bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms of Stigmatization in Family-Based Prevention and Treatment of Childhood Overweight and Obesity
Authors: Hoeeg Didde , Frohlich Katherine L. , Christensen Ulla , Grabowski Dan
Published: September 2023

It is well established that overweight and obesity are often accompanied by stigmatization. However, the influence of stigmatization on interventions for overweight and obesity remains unknown. Stigma may be particularly harmful to children. This study aimed to examine how stigmatization affects efforts to reduce childhood overweight and obesity through family interventions. This research was conducted in a socially disadvantaged area in Denmark. Twenty-seven families and forty professionals participated in in-depth interviews or workshops. The data were analyzed using CMO configurations from a realist evaluation and the theory of stigmatization developed by Link and Phelan. Thus, an abductive approach was employed in the analysis, with its foundation rooted in the empirical data. The study found that the mechanisms of stigmatization could 1. restrain professionals and parents from approaching the problem—thereby challenging family recruitment; 2. prevent parents from working with their children to avoid eating unhealthy food for fear of labeling the child as overweight or obese; and 3. cause children with obesity to experience a separation from other slimmer family members, leading at times to status loss, discrimination, and self-stigmatization. The study showed how the mechanisms of stigmatization may obstruct prevention and treatment of childhood obesity through family interventions. It is suggested that the concept of stigma should be incorporated into the program theories of interventions meant to reduce childhood overweight and obesity.
Predictors of Parental Acceptance towards Contemporary Behavior Management Techniques Used in Pediatric Dentistry: A Preliminary Study on Turkish Population
Authors: Candan Merve , Kutlu Elifcan , Yilmaz Karaman İmran
Published: September 2023

Background: Parents, who make the final decision regarding their child’s treatment, play a significant role in their dental care. Parental approval is important for each stage of treatment and may affect the physician’s approach to the treatment. Therefore, it is essential for pediatric dentists to comprehend which behavior management techniques (BMTs) are acceptable to parents and to identify the factors that influence their acceptability. Methods: Parents who were bringing their children for dental treatment answered a survey on the acceptance of twenty contemporary BMTs. The sociodemographic data of the parents and the age, gender, and Frankl behavior rating scale (Frankl) scores of their children were recorded. Parents were asked to indicate their level of acceptance of each BMT. Binary logistic regression analysis was designed to see the predictors of “accepted” and “declined” answers. Results: According to acceptance frequencies, the most accepted technique was communication and communicative guidance. The most declined technique was parental absence. The child’s age, gender, Frankl score, parental educational status, and parent type predict the acceptability of some BMTs. Conclusion: This study revealed that pediatric dentists must consider parent and child factors when selecting BMTs for children. We believe that this study can provide a basis for determining which factors pediatric dentists should consider when selecting individualized BMTs.
Long-Term Results after Chiari Pelvic Osteotomy in the Skeletally Immature and the Role of the Anti-Chiari Effect
Authors: Schneider Eleonora , Lutschounig Marie-Christine , Vertesich Klemens , Schreiner Markus , Peloschek Philipp , Bork Daniel , Windhager Reinhard , Chiari Catharina
Published: September 2023

Several authors observed a loss of correction after performing Chiari pelvic osteotomy (CPO) in young patients. Hence, the aim of this study was to answer two questions: (1) Does the Chiari pelvic osteotomy affect the development of the acetabulum in skeletally immature patients in the long term? (2) Is there any evidence of the previously described “Anti-Chiari” effect after a mean follow-up of 36 years? Data from 21 patients (27 hips) undergoing CPO before the age of 16 years were clinically assessed, and the evolution of radiological parameters over time was analyzed. The mean age at CPO was 11.2 years (±3; 4.4–15.7). The 20- and 30-year survival rates of the CPO were 100% and 92.6%, respectively. Mean postoperative medialization was 54% (±18; 23–99). The average osteotomy angle was 11° (±7; 2–28). No significant changes were found for the center-edge angle (CEA) and acetabular index (AI) over time; the angle of Idelberger and Frank (ACM) almost reached normal values at follow-up (FU); for the acetabular-head index (AHI), a slight shift toward the initial situation could be detected. The morphology of the acetabulum remained unchanged over time. The “Anti-Chiari effect” seems to be primarily caused by insufficient coverage of the femoral head rather than damage to the apophysis due to surgery.
Comprehensive Evaluation of Inflammatory Biomarkers and Osmolarity to Distinguish Simple and Complex Febrile Seizures in Children
Authors: Erdede Özlem , Sarı Erdal , Uyur Emek , Sezer Yamanel Rabia Gönül
Published: September 2023

With limited sample sizes and varying study outcomes regarding complete blood count (CBC)-associated biomarkers and their febrile seizure (FS) classification, along with limited research on osmolarity, this study aims to evaluate CBC-associated biomarkers, including osmolarity, for a comprehensive view of their diagnostic value. This single-center retrospective study used data from 364 children (aged 5–60 months) diagnosed with FS. The patients were categorized into simple FS (n = 221) and complex FS (n = 143) groups. CBC and biochemical tests, including sodium, potassium, chloride, glucose, blood urea nitrogen, and C-reactive protein levels, were evaluated. The neutrophil-to-lymphocyte ratio (NLR), mean platelet volume-to-lymphocyte ratio, and osmolarity were calculated and compared between FS types and the number of seizures. Receiver operating characteristic (ROC) curve analysis was conducted to assess the predictive utility of these markers. Inflammatory markers, including NLR, were ineffective in predicting FS types. Complex FS cases exhibited a significantly lower osmolarity than simple FS cases. The area under the ROC curve for osmolarity to distinguish complex FS was 0.754, while other markers did not reach the desired threshold of 0.700. Including osmolarity in the classification of FS has clinical applicability. Physicians may consider osmolarity as an additional tool to aid in clinical decision-making.
Specific Learning Disorders in Children and Adolescents with Obesity
Authors: Calcaterra Valeria , Schneider Laura , Baresi Stefano , Bodini Francesca , Bona Federica , Chillemi Claudia , De Silvestri Annalisa , Zanelli Sara , Zuccotti Gianvincenzo
Published: September 2023

Specific learning disorders (SLDs) are the most frequently diagnosed developmental disorders in childhood. Different neurocognitive patterns have been found in patients with overweight and obesity, but no data on childhood obesity and SLDs have been reported. To increase our understanding of the relationship between neuropsychological developmental and obesity, we assessed the prevalence of SLD in a pediatric population with obesity. We retrospectively included 380 children and adolescents with obesity. For all participants, auxological, metabolic, demographic features, relationship and social skills, anamnestic data on pregnancy and the perinatal period, stages of development and family medical history were reviewed. SLD was defined according to the DSM-5 criteria. A group of 101 controls of normal weight was included. The overall prevalence of SLD was 10.8%, and SLD was more prevalent in patients with obesity (p < 0.001), with male predominance (p = 0.01). SGA was associated with SLD (p = 0.02). Speech retardation (p < 0.001), limited relationships with peers (p < 0.001) and didactic support (p < 0.001) were noted in the SLD group compared to the group without SLD. A higher prevalence of family history of neuropsychiatric disorders was observed in the SLD group (p = 0.04). A higher fasting glucose level was detected in patients with obesity and SLD compared to subjects without SLD (p = 0.01). An association between obesity and SLD could not be excluded, and an overlap of pathogenic factors for both conditions should be considered.
Study of the Application of Recycled Gold Nanoparticles in Coatings for Eyewear Lenses
Authors: Majerič Peter , Koruga Djuro , Njegovan Zorana , Jelen Žiga , Švarc Tilen , Horvat Andrej , Rudolf Rebeka
Published: September 2023

The surface plasmon resonance of gold nanoparticles causes visible light absorption and scattering effects that may be used in optical coatings for eliminating blue light emission from display monitors, for blocking UV light, and for decorative applications. This study examines the achievement of functional properties provided by gold nanoparticles in a commercially established C60 fullerene-coated eyewear product. The gold nanoparticles used were sourced from recycling rapid lateral flow tests (LFIA), which use gold nanoparticles as test markers. After the gold’s recovery, Ultrasonic Spray Pyrolysis (USP) with freeze-drying was used for the synthesis of new gold nanoparticles, to be used in optical coatings. The gold nanoparticles were examined with SEM, TEM, DLS, zeta potential, BET, and Vis-NIR for characterising their shapes and sizes, as is required for determination of the surface plasmon resonance effect. After applying the newly produced gold nanoparticles with fullerene C60 in a combined coating for eyewear lenses, the absorption and transmission of the lenses were determined for establishing changes in the coating’s functionality. The results show that enhancing the fullerene C60 coating with gold nanoparticles improves light absorption and reflectance for blue and UV light further, which may be evaluated as beneficial for the eyewear user, as the reduction in eye strain is increased due to the coating.
Optimization of Friction Stir Processing Parameters for Improvement of Mechanical Properties of AlSi7Mg0.2 Alloy
Authors: Alzahrani Mahmoud , Alsoruji Ghazi , Moustafa Essam , Mosleh Ahmed , Mohamed Samah
Published: September 2023

This paper investigates the effects of Friction Stir Processing (FSP) parameters on the microstructure and mechanical properties of an Al-Si7Mg0.2 alloy. The study’s findings indicate that augmenting the rotational velocity of the tool in the context of Friction Stir Processing can reduce grain size and enhance the alloy’s mechanical properties. The optimization of process temperature plays a vital role in managing the thermal profile and preventing undesirable consequences such as overheating or excessive cooling. These adverse effects can significantly impact the microstructure and properties of the alloy. The finer grain size of the FSPed samples resulted from the intense plastic deformation and dynamic recrystallization during the process. This grain refinement improved hardness, wear, and corrosion resistance. The temperature distribution during FSP using finite element simulation was highly dependent on the process parameters, such as the rotational speed and the dwell time. The results of this study are employed to develop a fitting model to predict the temperature distribution along the workpiece during the dwelling stage, which can be used to optimize the process parameters for different applications. The optimization of the heat generation inside the stirred zone plays a vital role in managing the thermal profile and preventing undesirable consequences such as overheating or excessive cooling. These adverse effects can significantly impact the microstructure and properties of the alloy.
Surface-Active Ionic-Liquid-Based Coatings as Anti-Biofilms for Stone: An Evaluation of Their Physical Properties
Authors: Luci Marika , De Leo Filomena , De Pascale Donatella , Galasso Christian , La Russa Mauro Francesco , Lo Schiavo Sandra , Ricca Michela , Ruffolo Silvestro Antonio , Ruocco Nadia , Urzì Clara
Published: September 2023

The biodeterioration of stone surfaces can be a threat to the conservation of built heritage. Much effort has been put into finding treatments and processes to mitigate biocolonization and its effects, both in terrestrial and underwater environments. Recently, the use of surfactant ionic liquids has been shown to have biocidal and antifouling effects on stone. However, little information is currently available on the morphological and physical properties of such coatings. In this paper, we report on the physical characterization of coatings based on an ionic liquid (IL) consisting of N-(2-hydroxyethyl)-N,N-dimethyl-1-do-decanaminium cation and a combination of bromide and dodecylbenzenesulfonate (DBS) anions in a molar ratio of 3:1, respectively. Nanosilica and tetraethyl orthosilicate were used as binders to promote the adhesion of the ionic liquid to the stone surface. The coatings were applied on Carrara marble samples and analyzed using Scanning Electronic Microscopy (SEM), static contact angles, colorimetric measurements and capillary water absorption. The resistance to UV radiation and seawater was also investigated. The results show that the IL behaves differently depending on the binder. The latter influences the arrangement of the IL and its wettability, which decreases in the case of NanoEstel, whereas this parameter increases in the case of Estel. In addition, the coatings show good resistance to the degradation agents.
Model and Fuzzy Controller Design Approaches for Stability of Modern Robot Manipulators
Authors: Mustary Shabnom , Kashem Mohammod Abul , Chowdhury Mohammad Asaduzzaman , Uddin Jia
Published: September 2023

Robotics is a crucial technology of Industry 4.0 that offers a diverse array of applications in the industrial sector. However, the quality of a robot’s manipulator is contingent on its stability, which is a function of the manipulator’s parameters. In previous studies, stability has been evaluated based on a small number of manipulator parameters; as a result, there is not much information about the integration/optimal arrangement/combination of manipulator parameters toward stability. Through Lagrangian mechanics and the consideration of multiple parameters, a mathematical model of a modern manipulator is developed in this study. In this mathematical model, motor acceleration, moment of inertia, and deflection are considered in order to assess the level of stability of the ABB Robot manipulator of six degrees of freedom. A novel mathematical approach to stability is developed in which stability is correlated with motor acceleration, moment of inertia, and deflection. In addition to this, fuzzy logic inference principles are employed to determine the status of stability. The numerical data of different manipulator parameters are verified using mathematical approaches. Results indicated that as motor acceleration increases, stability increases, while stability decreases as moment of inertia and deflection increase. It is anticipated that the implementation of these findings will increase industrial output.
Hirshfeld Surface Analysis and Density Functional Theory Calculations of 2-Benzyloxy-1,2,4-triazolo[1,5-a] quinazolin-5(4H)-one: A Comprehensive Study on Crystal Structure, Intermolecular Interactions, and Electronic Properties
Authors: Bakheit Ahmed H. , Abuelizz Hatem A. , Al-Salahi Rashad
Published: September 2023

This study employs a comprehensive computational analysis of the 2-benzyloxy-1,2,4-triazolo[1,5-a] quinazolin-5(4H)-one (ID code: CCDC 834498) to explore its intermolecular interactions, surface characteristics, and crystal structure. Utilizing the Hirshfeld surface technique and Crystal Explorer 17.5, the study maps the Hirshfeld surfaces for a detailed understanding of atom pair close contacts and interaction types. The study also investigates the compound’s electronic and optical characteristics using Frontier Molecular Orbital (FMO) analysis and Global Reactivity Parameters (GRPs). The compound is identified as electron-rich with strong electron-donating and accepting potential, indicating its reactivity and stability. Its band gap suggests Nonlinear Optical (NLO) attributes. The Molecular Electrostatic Potential (MEP) map reveals charge distribution across the compound’s surface. The computational methods’ reliability is validated by the low Mean Absolute Error (MAE) and Mean Squared Error (MSE) in the comparison of experimental and theoretical bond lengths and angles.
Optimized Design with Artificial Intelligence Quantum Dot White Mini LED Backlight Module Development
Authors: Lee Tzu-Yi , Huang Wei-Ta , Chen Jo-Hsiang , Liu Wei-Bo , Chang Shu-Wei , Chen Fang-Chung , Kuo Hao-Chung
Published: September 2023

This study delves into the innovation of mini light-emitting diode (mini-LED) backlight module designs, a significant advancement in display technology. The module comprises a substrate, a receiving plane, and an LED structure, which uses a blue light with specific spectral characteristics. When combined with a red-green quantum dot (QD) film, it produces white light. For improved illumination uniformity, the Mini-LED structure was optimized with a focus on the thickness and concentration of layers, especially the TiO2 diffusion layer. A comprehensive design methodology using LightTools (8.6.0) optical simulation software was employed, linked with MATLAB (R2022a) for varied parameters and using the double deep Q-network (DDQN) algorithm via Python as a reinforcement learning agent. This approach facilitated optimal architecture design based on illumination uniformity. Also, the bidirectional scattering distribution function (BSDF) was employed to calculate the scattering properties of the backlight module’s surface, providing accurate simulation results. The DDQN algorithm enhanced the learning design, reducing simulation runs by 76.7% compared to traditional methods. The optimized solution achieved an impressive illumination uniformity of 83.8%, underscoring the benefits of integrating advanced algorithms into display technology optimization.
An Algorithm for the Development of a Recombinant Antiherpetic Subunit Vaccine Combining the Crystal Structure Analysis, AlphaFold2-Based Modeling, and Immunoinformatics
Authors: Rakitina Tatiana , Smirnova Evgeniya , Podshivalov David , Timofeev Vladimir , Komolov Aleksandr , Vlaskina Anna , Gaeva Tatiana , Vasilov Raif , Dyakova Yulia , Kovalchuk Mikhail
Published: September 2023

Using the envelope glycoprotein B (gB) crystal structure and digital prediction algorithm, the B- and T-cell antigenic determinants (epitopes) of human herpesvirus 1 (HHV-1), also known as herpes simplex virus 1 (HSV-1), were generated, and the method for their production in the form of recombinant proteins was proposed. First, the structure of the surface topological domain (ectodomain or spike) of gB with mapped epitopes was analyzed, and the most stable and immunogenic (due to their enrichment with B-and T-cell epitopes) subdomains were selected for the modeling of subunit vaccine prototypes using the AlphaFold2 (Google DeepMind, London, UK) artificial intelligence system. The proposed candidate vaccines included both small (about 100 amino acids) monomeric polypeptides, which were ideal for recombinant expression as fusion proteins, and a more complex polypeptide, which, due to its trimeric fold, looks like a miniature analog of the gB ectodomain. In this miniature analog, the ectodomain regions with the potential to interfere efficacious expression of soluble recombinant protein in Escherichia coli have been removed. The structural stability of the modeled proteins, confirmed by molecular dynamics simulation and host immune responses, predicted in silico, indicates the suitability of the two suggested polypeptides for generating subunit vaccines using recombinant DNA technology.
Use of X-ray Microscopy for Confirmation of Crystallinity Detection in Amorphous Formulations by Electrospray Laser Desorption Ionization Mass Spectrometry Imaging
Authors: Ramp Kelsey K. , Dierckman Noah R. , Sperry Margaret A. , Reuter Matthew E. , Tang Yongan , Webster Gregory K. , McVey Patrick A.
Published: September 2023

The use of mass spectrometry imaging for crystallinity detection offers improved matrix selectivity and sensitivity over the techniques, such as X-ray microscopy and Raman spectrometry, that are traditionally used with this work. Crystallinity is observed in electrospray laser desorption ionization mass spectrometry imaging (ELDI-MSI) as a high-intensity agglomeration of the analyte in a spatially resolved image. As this is an indirect method of crystallinity detection, confirmation of this method’s ability to detect crystallization in amorphous formulations is needed by directly correlating observations of tablet crystallinity by ELDI-MSI to those of an established detection technique. Micro-computed tomography (micro-CT) has the necessary sensitivity for this investigation and is ideal for use in evaluating the correlation with crystallinity detection by ELDI-MSI. In this work, micro-CT followed by ELDI-MSI, in the same location on tablets of amorphous formulations of miconazole spiked with trace levels of crystalline miconazole, were analyzed. Crystals detected by ELDI-MSI as an agglomeration spatially matched with the detected crystals but were chemically unidentified by micro-CT. The results of this correlation study and a conclusion about the effectiveness of ELDI-MSI as a complimentary technique to indirectly detect crystallinity in enabling formations of an amorphous API are presented.
Analytical Solution of the Interference between Elliptical Inclusion and Screw Dislocation in One-Dimensional Hexagonal Piezoelectric Quasicrystal
Authors: Zhang Zhiguo , Li Xing , Ding Shenghu
Published: September 2023

This study examines the interference problem between screw dislocation and elliptical inclusion in one-dimensional hexagonal piezoelectric quasicrystals. The general solutions are obtained using the complex variable function method and the conformal transformation technique. When the screw dislocation is located outside or inside the elliptical inclusion, the perturbation method and Laurent series expansion are employed to derive explicit analytical expressions for the complex potentials in the elliptical inclusion and the matrix, respectively. Considering four types of far-field force and electric loading conditions, analytical solutions for various specific cases are obtained by using matrix operations. Expressions for the phonon field stress, phason field stress, and electric displacement are given for special cases, including the absence of a dislocation, the presence of an elliptical hole, and the interference between a screw dislocation and circular inclusion, as well as the case of a circular hole. The design and analysis of quasicrystal inclusion structures can benefit from the results of this work.
Simple Synthesis of 3D Ground-Moss-Shaped MnO@N-C Composite as Superior Anode Material for Lithium-Ion Batteries
Authors: Zhai Yanjun , Gai Longhui , Gao Yingjian , Tong Ziwei , Wang Wenlin , Cao Huimei , Zeng Suyuan , Qu Konggang , Bai Zhongchao , Tian Gang , Wang Nana
Published: September 2023

A MnO@N-doped carbon (MnO@N-C) composite, with a three-dimensional (3D) ground-moss-like structure, was synthesized through hydrothermal treatment, polydopamine coating, and calcination, all without the use of surfactants. In lithium-ion batteries, the MnO@N-C sample, when used as an anode, achieved a performance of 563 mAh g−1 at 1.0 A g−1 across 300 cycles and boasted an initial Coulombic efficiency of 73.2%. In contrast, the MnO electrode had a discharge capacity of 258 mAh g−1 and an efficiency of 53.3% under the same conditions. The improved performance stems from the 3D carbon networks hosting MnO. These networks enhance MnO’s electron transfer ability and offer space to offset volume changes during the charge–discharge cycle.
Taxonomic Status and Composition of the Genera Caulaster, Porcellanaster and Eremicaster (Asteroidea) Based on Juvenile Morphology and Molecular Phylogenetic Data
Authors: Mironov Alexandr N. , Dilman Anna B. , Petrov Nikolay B. , Vladychenskaya Irina P.
Published: September 2023

The genus Porcellanaster Thomson 1878 has hitherto included two species, the type species P. ceruleus Thomson, 1878 and P. ivanovi Belyaev, 1969. According to WoRMS, the full list of junior synonyms of P. ceruleus consists of 15 specific names, including porcellanasterids of the genera Caulaster Perrier 1882 and Albatrossia Ludwig 1905. In this paper, the morphology of juvenile and adult Porcellanaster and synonymized species from the Atlantic, Pacific, Indian and Southern Oceans are studied. As a result, the composition of the genus Porcellanaster has been revised. The genus Caulaster is re-established and now includes two species, and two new morphological forms of Caulaster are described. The genera Albatrossia and Damnaster H.E.S Clark & McKnight, 1994 are considered junior synonyms of Caulaster. The number of species of the genus Porcellanaster has increased to five, including the recovered P. caulifer, P. fragilis and P. sladeni. The study of representatives of the closely related genus Eremicaster Fisher, 1905 has not led to a change in its species composition. The main diagnostic feature of Caulaster is the presence of adambulacral and dorsal pedicellariae both in adults and juveniles with a major radius (R) greater than 3.5 mm. Pedicellariae have never been found in Porcellanaster or Eremicaster at any stage of postlarval development. The species of Caulaster and some species of Porcellanaster are the smallest porcellanasterids, with the most simplified morphology and reduced papulae and paxillae responsible for respiration. These genera are located on the phylogenetic tree in different clades, which demonstrates the parallel evolution of these taxa and confirms the validity of the genus Caulaster. One of the reasons for miniaturization is likely the burrowing mode of life with feeding on subsurface sediment of low nutritional value. The simplification of morphology can be traced by many morphological charactercs in many ways, including the reduction in papulae and paxillae.
Enhancing Disassembly Practices for Electric Vehicle Battery Packs: A Narrative Comprehensive Review
Authors: Beghi Matteo , Braghin Francesco , Roveda Loris
Published: September 2023

In the context of current societal challenges, such as climate neutrality, industry digitization, and circular economy, this paper addresses the importance of improving recycling practices for electric vehicle (EV) battery packs, with a specific focus on lithium–ion batteries (LIBs). To achieve this, the paper conducts a systematic review (using Google Scholar, Scopus, and Web of Science as search engines), considering the last 10 years, to examine existing recycling methods, robotic/collaborative disassembly cells, and associated control techniques. The aim is to provide a comprehensive and detailed review that can serve as a valuable resource for future research in the industrial domain. By analyzing the current state of the field, this review identifies emerging needs and challenges that need to be addressed for the successful implementation of automatic robotic disassembly cells for end-of-life (EOL) electronic products, such as EV LIBs. The findings presented in this paper enhance our understanding of recycling practices and lay the groundwork for more precise research directions in this important area.
Application of Multimodal MRI in the Early Diagnosis of Autism Spectrum Disorders: A Review
Authors: Wang Miaoyan , Xu Dandan , Zhang Lili , Jiang Haoxiang
Published: September 2023

Autism spectrum disorder (ASD) is a neurodevelopmental disorder in children. Early diagnosis and intervention can remodel the neural structure of the brain and improve quality of life but may be inaccurate if based solely on clinical symptoms and assessment scales. Therefore, we aimed to analyze multimodal magnetic resonance imaging (MRI) data from the existing literature and review the abnormal changes in brain structural–functional networks, perfusion, neuronal metabolism, and the glymphatic system in children with ASD, which could help in early diagnosis and precise intervention. Structural MRI revealed morphological differences, abnormal developmental trajectories, and network connectivity changes in the brain at different ages. Functional MRI revealed disruption of functional networks, abnormal perfusion, and neurovascular decoupling associated with core ASD symptoms. Proton magnetic resonance spectroscopy revealed abnormal changes in the neuronal metabolites during different periods. Decreased diffusion tensor imaging signals along the perivascular space index reflected impaired glymphatic system function in children with ASD. Differences in age, subtype, degree of brain damage, and remodeling in children with ASD led to heterogeneity in research results. Multimodal MRI is expected to further assist in early and accurate clinical diagnosis of ASD through deep learning combined with genomics and artificial intelligence.
Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock
Authors: Elmenyar Eman , Aoun Sarah , Al Saadi Zain , Barkumi Ahmed , Cander Basar , Al-Thani Hassan , El-Menyar Ayman
Published: September 2023

Thyroid storm (TS) is a rare and fatal endocrine emergency that occurs due to undiagnosed and inadequately treated hyperthyroidism after stressful conditions in patients with thyroid disorders. The objective of this systematic scoping review was to better understand the pathophysiology of TS and its complications, in terms of myocardial affection, tachyarrhythmia, and cardiogenic shock. In addition, we explored the pharmacological, mechanical, and surgical treatments for TS. We also evaluated the outcomes of TS according to sex and cardiac involvement. Additionally, analytical analysis was performed on the selected data. A literature review of peer-reviewed journals was carried out thoroughly using medical terms, MeSH on PubMed, Google Scholar, and combinations such as thyrotoxicosis-induced cardiomyopathy, thyroid storm, cardiogenic shock, myocardial infarction, endocrine emergency, Burch–Wartofsky score, extracorporeal circulatory support, and thyroidectomy. A total of 231 papers were eligible (2 retrospective studies, 5 case series, and 224 case reports) with a total of 256 TS patients with cardiac involvement between April 2003 and August 2023. All age groups, sexes, patients with TS-induced cardiomyopathy, non-atherosclerotic myocardial infarction, tachyarrhythmia, heart failure, shock, and different forms of treatment were discussed. Non-English language articles, cases without cardiac involvement, and cases in which treatment modalities were not specified were excluded. Female sex was predominant, with 154 female and 102 male patients. Approximately 82% of patients received beta-blockers (BBs), 16.3% were placed on extracorporeal membrane oxygenation (ECMO) support, 16.3% received therapeutic plasma exchange (TPE), and 13.8% underwent continuous renal replacement therapy (CRRT), continuous venovenous hemofiltration (CVVHD), or dialysis. Overall, 18 females and 16 males died. BB-induced circulatory collapse, acute renal failure, CRRT, and ventricular fibrillation were significantly associated with mortality. Awareness of TS and not only thyrotoxicosis is vital for timely and appropriate treatment. The early diagnosis and management of TS in cardiac settings, including pharmacological, mechanical, and surgical modalities, can save high-risk patients. Sex matters in the presentation, treatment, and mortality of this population. However, further large-scale, and well-designed studies are required.
Double Transverse Foramina—An Anatomical Basis for Possible Vertebrobasilar Insufficiency Risk and Vertebral Artery Injury
Authors: Tuncel Çini Nilgün , Nalla Shahed , Mata-Escolano Federico , Blanco-Perez Esther , Valenzuela-Fuenzalida Juan José , Orellana-Donoso Mathias , Sanchis-Gimeno Juan A.
Published: September 2023

Cervical vertebrae may exhibit the anomalous presence of a double transverse foramen (DTF) that may impact the anatomy of related structures that traverse the cervical region, such as the vertebral artery (VA). This retrospective anatomical study utilized CT angiography cervical scans to examine the prevalence of DTF, VA, and TF areas. The subjects were separated into two groups: normal TF (NTF group; 26 males and 21 females) and double TF (DTF group; 21 males and 24 females). The males presented significantly higher TF area values (30.31 ± 4.52 mm2) than the females (27.48 ± 1.69 mm2) in the NTF group (p = 0.006). The sex differences disappeared when a DTF was present (p = 0.662). There were no differences in the VA area values between the sexes in both the NTF and DTF groups (p = 0.184). No significant differences in the VA area values between males of the NTF and DTF groups (p = 0.485) were noted. The DTF subjects presented an increased VA/TF area ratio than the NTF subjects (p < 0.001). This study showed that DTF presence reduced the TF area. In contrast, the VA area did not change despite the decreasing TF area. This might be an anatomical risk for transient vertebrobasilar insufficiency in subjects with DTF, especially in females, because VA space in the TF is less in DTF subjects than in NTF subjects. This may lead to easy VA compression in DTF subjects following neck trauma.
Exemplar MobileNetV2-Based Artificial Intelligence for Robust and Accurate Diagnosis of Multiple Sclerosis
Authors: Ekmekyapar Tuba , Taşcı Burak
Published: September 2023

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that prominently affects young adults due to its debilitating nature. The pathogenesis of the disease is focused on the inflammation and neurodegeneration processes. Inflammation is associated with relapses, while neurodegeneration emerges in the progressive stages of the disease. Magnetic resonance imaging (MRI) is commonly used for the diagnosis of MS, and guidelines such as the McDonald criteria are available. MRI is an essential tool to demonstrate the spatial distribution and changes over time in the disease. This study discusses the use of image processing techniques for the diagnosis of MS and specifically combines the MobileNetV2 network with exemplar-based learning, IMrMr feature selection, and K-Nearest Neighbors (KNN) classification methods. Experiments conducted on two different datasets (Dataset 1 and Dataset 2) demonstrate that these methods provide high accuracy in diagnosing MS. Dataset 1 comprises 128 patients with 706 MRI images, 131 MS patients with 667 MRI images, and 150 healthy control subjects with 1373 MRI images. Dataset 2 includes an MS group with 650 MRI images and a healthy control group with 676 MRI images. The results of the study include 10-fold cross-validation results performed on different image sections (Axial, Sagittal, and Hybrid) for Dataset 1. Accuracy rates of 99.76% for Axial, 99.48% for Sagittal, and 98.02% for Hybrid sections were achieved. Furthermore, 100% accuracy was achieved on Dataset 2. In conclusion, this study demonstrates the effective use of powerful image processing methods such as the MobileNetV2 network and exemplar-based learning for the diagnosis of MS. These findings suggest that these methods can be further developed in future research and offer significant potential for clinical applications in the diagnosis and monitoring of MS.
Machine Learning Predicts Pathologic Complete Response to Neoadjuvant Chemotherapy for ER+HER2- Breast Cancer: Integrating Tumoral and Peritumoral MRI Radiomic Features
Authors: Park Jiwoo , Kim Min Jung , Yoon Jong-Hyun , Han Kyunghwa , Kim Eun-Kyung , Sohn Joo Hyuk , Lee Young Han , Yoo Yangmo
Published: September 2023

Background: This study aimed to predict pathologic complete response (pCR) in neoadjuvant chemotherapy for ER+HER2- locally advanced breast cancer (LABC), a subtype with limited treatment response. Methods: We included 265 ER+HER2- LABC patients (2010–2020) with pre-treatment MRI, neoadjuvant chemotherapy, and confirmed pathology. Using data from January 2016, we divided them into training and validation cohorts. Volumes of interest (VOI) for the tumoral and peritumoral regions were segmented on preoperative MRI from three sequences: T1-weighted early and delayed contrast-enhanced sequences and T2-weighted fat-suppressed sequence (T2FS). We constructed seven machine learning models using tumoral, peritumoral, and combined texture features within and across the sequences, and evaluated their pCR prediction performance using AUC values. Results: The best single sequence model was SVM using a 1 mm tumor-to-peritumor VOI in the early contrast-enhanced phase (AUC = 0.9447). Among the combinations, the top-performing model was K-Nearest Neighbor, using 1 mm tumor-to-peritumor VOI in the early contrast-enhanced phase and 3 mm peritumoral VOI in T2FS (AUC = 0.9631). Conclusions: We suggest that a combined machine learning model that integrates tumoral and peritumoral radiomic features across different MRI sequences can provide a more accurate pretreatment pCR prediction for neoadjuvant chemotherapy in ER+HER2- LABC.
NT-proBNP—Possible Prognostic Marker in Pregnant Patients with Associated Cardiovascular Risk Factors and SARS-CoV-2 Infection
Authors: Marta Carmen-Ioana , Maghiari Anca Laura , Bernad Elena , Stelea Lavinia , Bernad Brenda , Boscu Lioara , Neamtu Radu , Gluhovschi Adrian , Diaconu Mircea , Dumitru Catalin , Sorop Bogdan , Babes Katalin
Published: September 2023

Background: N-terminal pro brain-type natriuretic peptide (NT-proBNP) is a practical biomarker in the clinical pathologies where the ventricle is under stress and particularly stretched in the general population. The study aims to compare the value of NT-proBNP and its importance in the prognosis and severity of the cases involving pregnant patients with SARS-CoV-2 infection and cardiovascular risk factors to those of low-risk pregnant patients, mainly by analysing their symptoms, administered medication, days of hospitalization and severity of the viral disease. Methods: The study included a total of eighty-three pregnant patients who underwent natural birth or caesarean section at out hospital. NT-proBNP levels were analyzed at hospital admission as a potential cardiovascular marker. A comparative analysis was performed between pregnant patients with cardiovascular risk factors and pregnant patients without cardiovascular risk factors regarding NT-proBNP values. Results: Pregnant patients with SARS-CoV-2 infection and cardiovascular risk factors had higher values of NT-proBNP in comparison to pregnant patients without cardiovascular risk factors. Conclusions: NT-proBNP testing in pregnant patients with SARS-CoV-2 infection can be a relatively important marker to be taken into consideration when it comes to the management, treatment and outcome of the cases, especially when it comes to women with associated cardiovascular risk factors.
The Influence of Body Fat and Lean Mass on HbA1c and Lipid Profile in Children and Adolescents with Type 1 Diabetes Mellitus
Authors: Menegucci Thais , Chagas Eduardo Federighi Baisi , de Oliveira Zanuso Barbara , Quesada Karina , dos Santos Haber Jesselina Francisco , Menegucci Zutin Tereza Laís , Felipe Pimenta Luis , Cressoni Araújo Adriano , Landgraf Guiguer Elen , Rucco P. Detregiachi Claudia , Gabaldi Rocha Marcia , Cincotto dos Santos Bueno Patrícia , Fornari Laurindo Lucas , Barbalho Sandra M.
Published: September 2023

Glycated hemoglobin (HbA1c) is used to assess glycemic control in Type 1 diabetes (DM1) patients. Apolipoproteins play an essential role in DM1 pathophysiology and may be associated with complications and HbA1c. This cross-sectional observational study of 81 children and adolescents of both sexes diagnosed with DM1 investigated the relationship between body fat distribution and lean mass with HbA1C and apolipoprotein values, analyzing biochemical and body composition measurements. A Shapiro–Wilk test with Lilliefors correction, a non-parametric Mann–Whitney test, and others were used with a significance level of 5%. The sample had a diagnosis time of 4.32 years and high blood glucose levels (mean 178.19 mg/dL) and HbA1c (mean 8.57%). Subjects also had a moderate level of adiposity, as indicated by arm and thigh fat areas. The study also found significant differences in the distribution of patients concerning levels of apolipoproteins A and B, with a smaller proportion of patients having undesirable levels. Finally, the study found a significant difference in the distribution of patients with estimated cardiovascular risk based on the ApoB/ApoA-I ratio. Conclusively, visceral fat in children and adolescents with DM1 may increase the risk of DM1 long-term complications owing to its association with elevated HbA1C and apolipoprotein values.
The Estimate of Parental Quality of Life Loss Due to Respiratory Syncytial Virus (RSV) Hospitalization
Authors: Wrotek August , Wrotek Oliwia , Jackowska Teresa
Published: September 2023

Background: Respiratory syncytial virus (RSV) is one of the leading causes of pediatric hospitalizations, mainly in children under 2 years of age. Hospitalization affects the caregivers’ quality of life (QoL). We assessed the caregivers’ QoL during RSV-confirmed hospitalizations of children under 2 years old, identified the most affected QoL dimensions and calculated utilities focusing on the assessment methods and potential confounders. Methods: The caregivers filled out the EQ-5D questionnaire, consisting of a descriptive system (assessing 5 QoL dimensions) and a visual analog scale (EQ VAS). Utility, utility loss and quality-adjusted life years (QALY) loss were calculated, and a concordance between the two systems was assessed. Results: A disturbance in any of the five assessed dimensions was reported by 42% (55 out of 132) of the caregivers, mostly anxiety/depression (37%) and pain/discomfort (17%). The utilities varied between 0.17 and 1 in the descriptive system and 0.33–1 (median 0.86) in the EQ VAS, with a utility loss of 0.14 (IQR: 0.1–0.2). The calculated QALY loss reached a median of 2.45 × 10−3 (IQR: 1.37 × 10−3–4.56 × 10−3) and was not influenced by the patient’s age or the final clinical diagnosis (QALY loss for bronchiolitis: 2.74 × 10−3, pneumonia: 1.84 × 10−3, bronchitis: 1.78 × 10−3, differences statistically insignificant). Only a moderate concordance between the descriptive system and the EQ VAS was seen (Spearman’s rank correlation coefficient = 0.437, p < 0.05), with the latter revealing a higher degree of QoL disturbances. Conclusions: RSV hospitalization influences parental QoL significantly, and anxiety/depression is the most commonly reported issue. Utility impairment scores depend on the assessment method but not on the patient’s age or final diagnosis. Thus, the impact of RSV on caregivers’ QoL cannot be underestimated.
Five Steps for the Maintenance and Interception of Complications in Zygomatic Implants
Authors: Sanavia Consuela , Vallerga Edoardo , Alessi Fanny , Tealdo Tiziano , Bevilacqua Marco , Alberti Christian , Menini Maria , Pesce Paolo
Published: September 2023

Zygomatic implants are used for the rehabilitation of the upper jaw of patients with severe and moderate bone atrophy. Possible post-surgical complications include soft tissue dehiscence, sinusitis, and prosthodontic fractures, and maintaining an accurate control is crucial. Additionally, zygomatic implants have a unique peri-implant anatomy, making traditional periodontal parameters unsuitable. The present paper aims to provide guidelines for the maintenance and interception of complications in patients rehabilitated with these kinds of implants. The proposed protocol includes: 1. intra/extraoral and temporo-mandibular joint examination; 2. soft tissue and transmucosal path observation with magnifiers; 3. peri-implant health indices and digital stimulation of tissues; 4. examination of prosthodontic devices; and 5. photographic recording. These steps facilitate the comprehensive evaluation and monitoring of clinical conditions of zygomatic-supported rehabilitations, including dehiscence and occlusal wear during follow-up appointments.
Analysis of UTM Tracking Performance for Conformance Monitoring via Hybrid SITL Monte Carlo Methods
Authors: Dai Wei , Quek Zhi Hao , Pang Bizhao , Feroskhan Mir
Published: September 2023

Conformance monitoring supports UTM safety by observing if unmanned aircraft (UA) are adhering to declared operational intent. As a supporting system, robust cooperative tracking is critical. Nevertheless, tracking systems for UAS traffic management (UTM) are in an early stage and under-standardized, and existing literature hardly addresses the problem. To bridge this gap, this study aims to probabilistically evaluate the impact of the change in tracking performances on the effectiveness of conformance monitoring. We propose a Monte Carlo simulation-based method. To ensure a realistic simulation environment, we use a hybrid software-in-the-loop (SITL) scheme. The major uncertainties contributing to the stochastic evaluation are measured separately and are integrated into the final Monte Carlo simulation. Latency tests were conducted to assess the performance of different communication technologies for cooperative tracking. Flight technical error generation via SITL simulations and navigational system error generation based on flight experiments were employed to model UA trajectory uncertainty. Based on these tests, further Monte Carlo simulations were used to study the overall impacts of various tracking key performance indicators in UTM conformance monitoring. Results suggest that the extrapolation of UA position enables quicker non-conformance detection, but introduces greater variability in detection delay, and exacerbates the incidence of nuisance alerts and missed detections, particularly when latencies are high and velocity errors are severe. Recommendations for UA position update rates of ≥1 Hz remain consistent with previous studies, as investments in increasing the update rate do not lead to corresponding improvements in conformance monitoring performance according to simulation results.
Distributed Control for Multi-Robot Interactive Swarming Using Voronoi Partioning
Authors: Eudes Alexandre , Bertrand Sylvain , Marzat Julien , Sarras Ioannis
Published: September 2023

The problem of safe navigation of a human-multi-robot system is addressed in this paper. More precisely, we propose a novel distributed algorithm to control a swarm of unmanned ground robots interacting with human operators in presence of obstacles. Contrary to many existing algorithms that consider formation control, the proposed approach results in non-rigid motion for the swarm, which more easily enables interactions with human operators and navigation in cluttered environments. Each vehicle calculates distributively and dynamically its own safety zone in which it generates a reference point to be tracked. The algorithm relies on purely geometric reasoning through the use of Voronoi partitioning and collision cones, which allows to naturally account for inter-robot, human-robot and robot-obstacle interactions. Different interaction modes have been defined from this common basis to address the following practical problems: autonomous waypoint navigation, velocity-guided motion, and follow a localized operator. The effectiveness of the algorithm is illustrated by outdoor and indoor field experiments.