bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with ‘difficult to treat’ rheumatoid arthritis
Authors: Bertsias Antonios , Flouri Irini D , Repa Argyro , Avgoustidis Nestor , Kalogiannaki Eleni , Pitsigavdaki Sofia , Bertsias George , Sidiropoulos Prodromos
Published: January 2024

Background

Characterisation of the long-term outcome of patients with ‘difficult to treat’ (D2T) rheumatoid arthritis and factors contributing to its evolution are unknown. Herein, we explored the heterogeneity and contributing factors of D2T long-term outcome.

Methods

Patients included from a prospective single centre cohort study. The EULAR definition of D2T was applied. Longitudinal clustering of functional status (modified Health Assessment Questionnaire (mHAQ)) and disease activity (Disease Activity Score-28 (DAS28)) were assessed using latent-class trajectory analysis. Multiple linear mixed models were used to examine the impact of comorbidities and their clusters on the long-term outcome.

Results

251 out of 1264 patients (19.9%) were identified as D2T. Younger age, fibromyalgia, osteoarthritis, DAS28-erythrocyte sedimentation rate (ESR) at first biological or targeted synthetic disease-modifying antirheumatic drug (b/ts-DMARD) initiation and failure to reduce DAS28-ESR scores within the first 6 months of b/ts-DMARD therapy were significant predictors of patients becoming D2T. Long-term follow-up (total of 5872 person-years) revealed four groups of functional status evolution: 18.2% had stable, mildly compromised mHAQ (mean 0.41), 39.9% had gradual improvement (1.21–0.87) and two groups had either slow deterioration or stable significant functional impairment (HAQ>1). Similarly, four distinct groups of disease activity evolution were identified. Among the different clusters of comorbidities assessed, presence of ‘mental-health and pain-related illnesses’ or ‘metabolic diseases’ had significant contribution to mHAQ worsening (p<0.0001 for both) and DAS28 evolution (p<0.0001 and p=0.018, respectively).

Conclusion

D2T patients represent a heterogeneous group in terms of long-term disease course. Mental-health/pain-related illnesses as well as metabolic diseases contribute to long-term adverse outcomes and should be targeted in order to optimise the prognosis of this subset of rheumatoid arthritis.
Upadacitinib therapy in refractory inflammatory myositis: a case series of 10 patients
Authors: Beckett Madelaine , Dutz Jan , Huang Kun
Published: January 2024

Objectives

To evaluate the effectiveness and safety of upadacitinib in treatment-refractory inflammatory myositis.

Methods

Patients with refractory inflammatory myositis treated with upadacitinib from a single urban centre in Vancouver, British Columbia, Canada, were included from September 2020 to June 2023. The medical records of these patients were retrospectively reviewed.

Results

10 total patients were identified for review, including 5 classic dermatomyositis (DM), 3 amyopathic DM (ADM) and 2 antisynthetase syndrome. The patients failed an average of four immunosuppressants before initiation of upadacitinib. Three had prior Janus kinase inhibitor therapy with tofacitinib. In the classic DM and ADM aggregate group, upadacitinib offered clinically and statistically significant cutaneous improvement. Lack of active muscle disease at baseline precluded analysis of the effect of upadacitinib on muscle weakness. Nine patients remained on upadacitinib at the end of the study period. One patient discontinued upadacitinib due to severe facial acne.

Conclusion

Upadacitinib appears to be effective in targeting cutaneous manifestations of refractory inflammatory DM. Further research is still needed to validate its efficacy on a broader population scale.
Impact of regulatory tightening of the Hungarian tobacco retail market on availability, access and cigarette smoking prevalence of adolescents
Authors: Joó Tamás , Foley Kristie , Brys Zoltán , Rogers Todd , Szócska Miklós , Bodrogi József , Gaál Péter , Pénzes Melinda
Published: January 2024

Introduction

Policies that reduce tobacco retail density to decrease tobacco use among the youth are critical for the tobacco endgame. This paper reviews a Hungarian tobacco regulatory measure, which, since 2013, has confined the sale of tobacco products exclusively to so-called National Tobacco Shops, summarises the changes in the national tobacco retail marketplace and reports on analyses of the impact of this intervention on illegal sales to minors and adolescent smoking behaviour.

Methods

We reviewed the available national statistical data on the structure and dynamics of the tobacco retail market. Changes in lifetime and current (past 30 days) use of cigarettes among Hungarian adolescents aged 13–17 years were assessed using data from international youth surveys on health behaviours collected in 2010–2020.

Results

Since the start of policy implementation, the density of tobacco shops in Hungary decreased by 85%, from 4.1 to 0.6 per 1000 persons. The prevalence of lifetime and current cigarette smoking among adolescents declined by 13–24 percentage points (pp) and by 4.8–15 pp, respectively. The rate of illegal sales of tobacco products to minors decreased by 27.6 pp, although the prevalence of compensatory access strategies, especially asking others to buy cigarettes for minors, increased.

Conclusions

After a significant decrease in the nationwide availability of licensed tobacco retailers, Hungary experienced short-term reductions in youth smoking prevalence. However, the sporadic implementation of complementary, evidence-based tobacco control strategies might limit further declines in youth smoking initiation and tobacco product use.
A survey of preoperative surgical nutrition practices, opinions, and barriers across Canada
Authors: Bellafronte Natalia Tomborelli , Nasser Roseann , Gramlich Leah , Carli Francesco , Liberman Sender , Santa Mina Daniel , Schierbeck Geoff , Ljungqvist Olle , Gillis Chelsia
Published: January 2024

Malnutrition is prevalent among surgical candidates and associated with adverse outcomes. Despite being potentially modifiable, malnutrition risk screening is not a standard preoperative practice. We conducted a cross-sectional survey to understand healthcare professionals’ (HCPs) opinions and barriers regarding screening and treatment of malnutrition. HCPs working with adult surgical patients in Canada were invited to complete an online survey. Barriers to preoperative malnutrition screening were assessed using the Capability Opportunity Motivation-Behaviour model. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using summative content analysis. Of the 225 HCPs surveyed ( n = 111 dietitians, n = 72 physicians, n = 42 allied HCPs), 96%–100% agreed that preoperative malnutrition is a modifiable risk factor associated with worse surgical outcomes and is a treatment priority. Yet, 65% ( n = 142/220; dietitians: 88% vs. physicians: 40%) reported screening for malnutrition, which mostly occured in the postoperative period ( n = 117) by dietitians ( n = 94). Just 42% (48/113) of non-dietitian respondents referred positively screened patients to a dietitian for further assessment and treatment. The most prevalent barriers for malnutrition screening were related to opportunity, including availability of resources (57%, n = 121/212), time (40%, n = 84/212) and support from others (38%, n = 80/212). In conclusion, there is a gap between opinion and practice among surgical HCPs pertaining to malnutrition. Although HCPs agreed malnutrition is a surgical priority, the opportunity to screen for nutrition risk was a great barrier.
Effect of flyash addition to flocculation and freezing and thawing treatment on consolidation of oil sands fluid fine tailings
Authors: Kabwe L.K. , Beier N.A. , Wilson G.W. , Rima U. , Scott J.D.
Published: January 2024

The total volume of fluid fine tailings (FFT), reached 1,270 Mm3 in 2019. Extensive research is underway by a number of operators to develop dewatering technologies for oil sand tailings reclamation to comply with Directive 085 issued by the Alberta Energy Regulator. A promising technology for the disposal of FFT is to add flocculents and then use thickeners or centrifuges to decrease the water content. Following this treatment, freezing/thawing processes can then be utilized to further dewater the tailings. The effect of flocculation/flyash addition and thickening coupled with freezing/thawing treatments on FFT was investigated by performing large-strain consolidation and shear strength tests on the treated flocculated TTs. It was found that flocculation and thickening treatment increases the hydraulic conductivity of the treated TT which will result in the TT consolidating much faster than the untreated TT. The most important benefit of the flyash addition is the increase in shear strength and hydraulic conductivity of the flyash-treated TTs. The benefit of the freezing/thawing treatment processes coupled with flyash treatment is the increase in the compressibility and hydraulic conductivity at effective stresses lower than 100 kPa and void ratios greater than 1.2, respectively. This will facilitate earlier progressive reclamation required to support hydraulic sand capping.
Towards sustainable manufacturing: Multiple optimization of surface roughness Ra, flank wear Vb in MQL-assisted milling of Titanium Alloy Ti-6Al-4V
Authors: Nguyen Van-Canh , Tien Dung Hoang , Pham Van Hung , Nguyen Thuy Duong
Published: January 2024

This research focuses on the sustainable optimization of the milling process for Titanium Alloy Ti-6Al-4V using Minimum Quantity Lubrication (MQL) assistance. This experimental research investigates the effects of cutting parameters and lubrication conditions on the surface roughness ([Formula: see text]) and flank wear ([Formula: see text]) in the milling process of Titanium Alloy Ti-6Al-4V. The study aims to evaluate the influence of cutting speed ([Formula: see text]), feed rate ([Formula: see text]) and depth of cut ([Formula: see text]) on the selected machining performance indicators. The experiments were carried out using a DMG Mori Seiki DMU50 CNC center, and the workpiece samples were measured at [Formula: see text]. Three different lubrication conditions were employed, including dry machining, conventional flood cooling and Minimum Quantity Lubrication (MQL) using peanut oil. The cutting parameters were varied based on a Taguchi L9 orthogonal array design to explore the main effects of each parameter on [Formula: see text] and [Formula: see text].

The results reveal that cutting speed ([Formula: see text]) has the most significant influence on surface roughness, followed by feed rate ([Formula: see text]), while the impact of depth of cut ([Formula: see text] is negligible in comparison. Conversely, the coolant mode has the most significant impact on flank wear ([Formula: see text]), followed by feed rate ([Formula: see text]) and depth of cut ([Formula: see text]), while the influence of cutting speed ([Formula: see text] is relatively minor. Under the same cutting parameters, transitioning from dry machining to MQL led to a sharp decrease in [Formula: see text] from 170 to 100[Formula: see text][Formula: see text]m, and it increased to approximately 145[Formula: see text][Formula: see text]m when switching to flood cooling. Additionally, increasing the feed rate from 0.02 to 0.06[Formula: see text]mm/tooth reduced [Formula: see text] from around 135 to 120[Formula: see text][Formula: see text]m, but it significantly rose to approximately 165[Formula: see text][Formula: see text]m when the feed rate was further increased. Furthermore, the application of MQL with peanut oil as a lubricant and coolant demonstrated improvements in surface finish and reduced tool wear compared to dry and conventional flood cooling. The MQL approach led to better machining performance with lower [Formula: see text] and [Formula: see text] values. Overall, this study provides valuable insights into the effects of cutting parameters and lubrication conditions on surface roughness and flank wear in the milling process of Titanium Alloy Ti-6Al-4V. The findings offer practical guidelines for optimizing machining conditions to achieve desired surface quality and extend tool life while considering the environmental benefits of employing MQL in the manufacturing process.
A study on rocker arm defect inspection based on vision system
Authors: Nguyen Thanh-Hung , Nguyen Duc-Toan , Tran Van-Huy , Mac Thi-Thoa
Published: January 2024

The rocker arm plays a crucial role in an internal combustion engine’s valve train system. Issues often arise when there are errors in the production of the rocker arm, such as the following: (1) misalignment of the rocker arm spindle hole and thread hole; and (2) bevel errors in the rocker arm spindle hole. This paper focuses on the development of a rocker arm chamfering and coaxial defect inspection system, which utilizes the RANSAC algorithm. The algorithm consists of five steps: (i) representing a 2D point cloud as a matrix with X and Y coordinates; (ii) detecting the number of circles present in the input point cloud; (iii) setting a tolerance threshold for the distance between the selected circle and other points, crucial for achieving high accuracy; (iv) specifying the maximum number of iterations to find the best model from the input points; (v) defining the maximum number of points that can belong to the same circle, considering point density and the anticipated circle’s surface. The real-time inspection system is designed with a camera mounted on top of the box, and two LED arrays positioned around the box at suitable distances. Test results using a collected data set demonstrate the effectiveness and accuracy of the proposed method in detecting each type of error. In the experiments, the proposed method successfully detected all coaxial defect samples and achieved a detection rate of 95.1% for chamfer defect samples.
Investigating the structural and mechanical behavioral properties of semi-organic nonlinear optical single crystal: L-arginine tetrafluoroborate
Authors: Indu  , Babita  , Sonia
Published: January 2024

A semi-organic nonlinear optical material L-Arginine tetrafluoroborate (LAFB) was synthesized as single crystal using Slow Evaporation Technique. Various properties of this material were analyzed to make it suitable for NLO applications. The structural behavior of the material was determined by single crystal XRD and found that the crystal has orthorhombic structure and was synthesized with P212121 space group. The High-Resolution X-Ray Diffraction (HRXRD) study was conducted to determine the change in the lattice parameters resulting from strain, defects or by other means in LAFB material. The diffraction curve analysis show that the grown crystal consisted of interstitial type point defect. The Shock Damage Threshold (SDT) measures the stability of the compound against shock, the analysis exhibits that under Mach number 2.2 up to 10th shock no significant cracks were observed in the crystal but damage area of the crystal was increased. The mechanical behavior of the sample against highly intense laser was analyzed through Laser Damage Threshold (LDT). The calculated value of LDT was to be 0.75[Formula: see text]GW/cm2 for 1 pulse per second whereas it decreased to 0.57[Formula: see text]GW/cm2 for 10 pulse per second. To explore the mechanical properties of the material, Nano indentation was carried out, by which the values of H[Formula: see text][Formula: see text]MPa and E[Formula: see text][Formula: see text]GPa were obtained.
Modeling the transmission dynamics of a two-strain dengue disease with infection age
Authors: Li Xiaoguang , Cai Liming , Ding Wandi
Published: January 2024

In this paper, we introduce a partial differential equation (PDE) model to describe the transmission dynamics of dengue with two viral strains and possible secondary infection for humans. The model features the variable infectiousness during the infectious period, which we call the infection age of the infectious host. We define two thresholds [Formula: see text] and [Formula: see text], and show that the strain [Formula: see text] can not invade the system if [Formula: see text]. Further, the disease-free equilibrium of the system is globally asymptotically stable if [Formula: see text]. When [Formula: see text], strain [Formula: see text] dominance equilibrium [Formula: see text] exists, and is locally asymptotically stable when [Formula: see text], [Formula: see text], [Formula: see text]. Then, by applying Lyapunov–LaSalle techniques, we establish the global asymptotical stability of the dominance equilibrium corresponding to some strain [Formula: see text]. This implies strain [Formula: see text] eliminates the other strain as long as [Formula: see text], where [Formula: see text] denotes the probability of a given susceptible mosquito being transmitted by a primarily infected human with strain [Formula: see text]. Finally, we study the existence of the coexistence equilibria under some conditions.
SPATIOTEMPORAL PROJECTIONS OF EXTREME TEMPERATURE INDICES OVER ALGERIA USING CMIP6-GLOBAL CLIMATE MODELS
Authors: SAHABI-ABED SALAH , NOUR-EL-ISLAM SELMANE AHMED
Published: January 2024

We assess in this paper the spatiotemporal projections of extreme temperature indices over Algeria derived from the adjusted multi-model ensemble mean (MME) data derived from 11 daily historical simulations of CMIP6-GCMs models that participated in the IPCC Sixth Assessment Report (AR6). The projected spatial patterns of 12 extreme temperature indices defined by the Expert Team on Climate Change Detection and Indices are assessed for two future time periods: the mid-future 2041–2070 and the far future 2071–2100, relative to the baseline period 1985–2014 and under three Shared Socio-economic Pathways (SSP) scenarios: low emission SSP1-2.6; medium emission SSP2-4.5 and high emission scenario (SSP5-8.5). The selected climate indices reflect the intensity (TXx, TNx, TXn, TNn and DTR), frequency (TX90p and TN10p) and duration (WSDI, SU, CSDI, TR and FD) of the extreme thermal events. The MME Projections show a global heightened warming over Algeria. Future Climate features depict a continuous increase in the occurrence of hot days by the end of the century reaching 60% for SSP5-8.5 and an amplification of the intensity of the extreme temperature of about 6∘C for SSP5-8.5 and an extension of the heat wave duration period of about 80 days in the north and 100 days in the south of the country compared to the historical period. However, the study shows a projected simultaneous decline in the cold spell duration of 7 days and in the frost days reaching 25 days. A stabilization of the upsurge trend is remarkably observed for most indices under SSP1-2.6 starting from the 2050s. The future changes depicted in this study should help to assess the distribution of the impacts across different regions of Algeria in order to enhance resilience, establish the appropriate adaptation responses and improve disaster preparedness.
Exhumation of the Qilian Shan and Miocene activity of the Haiyuan fault: insights from apatite (U–Th)/He thermochronology in the Laolongwan basin, northeastern Tibetan Plateau
Authors: Liu Kang , Wang Weitao , Jin Ruizhi , Jing Hulu , Zhou Renjie
Published: January 2024

The Tibetan Plateau, which is deformed by the collision between the Indian and Eurasian plates, is a natural laboratory in which to study intracontinental deformation related to northeastward growth of the plateau. However, how and when the Tibetan Plateau propagated to its present-day margins remain unclear. The Qilian Shan and Haiyuan fault, which serve as the topographic and geological boundaries of the high plateau, are key to revealing the uplift and expansion of the Tibetan Plateau. Here, we present detrital apatite (U–Th)/He and reverse modelling results from the Laolongwan basin, which is interpreted as a pull-apart basin controlled by activity of the Haiyuan fault in the east portion of the Qilian Shan region. Our results reveal three-stage tectono-thermal evolution of Qilian Shan: (1) Late Jurassic to Cretaceous rapid exhumation; (2) Late Cretaceous to middle Miocene tectonic quiescence period; and (3) exhumation after the middle Miocene. We suggest that the Jurassic to Cretaceous rapid exhumation might be related to the convergence of the Lhasa block with the Eurasian plate or regional extension during the Mesozoic closure of the Meso-Tethys, and the mid-Miocene accelerated exhumation was driven by Haiyuan fault activation related to the growth of the Tibetan Plateau to its northeastern margin.

Supplementary material:
Time–temperature paths of (U–Th)/He thermal history models (Fig. S1) and AHe age–depth relationship (Fig. S2) are available at
https://doi.org/10.6084/m9.figshare.c.7018149

Thematic collection:
This article is part of the Mesozoic and Cenozoic tectonics, landscape and climate change collection available at:
https://www.lyellcollection.org/topic/collections/mesozoic-and-cenozoic-tectonics-landscape-and-climate-change
Using the geoheritage framework to explore the intersection of diverse legacies at Grand Caverns, Virginia, USA
Authors: Garcia Ángel A. , Shank Austin
Published: January 2024

Grand Caverns is the oldest show cave in continuous operation in the contiguous United States. Discovered in 1804, Grand Caverns has been offering at least one tour per year continuously from 1806 until now. For more than two centuries Grand Caverns – which is host to diverse and uncommon solution cave speleothems, such as cave shields – has served as the centre for multidisciplinary research related to limestones in Virginia and has accrued historical accounts relevant to the Shenandoah Valley (nestled between the Blue Ridge Mountains to the east and the Allegheny Mountains to the west) in the Commonwealth of Virginia. In this article, we explore the geological, historical, mapping and geotourism legacies of Grand Caverns, using its geoheritage as a narrative framework. In addition, we discuss the intersection of historical and diverse concurrent heritages at Grand Caverns and their relevance for understanding national show caves and cave development processes, and we share ongoing efforts towards the construction of a proposal to elevate Grand Caverns to the United Nations Educational, Scientific and Cultural Organization World Heritage list.
TaSPM: Targeted Sequential Pattern Mining
Authors: Huang Gengsen , Gan Wensheng , Yu Philip S.
Published: January 2024

Sequential pattern mining (SPM) is an important technique in the field of pattern mining, which has many applications in reality. Although many efficient SPM algorithms have been proposed, there are few studies that can focus on targeted tasks. Targeted querying of the concerned sequential patterns can not only reduce the number of patterns generated, but also increase the efficiency of users in performing related analysis. The current algorithms available for targeted sequence querying are based on specific scenarios and can not be extended to other applications. In this article, we formulate the problem of targeted sequential pattern mining and propose a generic algorithm, namely TaSPM. What is more, to improve the efficiency of TaSPM on large-scale datasets and multiple-item-based sequence datasets, we propose several pruning strategies to reduce meaningless operations in the mining process. Totally four pruning strategies are designed in TaSPM, and hence TaSPM can terminate unnecessary pattern extensions quickly and achieve better performance. Finally, we conducted extensive experiments on different datasets to compare the baseline SPM algorithm with TaSPM. Experiments show that the novel targeted mining algorithm TaSPM can achieve faster running time and less memory consumption.
Optimized Distortion and Proportional Fairness in Voting
Authors: Ebadian Soroush , Kahng Anson , Peters Dominik , Shah Nisarg
Published: January 2024

A voting rule decides on a probability distribution over a set of
m
alternatives, based on rankings of those alternatives provided by agents. We assume that agents have cardinal utility functions over the alternatives, but voting rules have access to only the rankings induced by these utilities. We evaluate how well voting rules do on measures of social welfare and of proportional fairness, computed based on the hidden utility functions.

In particular, we study the
distortion
of voting rules, which is a worst-case measure. It is an approximation ratio comparing the utilitarian social welfare of the optimum outcome to the social welfare produced by the outcome selected by the voting rule, in the worst case over possible input profiles and utility functions that are consistent with the input. The previous literature has studied distortion with unit-sum utility functions (which are normalized to sum to 1), and left a small asymptotic gap in the best possible distortion. Using tools from the theory of fair multi-winner elections, we propose the first voting rule which achieves the optimal distortion

\(\Theta (\sqrt {m})\)

for unit-sum utilities. Our voting rule also achieves optimum

\(\Theta (\sqrt {m})\)

distortion for a larger class of utilities, including unit-range and approval (0/1) utilities.

We then take a similar worst-case approach to a quantitative measure of the fairness of a voting rule, called
proportional fairness
. Informally, it measures whether the influence of cohesive groups of agents on the voting outcome is proportional to the group size. We show that there is a voting rule which, without knowledge of the utilities, can achieve a Θ (log
m
)-approximation to proportional fairness. As a consequence of its proportional fairness, we show that this voting rule achieves Θ (log
m
) distortion with respect to the Nash welfare, and selects a distribution that provides a Θ (log
m
)-approximation to the core, making it interesting for applications in participatory budgeting. For all three approximations, we show that Θ (log
m
) is the best possible approximation.
Molecular Mechanics of Liquid and Gas Slip Flow
Authors: Hadjiconstantinou Nicolas G.
Published: January 2024

By taking into account the inhomogeneity introduced by the presence of a solid boundary, slip-flow theory extends the range of applicability of the venerable Navier–Stokes description to smaller scales and into the regime where confinement starts to be important. Due to the inherently atomistic nature of solid–fluid interactions at their interface, slip flow can be described, at least in principle, predictively at this level. This review aims to summarize our current understanding of slip flow at the atomistic level in dilute gases and dense liquids. The discussion extends over the similarities and differences between slip in gases and liquids, characterization and measurement of slip by molecular simulation methods, models for predicting slip, and open questions requiring further investigation.
Sitting leg vasculopathy: potential adaptations beyond the endothelium
Authors: Ferreira-Santos Larissa , Martinez-Lemus Luis A. , Padilla Jaume
Published: January 2024

Increased sitting time, the most common form of sedentary behavior, is an independent risk factor for all-cause and cardiovascular disease mortality; however, the mechanisms linking sitting to cardiovascular risk remain largely elusive. Studies over the last decade have led to the concept that excessive time spent in the sitting position and the ensuing reduction in leg blood flow-induced shear stress cause endothelial dysfunction. This conclusion has been mainly supported by studies using flow-mediated dilation in the lower extremities as the measured outcome. In this review, we summarize evidence from classic studies and more recent ones that collectively support the notion that prolonged sitting-induced leg vascular dysfunction is likely also attributable to changes occurring in vascular smooth muscle cells (VSMCs). Indeed, we provide evidence that prolonged constriction of resistance arteries can lead to modifications in the structural characteristics of the vascular wall, including polymerization of actin filaments in VSMCs and inward remodeling, and that these changes manifest in a time frame that is consistent with the vascular changes observed with prolonged sitting. We expect this review will stimulate future studies with a focus on VSMC cytoskeletal remodeling as a potential target to prevent the detrimental vascular ramifications of too much sitting.
Fibroblasts and platelets: a face-to-face dialogue at the heart of cardiac fibrosis
Authors: Dufeys Cécile , Bodart Julie , Bertrand Luc , Beauloye Christophe , Horman Sandrine
Published: January 2024

Myocardial fibrosis is a feature found in most cardiac diseases and a key element contributing to heart failure and its progression. It has therefore become a subject of particular interest in cardiac research. Mechanisms leading to pathological cardiac remodeling and heart failure are diverse, including effects on cardiac fibroblasts, the main players in cardiac extracellular matrix synthesis, but also on cardiomyocytes, immune cells, endothelial cells, and more recently, platelets. Although transforming growth factor-β (TGF-β) is a primary regulator of fibrosis development, the cellular and molecular mechanisms that trigger its activation after cardiac injury remain poorly understood. Different types of anti-TGF-β drugs have been tested for the treatment of cardiac fibrosis and have been associated with side effects. Therefore, a better understanding of these mechanisms is of great clinical relevance and could allow us to identify new therapeutic targets. Interestingly, it has been shown that platelets infiltrate the myocardium at an early stage after cardiac injury, producing large amounts of cytokines and growth factors. These molecules can directly or indirectly regulate cells involved in the fibrotic response, including cardiac fibroblasts and immune cells. In particular, platelets are known to be a major source of TGF-β1. In this review, we have provided an overview of the classical cellular effectors involved in the pathogenesis of cardiac fibrosis, focusing on the emergent role of platelets, while discussing opportunities for novel therapeutic interventions.
Development of Plasma-Activated Water (PAW) System: Molecular Dynamics Simulation and Experimental Study on Almond Aflatoxins
Authors: Aarabi Mohammad Javad , Rostami Sajad , Samani Bahram Hosseinzadeh , Nazari Firouzeh
Published: January 2024

Almonds play a significant role in Iran’s economy, and factors that threaten their market, such as aflatoxins, need careful consideration. Plasma-activated water (PAW) is a new method that has antioxidant activity and can eliminate toxins and microbial agents, making it a suitable solution for removing aflatoxins from almonds. In a study, the continuous PAW production system was used to control and remove almond aflatoxins, and molecular dynamics simulation was employed to evaluate the impact of PAW on aflatoxin B1. The study found that reducing the flow rate of plasma-treated water had the greatest effect on reducing aflatoxin concentration, followed by PAW application time, the dose of inoculated toxin, and the air/gas mixture ratio. The use of PAW reduced aflatoxin concentration in almonds by 12% to 56.8%. The simulation results suggested that PAW can affect the structure of aflatoxin B1, change and destroy its activity, and reduce its toxicity. Among the free radicals tested, NO3− was found to be the most effective in degrading aflatoxin B1. This study demonstrates the potential of PAW as a method to remove aflatoxins and enhance the safety of almonds.
A Decision‐Making Approach Incorporating TODIM Method and Sine Entropy in q‐Rung Picture Fuzzy Set Setting
Authors: Aydoğan Büşra , Olgun Murat , Smarandache Florentin , Ünver Mehmet
Published: January 2024

In this study, we propose a new approach based on fuzzy TODIM (Portuguese acronym for interactive and multicriteria decision‐making) for decision‐making problems in uncertain environments. Our method incorporates group utility and individual regret, which are often ignored in traditional multicriteria decision‐making (MCDM) methods. To enhance the analysis and application of fuzzy sets in decision‐making processes, we introduce novel entropy and distance measures for q‐rung picture fuzzy sets. These measures include an entropy measure based on the sine function and a distance measure derived from the Jensen‐Shannon divergence. In our methodology, incorporating the sine function into the entropy measure stands out as a distinctive decision, grounded in a profound understanding of the inherent characteristics of fuzzy sets. Utilizing the sine function proves especially advantageous when handling fuzzy sets that exhibit cyclical variations or fluctuations in their membership degrees. We effectively weight the criteria for an improved evaluation by using this new entropy measure. The introduced distance measure finds application in the TODIM approach, allowing the execution of TODIM method steps within a fuzzy environment until the determination of one alternative’s dominance over another—an advancement beyond traditional approaches. We apply our enhanced fuzzy TODIM method to a real‐life construction project management problem from the literature and compare the results with those in the literature and obtained from other MCDM methods. Our proposed measures are robust, as demonstrated by the sensitivity analysis that varied the weights of group utility and individual regret, with the results visualized in a 3D sensitivity plot. The findings demonstrate the superiority of our method in providing a more comprehensive evaluation of alternatives, making it a useful tool for decision‐makers facing complex and uncertain decision‐making problems.
Guanfacine Treatment in a Patient with Intravenous Buprenorphine/Naloxone Misuse
Authors: Karabulut Sercan
Published: January 2024

In this case report, we described a patient admitted with buprenorphine/naloxone (BN) misuse, accompanied by intermittent pregabalin misuse, to self-treat the opioid withdrawal symptoms. We treated the withdrawal symptoms after cessation of BN with guanfacine extended-release (XR). To our knowledge, it has been the first case report describing guanfacine-XR in the treatment of BN misuse. Notably, our patient responded to the treatment with a decrease in withdrawal symptoms without any significant side-effect. Although it is not possible to generalize our findings with a single case report, it might be useful to mark guanfacin-XR as a potential treatment agent for opioid use disorders, including patients with synthetic opioid misuse.
Mechanical Properties and Hardening Mechanism of Magnesium Ammonium Phosphate Cements Modified by Fly Ash
Authors: Hai Ran , Zhang Jingyu , Liu Junxia , Hui Cun , Yang Fei
Published: January 2024

High hydration heat and poor water resistance are the main factors restricting the application of magnesium ammonium phosphate cement (MAPC). To alleviate the problem, fly ash was used to partially replace dead‐burned MgO and NH4H2PO4 in this paper. The effect of fly ash content on MAPC properties, such as setting time, fluidity, mechanical properties, and water resistance, was investigated. The micromorphology of hydration products and the influence mechanism of fly ash on the macrocharacteristics and hydration process of MAPC were also discussed. The results showed the mechanical properties of fly ash‐modified MAPC decreased with the increase of the fly ash content, but their increments at later hydration were greater than the control MAPC. Meanwhile, fly ash could improve the water‐resistance significantly and reduce the total hydration heat. The fly ash refined the struvite crystal and increased the compactness of MAPC, although no obvious hydration products of fly ash were observed. So, when the content of fly ash is 30 wt%, the MAPC has appropriate mechanical properties, while its water resistance is significantly improved, and its hydration heat is reduced compared with the control group.
Cyclic Fasting–Mimicking Diet Plus Bortezomib and Rituximab Is an Effective Treatment for Chronic Lymphocytic Leukemia
Authors: Raucci Franca , Vernieri Claudio , Di Tano Maira , Ligorio Francesca , Blaževitš Olga , Lazzeri Samuel , Shmahala Anastasiya , Fragale Giuseppe , Salvadori Giulia , Varano Gabriele , Casola Stefano , Buono Roberta , Visco Euplio , de Braud Filippo , Longo Valter D.
Published: January 2024

Cyclic fasting–mimicking diet (FMD) is an experimental nutritional intervention with potent antitumor activity in preclinical models of solid malignancies. FMD cycles are also safe and active metabolically and immunologically in cancer patients. Here, we reported on the outcome of FMD cycles in two patients with chronic lymphocytic leukemia (CLL) and investigated the effects of fasting and FMD cycles in preclinical CLL models. Fasting-mimicking conditions in murine CLL models had mild cytotoxic effects, which resulted in apoptosis activation mediated in part by lowered insulin and IGF1 concentrations. In CLL cells, fasting conditions promoted an increase in proteasome activity that served as a starvation escape pathway. Pharmacologic inhibition of this escape mechanism with the proteasome inhibitor bortezomib resulted in a strong enhancement of the proapoptotic effects of starvation conditions in vitro. In mouse CLL models, combining cyclic fasting/FMD with bortezomib and rituximab, an anti-CD20 antibody, delayed CLL progression and resulted in significant prolongation of mouse survival. Overall, the effect of proteasome inhibition in combination with FMD cycles in promoting CLL death supports the targeting of starvation escape pathways as an effective treatment strategy that should be tested in clinical trials.

Significance:

Chronic lymphocytic leukemia cells resist fasting-mimicking diet by inducing proteasome activation to escape starvation, which can be targeted using proteasome inhibition by bortezomib treatment to impede leukemia progression and prolong survival.
BRCA Mutation Patients: Are There Other Predisposing Factors for Ovarian Cancer Occurrence? A Multicenter Retrospective Study
Authors: Loizzi Vera , Mongelli Michele , Arezzo Francesca , Romagno Isabella , Cazzato Gerardo , Popescu Ondina , Legge Francesco , Trerotoli Paolo , Silvestris Erica , Kardhashi Anila , Cormio Gennaro
Published: January 2024

Objectives: The objective of this multicenter retrospective study aimed to evaluate the association of clinical variables and the incidence of ovarian cancer in patients with BRCA 1–2 mutation carriers who underwent risk-reducing salpingo-oophorectomy (RRSO). Design: Patients with a pathogenic mutation of BRCA 1–2 genes and with no evidence of disease are considered eligible. The exclusion criterion was the refusal to undergo the surgery. The retrospective study included all RRSO performed from May 2015 to April 2022 in the three gynecological Institutions of Southern Italy for were included in this retrospective study. Participants/Materials, Setting, Methods: Age, menarche age, BMI, menopause at time of RRSO, breast cancer first- and second-degree relatives, ovarian cancer first- and second-degree relatives, estroprogestin use, pregnancy normal full-term delivery, history of endometriosis, previous breast cancer and histologic type, previous abdominal/pelvic surgery, BRCA 1 or BRCA 2 status, preoperative serum CA-125 levels (IU/mL), age at time of RRSO and histological analysis were collected. Results: 184 were recruited. One was excluded. To assess cancer risk, the outcome variable was classified into three classes: no event, cancer, and other conditions excluding cancer. 14 women presented ovarian cancer and tubal intraepithelial carcinoma (STIC) on histopathologic final report. Ovarian cancer was found in 8 patients, whereas the presence of STIC was found in 6 of them. Limitations: The low incidence of patients diagnosed with ovarian cancer or STIC compared with the total number of patients undergoing RRSO is a potential bias. Conclusions: Our study did not demonstrate a correlation between clinical features and the occurrence of precancerous or cancerous lesions in BRCA mutation carrier patients.
Enhancing Human Papillomavirus Vaccination Rates through Better Knowledge? Insights from a Survey among German Medical Students
Authors: Aksoy Cem , Reimold Philipp , Schumann Annika , Schneidewind Laila , Karschuck Philipp , Flegar Luka , Leitsmann Marianne , Heers Hendrik , Huber Johannes , Zacharis Aristeidis , Ihrig Andreas
Published: January 2024

Introduction: Vaccination against human papillomavirus (HPV) significantly reduces the risk for malignant diseases like cervix, anal, or penile cancer. However, although vaccination rates are rising, they are still too low mirroring a lack of disease awareness in the community. This study aims to evaluate knowledge about HPV vaccination as well as the vaccination rate among German medical students. Material and Methods: Medical students were surveyed during a German medical students’ sports event. The self-designed survey on HPV vaccination consisted of 24 items. The data collection was anonymous. Results: Among 974 participating medical students 64.9% (632) were women, 335 (34.4%) were male and 7 (0.7%) were nonbinary. Mean age was 23.1 ± 2.7 (± standard deviation; range 18–35) years. Respondents had studied mean 6.6 ± 3.3 (1–16) semesters and 39.4% (383) had completed medical education in urology. 613 (64%) respondents reported that HPV had been discussed during their studies. 7.6% (74) had never heard of HPV. In a multivariate model female gender, the knowledge about HPV, and having worked on the topic were significantly associated with being HPV-vaccinated. Older students were vaccinated less likely. Conclusions: Better knowledge and having worked on the topic of HPV were associated with a higher vaccination rate. However, even in this highly selected group the knowledge about HPV vaccination was low. Consequently, more information and awareness campaigns on HPV vaccination are needed in Germany to increase vaccination rates.
A survey of autonomous vehicles for traffic analysis
Authors: Kamal Ilias , Housni Khalid , Youssef Hadi Moulay
Published: January 2024

Autonomous vehicles stand at the forefront of technological advancement, promising to alter fundamentally how we navigate, with implications for everything from intercity logistics to daily commuting. The expected benefits of this technology include advancements in safety protocols, streamlining of traffic flow, and superior comfort for those onboard. However, the path to widespread integration is paved with significant barriers that need to be overcome. This article provides a thorough review of the historical development of autonomous driving technologies, beginning with the early vehicles powered by internal combustion engines and extending to the present excitement over Apple’s Project Titan. Rumors suggest this particular project involves the creation of an electric vehicle fully capable of operating without traditional manual controls, including steering wheels and seats. The article concludes by spotlighting the potential for autonomous vehicles to enable disruptive changes in the transport sector, while also considering the myriad of challenges that must be surmounted for their adoption on a grand scale.
A machine learning approach to cardiovascular disease prediction with advanced feature selection
Authors: Abdullahi Abdijalil , Ali Barre Mohamed , Hussein Elmi Abdikadir
Published: January 2024

Cardiovascular diseases (CVDs) pose a significant global public health challenge, necessitating precise risk assessment for proactive treatment and optimal utilization of healthcare resources. This study employs machine learning algorithms and sophisticated feature selection techniques to enhance the accuracy and comprehensibility of CVD prediction models. While traditional risk assessment tools are valuable, they frequently fail to consider the myriad intricate factors that contribute to the heightened risk of CVD. Our methodology employs machine learning algorithms to analyze diverse healthcare data sources and produce advanced predictive models. The salient feature of this research lies in the meticulous application of advanced feature selection techniques, enabling the identification of pivotal factors within heterogeneous datasets. Optimizing feature selection enhances the interpretability of the model, reduces dimensionality, and improves predictive accuracy. The area under the ROC curve (AUC-ROC) score of the wrapper method model significantly decreased from 95.1% to 75.1% after tuning, based on empirical tests that supported the suggested method. This showcases its capacity as a tool for assessing premature CVD susceptibility and developing tailored healthcare strategies. The study highlights the significance of integrating machine learning with feature selection due to the widespread influence of cardiovascular diseases. Integrating this system has the potential to enhance patient care and optimize the utilization of healthcare resources.
Academic assistance chatbot-a comprehensive NLP and deep learning-based approaches
Authors: K. Negied Nermin , H. Anwar Sara , M. Abouaish Karim , M. Matta Emil , A. Ahmed Ahmed , K. Farouq Amr
Published: January 2024

The rapid growth of digital technologies and natural language processing (NLP) have revolutionized the field of education, creating new demand for automated academic assistance systems. In this paper, we present an NLP-based academic assistance chatbot designed to provide comprehensive support to students and researchers using deep learning techniques.
 The chatbot incorporates a range of intelligent features to assist with university recommendations, article writing, automatic question answering (QA), and job search. By leveraging sentiment analysis and sarcasm detection models. The proposed chatbot could offer accurate and insightful university recommendations. Additionally, the chatbot incorporates spell and grammar checking, summarization, paraphrasing, and topic modeling capabilities to aid users in enhancing their writing skills. The QA module enables users to obtain quick and precise answers to factoid-based questions. Moreover, the chatbot helps with internships and job search. According to literature, this work presents the first assistance chatbot that encapsulates all features that may be needed by a university student to facilitate and improve his/her learning process. The results demonstrated clearly in the body of the paper showed the success achieved by the academic assistant proposed and built in this work in all its features or modules to offer help to university students and graduates.
Cybersecurity integration in distance learning: an analysis of student awareness and attitudes
Authors: Hnaif Adnan , Mofeed Derbas Areej , Almanasra Sally
Published: January 2024

With the rapid growth of distance learning, especially since the COVID-19 pandemic, cybersecurity has become increasingly essential to protect students, instructors, and institutions from cyber threats. This paper examines the role of cybersecurity in enhancing students’ security awareness during distance learning. A literature review covers critical cyber threats in distance learning and strategies to mitigate risks through cybersecurity tools, policies, training, and promoting a culture of cybersecurity. Primary research was conducted by surveying 531 university students engaged in distance learning to assess their cybersecurity awareness, attitudes, and behaviors. Results indicate relatively low awareness and adoption of secure practices. Recommendations include implementing multi-layered cybersecurity defenses, student security awareness training, and nurturing a “human firewall” through a cyber-aware campus culture. Cyber risks can be reduced through proactive partnerships between students, faculty, information technology (IT) staff, and administrators to secure distance learning environments.