient loses the ability to carry on a conversation. AD (for which there is no exact cause and cure known so far) is the sixth leading cause of deaths in the United States. Every 68 second someone develops AD. This study focuses on protein structure modeling of genes presenilin 1 and 2 (PSEN1 and PSEN2) and their mutated forms (Asn141Tyr found in Chinese family, Gly34Ser identified in a Japanese patient, and Arg62Cys & Val214Leu identified in the Korean patients). It also involves wild and mutant type comparison, protein interaction studies, docking and phylogenetic history based on representative ortholog species and also sheds insight into the comparative evolutionary rates of coding sequence across various orthologs. This study gives a time and cost-effective analysis of genes (PSEN1 and PSEN2) underlying AD and genetic alterations that drive development and causes of disease.
Utility of J-Shaped Scar Tissue-Based Flap for Secondary Bilateral Cleft Lip Repair: A One-Stage Procedure with Successful Outcomes on Correction of Vermilion Border, Volume Deficiency of Lip, and Muscular Function
Authors: Okumus Ayhan
Published: January 2024

This study aimed to evaluate the utility of J-shaped scar-tissue-based flap as a new technique in secondary bilateral cleft lip reconstruction in patients with challenging secondary deformities. A total of 52 patients, comprising 38 males and 14 females with a mean age of 21.0 years (range: 16–42 years), who underwent secondary bilateral cleft lip repair operation via the J-shaped scar tissue flap technique in our clinic between 2014 and 2019 were included. Postoperatively, patients were followed up for an average of 2 years (range, 6 months to 5 years) to assess the outcomes regarding vermilion border, philtrum symmetry, function of the orbicularis muscle, and lip volumetric symmetry, based on the Global Aesthetic Improvement Scale (GAIS), patient-reported outcomes, and independent plastic surgeons' examinations. After an average follow-up of 2 years, outcomes regarding vermilion border, philtrum symmetry, function of the orbicularis muscle, and lip volumetric symmetry were successful, and none of the patients experienced new notch formation, muscular functional loss, lip volume loss, or asymmetry. Owing to good muscular function preventing the stretching, the postoperative scars become more acceptable to the patients. The technique has proven to be safe and successful through the GAIS objective assessment, as also confirmed by the examinations of the three independent surgeons, while the majority of patients reported an exceptional improvement in the appearance alongside a more than 95% satisfaction rate with the operation. In conclusion, our findings revealed successful functional and aesthetic outcome of using J-shaped scar tissue flaps in secondary repair of cleft lips. The technique was associated not only with the correction of significant secondary deformities yielding an improved and symmetrical lip volume, correction of vermilion notch, and prevention of notch re-formation but also with the restoration of orbicularis oris muscle function and thus integrity of the lip with minimal scarring.
Sample Size Considerations in the Design of Orthopaedic Risk-Factor Studies
Authors: Evans Richard , Pozzi Antonio
Published: January 2024

Objective Sample size calculations play a central role in risk-factor study design because sample size affects study interpretability, costs, hospital resources and staff time. We demonstrate the consequences of using misclassified control groups on the power of risk association tests, with the intent of showing that control groups with even small misclassification rates can reduce the power of association tests. So, sample size calculations that ignore misclassifications may underpower studies.

Study Design This was a simulation study using study designs from published orthopaedic risk-factor studies. The approach was to use their designs but simulate the data to include known proportions of misclassified affected subjects in the control group. The simulated data were used to calculate the power of a risk-association test. We calculated powers for several study designs and misclassification rates and compared them to a reference model.

Results Treating unlabelled data as disease-negative only always reduced statistical power compared with the reference power, and power loss increased with increasing misclassification rate. For this study, power could be improved back to 80% by increasing the sample size by a factor of 1.1 to 1.4.

Conclusion Researchers should use caution in calculating sample sizes for risk-factor studies and consider adjustments for estimated misclassification rates.
Early Time Courses of Recurrent Venous Thromboembolism and Bleeding during Apixaban or Dalteparin Therapy for Patients with Cancer
Authors: Cohen Alexander T. , Creeper Katherine J. , Alikhan Raza , Er Chaozer , Connors Jean M. , Huisman Menno V. , Munoz Andres , Vescovo Giorgio , Bauersachs Rupert , Ageno Walter , Agnelli Giancarlo , Becattini Cecilia
Published: January 2024

Background In patients with acute venous thromboembolism (VTE), the rates of recurrence and major bleeding are highest during the first weeks of anticoagulation. The CARAVAGGIO trial demonstrated noninferiority of apixaban to dalteparin for treatment of cancer-associated VTE without an increased risk of major bleeding. We compared the early time course of VTE recurrence and major bleeding events of apixaban compared with dalteparin at 7, 30, and 90 days of treatment in patients with cancer-associated VTE.

Methods The study design of the CARAVAGGIO trial has been described. Eligible patients were randomly assigned to receive monotherapy with either apixaban or dalteparin for 6 months. The primary efficacy outcome was the incidence of objectively confirmed recurrent VTE. The primary safety outcome was major bleeding.

Results In 1,155 patients, recurrent VTE after 7, 30, and 90 days occurred in 6 (1%), 15 (2.6%), and 27 (4.7%) patients in the apixaban arm versus 5 (0.9%), 20 (3.5%), and 36 (6.2%) patients respectively in the dalteparin arm. By day 7, 30, and 90, major bleeding events had occurred in 3 (0.5%), 9 (1.6%), and 16 (2.8%) patients in the apixaban group versus 5 (0.9%), 11 (1.9%), and 17 (2.9%) patients in the dalteparin group.

Conclusion The frequencies of recurrent VTE and major bleeding events at 7, 30, and 90 days of apixaban compared with dalteparin were similar in patients with cancer-associated VTE. This supports the use of apixaban for the initiation and early phase of anticoagulant therapy in cancer-associated VTE.
Impacts of internet access and use on grain productivity: evidence from Central China
Authors: Li Xiaohui , Xiong Hang , Hao Jinghui , Li Gucheng
Published: January 2024

The impacts of Internet use on farming productivity in China have been extensively examined. However, existing studies focus on non-grain crops and often do not distinguish between Internet access and Internet use. This study investigates the effects of both Internet access and Internet use for farming purposes on farmers’ technical efficiency (TE) using data collected from 855 grain-farmers in Central China. The TE is evaluated following a stochastic frontier analysis approach. Endogenous switching regression models are used to address the potential endogeneity issue associated with Internet access or use. Our empirical results show that the use of the Internet for obtaining farming-related information is crucial for improving farmers’ TE. Having access to the Internet itself does not necessarily improve TE. This is also true when considering the effects through the two channels of technology adoption and risk management. Furthermore, using the Internet for non-farming purposes could impede the improvement of TE. Heterogeneity analysis indicates that the Internet can help to reduce the discrepancy of TE among grain farmers.
A new particle filter algorithm filtering motion artifact noise for clean electrocardiogram signals in wearable health monitoring system
Authors: Ma Min , Du Mingrui , Feng Qiuyue , Xiahou Shiji
Published: January 2024

With the evolution of wearable systems, more and more people tend to wear wearable devices for health monitoring during sports. However, a large amount of motion artifact noise is introduced at this time, which is difficult to filter out due to its stochasticity. The amplitude and characteristics of motion artifact noise vary with changes in motion intensity. In order to filter out the motion artifact noise, the paperproposes a new particle algorithm, which can detect the intensity of the motion artifact for adaptive filtering, especiallysuitable for wearable health monitoring systems. In this algorithm, variational mode decomposition was first introduced to analyze the noisy electrocardiogram (ECG) signal in order to find the clean components. Then, the Laguerre estimation technique was applied to obtain an accurate ECG polar model. Taking this model as the state equation, a particle filter algorithm was defined to filter out the motion artifact noise. In the particle filter algorithm, we defined a parameter γ whose values were obtained from the six-axis data of motion sensor MPU6050 in our wearable device. This parameter γ could reflect the current noise levels and adaptively update the particle weights. Finally, some exercise experiments proved that the parameter γ could map the motion artifacts in real time and also demonstrated the superiority of the algorithm in terms of signal-to-noise ratio improvement and error reduction compared to other algorithms. The new particle filter algorithm proposed in this paper combines the six-axis data (three-axis accelerometer and three-axis gyroscope) with the ECG signal to effectively eliminate a large amount of motion artifact noise, thus solving the problem of excess noise from wearable devices when people are exercising, allowing them to accurately obtain real-time ECG health information.
Early warnings of tipping in a non-autonomous turbulent reactive flow system: Efficacy, reliability, and warning times
Authors: Banerjee Ankan , Pavithran Induja , Sujith R. I.
Published: January 2024

Real-world complex systems such as the earth’s climate, ecosystems, stock markets, and combustion engines are prone to dynamical transitions from one state to another, with catastrophic consequences. State variables of such systems often exhibit aperiodic fluctuations, either chaotic or stochastic in nature. Often, the parameters describing a system vary with time, showing time dependency. Constrained by these effects, it becomes difficult to be warned of an impending critical transition, as such effects contaminate the precursory signals of the transition. Therefore, a need for efficient and reliable early-warning signals (EWSs) in such complex systems is in pressing demand. Motivated by this fact, in the present work, we analyze various EWSs in the context of a non-autonomous turbulent thermoacoustic system. In particular, we investigate the efficacy of different EWS in forecasting the onset of thermoacoustic instability (TAI) and their reliability with respect to the rate of change of the control parameter. This is the first experimental study of tipping points in a non-autonomous turbulent thermoacoustic system. We consider the Reynolds number (Re) as the control parameter, which is varied linearly with time at finite rates. The considered EWSs are derived from critical slowing down, spectral properties, and fractal characteristics of the system variables. The state of TAI is associated with large amplitude acoustic pressure oscillations that could lead thermoacoustic systems to break down. We consider acoustic pressure fluctuations as a potential system variable to perform the analysis. Our analysis shows that irrespective of the rate of variation of the control parameter, the Hurst exponent and variance of autocorrelation coefficients warn of an impending transition well in advance and are more reliable than other EWS measures. Additionally, we show the variation in the warning time to an impending TAI with rates of change of the control parameter. We also investigate the variation in amplitudes of the most significant modes of acoustic pressure oscillations with the Hurst exponent. Such variations lead to scaling laws that could be significant in prediction and devising control actions to mitigate TAI.