bluuebunny/crossref_metadata_2025 huggingface dataset:
Automation in Dentistry with Mechanical Drills and Lasers for Implant Osteotomy: A Narrative-Scoping Review
Authors: Ganta Gopala Krishna , Mosca Rodrigo Crespo , Varsani Ridham , Murthy Venkata Ramana , Cheruvu Kamala , Lu Michael , Arany Praveen R.
Published: December 2023

The popularity of implants is increasing with the aging population requiring oral–dental rehabilitation. There are several critical steps in the implant workflow, including case selection, implant design, surgical procedure, biological tissue responses, and functional restoration. Among these steps, surgical osteotomy procedures are a crucial determinant of clinical success. This brief review was aimed at outlining the current state of the field in automation-assisted implant surgical osteotomy technologies. A broad search of the literature was performed to identify current literature. The results are outlined in three broad categories: semi-automated static (image-guided) or dynamic (navigation-assisted) systems, and fully-automated robotic systems. As well as the current mechanical rotary approaches, the literature supporting the use of lasers in further refinement of these approaches is reviewed. The advantages and limitations of adopting autonomous technologies in practical clinical dental practices are discussed. In summary, advances in clinical technologies enable improved precision and efficacious clinical outcomes with implant dentistry. Hard-tissue lasers offer further advancements in precision, improved biological responses, and favorable clinical outcomes that require further investigation.
Accelerating the Appropriate Adoption of Artificial Intelligence in Health Care: Prioritizing IDEA to Champion a Collaborative Educational Approach in a Stressed System
Authors: Teferi Bemnet , Omar Maram , Jeyakumar Tharshini , Charow Rebecca , Gillan Caitlin , Jardine Jessica , Mattson Jane , Dhalla Azra , Kocak Sedef Akinli , Salhia Mohammad , Davies Bryn , Clare Megan , Younus Sarah , Wiljer David
Published: December 2023

In a dynamic healthcare landscape, healthcare professionals (HCPs) must be proficient in artificial intelligence (AI). The Clinician Champions Program was created to address these AI education gaps. Over six weeks, three cohorts participated in this interprofessional program, featuring weekly assignments and a capstone project. This study employs a qualitative descriptive approach to assess the program’s effectiveness in enhancing knowledge, confidence, and skills in AI integration. With a 78% completion rate among 158 clinicians, the program utilized engaging methods, including case studies, capstone projects, and reflective learning to meet diverse learning needs. It also emphasized ethical considerations (e.g., IDEA framework) and the importance of extending educational opportunities to various healthcare professionals. The findings highlight the necessity of a diverse, equitable, and inclusive learning environment to bridge AI education gaps in healthcare. The program’s success supports the idea that enhancing AI knowledge and fostering confidence can lead to meaningful AI discussions in healthcare practice. This research offers insights for educators and institutions aiming to address the evolving healthcare needs through innovative interprofessional educational approaches.
Facilitating Preservice Biology Teacher Development through Material-Based Lesson Planning
Authors: Koberstein-Schwarz Maren , Meisert Anke
Published: December 2023

Lesson planning is a core task for preservice teachers and simultaneously a major challenge due to the complexity of the planning process. This complexity can be reduced by using preselected teaching materials (material-based planning). To explore its potential, think-aloud protocols of material-based planning on the topics of photosynthesis and digestion by 13 preservice biology teachers at a German university serve as the main data source. The data were coded using qualitative content analysis, whereby a superordinate distinction was made between core and secondary dimensions of lesson planning. The results reveal a focus on core dimensions such as instructional strategies (visible structures) and student understanding (deep structures), while secondary dimensions like reflecting task authenticity are comparatively rare. This shows the potential of material-based planning, which enables preservice teachers to concentrate on central planning dimensions due to a reduced workload. Further analysis of the code frequencies shows an imbalance between visible and deep structures, which is more commonly observed in the planning of photosynthesis and is interpreted as an indicator of students’ overload due to the complexity of the topic. Successful planning by preservice teachers is therefore dependent on both planning task and topic selection. Corresponding implications for teacher education are discussed.
Evaluation of Students’ Learning Engagement in Online Classes Based on Multimodal Vision Perspective
Authors: Qi Yongfeng , Zhuang Liqiang , Chen Huili , Han Xiang , Liang Anye
Published: December 2023

The method of evaluating student engagement in online classrooms can provide a timely alert to learners who are distracted, effectively improving classroom learning efficiency. Based on data from online classroom scenarios, a cascaded analysis network model integrating gaze estimation, facial expression recognition, and action recognition is constructed to recognize student attention and grade engagement levels, thereby assessing the level of student engagement in online classrooms. Comparative experiments with the LRCN model, C3D network model, etc., demonstrate the effectiveness of the cascaded analysis network model in evaluating engagement, with evaluations being more accurate than other models. The method of evaluating student engagement in online classrooms compensates for the shortcomings of single-method evaluation models in detecting student engagement in classrooms.
Correction: Pun-García, E.; López-Vallejo, M. A Survey of Analog-to-Digital Converters for Operation under Radiation Environments. Electronics 2020, 9, 1694
Authors: Pun-García Ernesto , López-Vallejo Marisa
Published: December 2023

In the published publication [...]
Investigation of Nano-Heat-Transfer Variability of AlGaN/GaN-Heterostructure-Based High-Electron-Mobility Transistors
Authors: Mzoughi Haikel , Nasri Faouzi , Almoneef Maha , Soltani Sonia , Mbarek Mohamed , Guizani Amenallah
Published: December 2023

The aim of this work is to propose an electrothermal model for predicting the electron mobility, the effective thermal conductivity, and the operating temperature of AlGaN/GaN HEMT devices. The suggested model comprises an enhanced ballistic-diffusive model (BDE) coupled with a drift-diffusion model (D-D). Furthermore, the given model considers total electron mobility, which depends on mobility degradation caused by phonon interactions, surface imperfections, and carrier mobility inside the bulk GaN material. The model is validated based on available experimental and numerical results, and good concordance is observed. It is found that the degradation of the drain current is due to electron mobility and effective thermal conductivity degradation. The output characteristic’s degradation due to changing device temperature is analyzed. We demonstrate that for gate biases of −1 V, 0 V, and 1 V, operating temperatures of 390 K, 470 K, and 570 K are obtained when the drain currents are 0.1 A, 0.24 A, and 0.38 A, respectively. Furthermore, we demonstrate that the temperature is maximal in the active region. The temporal temperature evolution presents the same trends with the same amplitude compared to the experimental data, and the error does not exceed 5%.
A Miniaturized Bandpass Filter with Wideband and High Stopband Rejection Using LTCC Technology
Authors: Ma Yue , Du Qifei , Zhang Wei , Liu Cheng , Zhang Hao
Published: December 2023

This paper designs an L-band wide stopband bandpass filter by applying low-temperature cofired ceramic (LTCC) technology to the global positioning system (GPS) frequency band. Taking the Chebyshev filter as a prototype, an equivalent collector element (capacitive and inductor) structure is adopted to fully use the three-dimensional package structure of LTCC to reduce the filter size. The filter is integrated into an eight-layer LTCC dielectric, and the series–parallel connection of the collector elements in the resonance unit is utilized to produce out-of-band transmission zeros, while the input and output ports’ capacitance is adjusted to control the bandwidth. Harmonic suppression is achieved by cascading two new compact stopband filters, while the size increase is insignificant due to LTCC technology. The simulation results are as follows: the center frequency is 1.575 GHz, 1 dB relative bandwidth is 6.3%, insertion loss in the passband is as slight as 1.6 dB, return loss is better than 30 dB, rejection bandwidth up to 16 GHz is more than 44 dB, and the volume of the whole filter is 6.2 × 3.7 × 0.78 mm3.
Automatic Separation of Photosynthetic Components in a LiDAR Point Cloud Data Collected from a Canadian Boreal Forest
Authors: Taheriazad Leila , Moghadas Hamid , Sanchez Azofeifa Arturo
Published: December 2023

Terrestrial LiDAR has emerged as a promising technology for accurate forest assessment. LiDAR can provide a 3D image composed of a cloud of points using a rotary laser scanner. The point cloud data (PCD) contain information on the (x, y, z) coordinates of every single scanned point and a raw intensity parameter. This study introduces an algorithm for the automatic and accurate separation of the photosynthetic features of a PCD. It is shown that the recorded raw intensity is not a suitable parameter for the separation of photosynthetic features. Instead, for the first time, the absorption intensity is developed for every point based on its raw intensity and distance from the scanner, using proper scaling functions. Then, the absorption intensity is utilized as the only criterion for the classification of the points between photosynthetic and non-photosynthetic features. The proposed method is applied to the scans from a Canadian Boreal Forest and successfully extracted the photosynthetic features with minimal average type I and type II error rates of 5.7% and 4.8%. The extracted photosynthetic PCD can be readily used for calculating important forest parameters such as the leaf area index (LAI) and the green biomass. In addition, it can be used for estimating forest carbon storage and monitoring temporal changes in vegetation structure and ecosystem health.
Environmental Inequalities in Ecosystem Services Benefits of Green Infrastructure: A Case Study from China
Authors: Xiong Guoling , He Rongxiao , Wang Guangyu , Hong Jingke , Jin Yawen
Published: December 2023

Rapid urbanization is widespread globally, particularly impacting developing countries. In the face of climate challenges and shrinking public spaces resulting from urbanization, the significance of green infrastructure (GI) for human well-being and sustainability has increasingly taken center stage. This study employs an array of social-environmental benefits to evaluate GI’s contributions to human well-being, including mitigation of the urban heat island (UHI) effect, recreational functions, enhanced landscape connectivity, and efficient stormwater management. By mapping GI’s advantages, we scrutinized tradeoffs and ‘hot spots’ linked to these benefits within a metropolitan region. Moreover, we correlated GI’s advantages with the well-being of different socio-economic status (SES) groups by global and local regression. The study reveals environmental inequality, with higher SES areas—such as affluent and well-educated neighborhoods—providing superior and multifaceted GI benefits. The income coefficient is significantly positively correlated with the recreation function at the 1% significance level, while the coefficient for education is significant at the 10% level. Moreover, the income coefficient (0.349) surpasses the education coefficient (0.012). Our research also highlights that accessibility to GI’s recreational services may be an essential and overlooked indicator of environmental justice, especially for communities with a high proportion of elderly and low-income individuals.
Evaluation of the Phenolic Composition and Biological Activities of Six Aqueous Date (Phoenix dactylifera L.) Seed Extracts Originating from Different Countries: A Comparative Analysis
Authors: Swaidan Aseel , Azakir Bilal , Neugart Susanne , Kattour Naim , Sokhn Elie Salem , Osaili Tareq M. , Darra Nada El
Published: December 2023

Date seeds, which are the main by-products of date fruit consumption, were shown to possess promising biological activities and health benefits with minimal human use. The present investigation analyzed and compared the phenolic content of six date seed varieties from four different origins (Khudari, Sakai, and Safawi from Saudi Arabia, Majdool from Jordan, Zahdi from Iraq, and Kabkab from Iran). The aqueous extracts were examined for possible antioxidant, antibacterial, and anti-tumor potential. Date seed oil was extracted, and fatty acid profiles were compared. The results revealed that date seeds are a rich source of polyphenols, which have been linked to biological activities. Furthermore, the phenolic content seemed highly dependent on the variety, where Kabkab had the highest TPC value (271.2 mg GAE/g DM) while Majdool had the lowest value (63.2 mg GAE/g DM). Antioxidant activities of all varieties were highly correlated with the total phenolic content. The antibacterial investigation demonstrated that the Sakai variety possessed the dominant activity, whereas Majdool showed no activity. The results further indicated the sensitivity of both Staphylococcus aureus and Bacillus cereus, with a stronger effect against B. cereus, while no effect was observed against Gram-negative strains (Salmonella Typhi and Escherichia coli). All varieties were able to decrease colon and lung cancer cell viability, especially Khudari and Sakai, with stronger effects against colon cancer cells. Analysis of date seed oil showed high oleic acid content, especially in Sakai. The findings suggest that date seeds are promising candidates for future pharmaceutical applications as nutraceuticals to help combat certain illnesses, as well as functional foods and natural additives that boost the nutritional value of food products, increase their shelf lives, and improve the overall health of consumers.
Sensory Attributes and Instrumental Chemical Parameters of Commercial Spanish Cured Ewes’ Milk Cheeses: Insights into Cheese Quality Figures
Authors: Beltrán Sanahuja Ana , Pesci de Almeida Rafaela , Igler Marí Kilian-Anja , Lamadrid Marina Cano , Valdés García Arantzazu , Nadal Esther Sendra
Published: December 2023

The external appearance of some of the Protected Designation of Origin (PDO) cured cheeses is similar to other cheese samples made in Spain: 1 kg and 2.5–3 kg formats, cylindrical, and with or without a pleita mark on the surface. In this work, commercial cured ewe’s milk cheese samples with a similar external appearance were analyzed, including five PDO and five non-PDO samples. The parameters analyzed were color, texture, pH, humidity, water activity, and the volatile profile. Additionally, a descriptive and consumer-sensory analysis of the cheese samples was carried out. Statistical analysis of the results showed that luminosity, color coordinates a* and b*, percentage of deformation, humidity, water activity, and acid contents were significantly higher in non-PDO cheese samples. The breaking force, maximum force, and the content of esters were significantly higher in those cheese samples with PDO. In addition, PDO cheese samples showed higher scores for all attributes evaluated by consumers, except for color. These results suggest that PDO cheeses are placed on the market with a higher degree of ripening than non-PDO ones and that consequently they are more positively valued by consumers.
Elevated Midkine Serum Levels Are Associated with Long-Term Survival in Critically Ill Patients
Authors: Hohlstein Philipp , Abu Jhaisha Samira , Yagmur Eray , Wawer Dennis , Pollmanns Maike R. , Adams Jule K. , Wirtz Theresa H. , Brozat Jonathan F. , Bündgens Lukas , Hamesch Karim , Weiskirchen Ralf , Tacke Frank , Trautwein Christian , Koch Alexander
Published: December 2023

Midkine (Mdk) is a multifunctional protein involved in inflammatory processes. Hence, circulating Mdk is increased in sepsis and has been previously suggested as a potential biomarker in these patients. The aim of this study was to elucidate the role of Mdk serum concentrations in critical illness and sepsis and to verify its value as a prognostic biomarker. Thus, we analyzed the Mdk serum concentrations of 192 critically ill patients on admission to the medical intensive care unit (ICU). While the serum levels of Mdk at admission were similar in septic and nonseptic critical illness (362 vs. 337 ng/L, p = 0.727), we found several interesting correlations of Mdk to laboratory and clinical markers associated with ischemia or hypoxia, e.g., to renal failure and hepatic injury. Mdk serum concentrations at admission did not differ between various causes of sepsis or other critical illness. Most noticeable, we observed upregulated Mdk serum concentrations at admission in patients surviving in the long-term, which was only seen in nonseptic critical illness but not in sepsis. Our study suggests a relevant role of Mdk in critically ill patients in general and highlights the possible protective features of Mdk in critical illness.
Neuroprotective Effect of Antiapoptotic URG7 Protein on Human Neuroblastoma Cell Line SH-SY5Y
Authors: Nigro Ilaria , Miglionico Rocchina , Carmosino Monica , Gerbino Andrea , Masato Anna , Sandre Michele , Bubacco Luigi , Antonini Angelo , Rinaldi Roberta , Bisaccia Faustino , Armentano Maria Francesca
Published: December 2023

Up-regulated Gene clone 7 (URG7) is a protein localized in the endoplasmic reticulum (ER) and overexpressed in liver cells upon hepatitis B virus (HBV) infection. Its activity has been related to the attenuation of ER stress resulting from HBV infection, promoting protein folding and ubiquitination and reducing cell apoptosis overall. While the antiapoptotic activity of URG7 in HBV-infected cells may have negative implications, this effect could be exploited positively in the field of proteinopathies, such as neurodegenerative diseases. In this work, we aimed to verify the possible contribution of URG7 as a reliever of cellular proteostasis alterations in a neuronal in vitro system. Following tunicamycin-induced ER stress, URG7 was shown to modulate different markers of the unfolded protein response (UPR) in favor of cell survival, mitigating ER stress and activating autophagy. Furthermore, URG7 promoted ubiquitination, and determined a reduction in protein aggregation, calcium release from the ER and intracellular ROS content, confirming its pro-survival activity. Therefore, in light of the results reported in this work, we hypothesize that URG7 offers activity as an ER stress reliever in a neuronal in vitro model, and we paved the way for a new approach in the treatment of neurodegenerative diseases.
An In Vitro Model for Acute Myeloid Leukemia Relapse Using the SORE6 Reporter
Authors: Lai Justine , Shang Chuquan , Chen Will , Izevbaye Iyare , Chu Michael P. , Sandhu Irwindeep , Brandwein Joseph , Lai Raymond , Wang Peng
Published: December 2023

Many patients diagnosed with acute myeloid leukemia (AML) relapse within two years of the initial remission. The biology of AML relapse is incompletely understood, although cancer stem-like (CSL) cells have been hypothesized to be important. To test this hypothesis, we employed SORE6, a reporter designed to detect the transcriptional activity of the embryonic stem cell proteins Oct4 and Sox2, to identify/purify CSL cells in two FLT3-mutated AML cell lines. Both cell lines contained ~10% of SORE6+ cells in the steady state. Compared to SORE6− cells, SORE6+ cells exhibited more characteristics of CSL cells, with significantly higher chemoresistance and rates of spheroid formation. SORE6+ cells had substantially higher expression of Myc and FLT3 proteins, which are drivers of SORE6 activity. Using a mixture of SORE6−/SORE6+ cells that were molecularly barcoded, we generated an in vitro study model for AML relapse. Specifically, after ‘in vitro remission’ induced by Ara-C, both cell lines regenerated after 13 ± 3 days. Barcode analysis revealed that most of the regenerated cells were derived from the original SORE6+ cells. Regenerated cells exhibited more CSL features than did the original SORE6+ cells, even though a proportion of them lost SORE6 activity. In bone marrow samples from a patient cohort, we found that relapsed blasts expressed significantly higher levels of Myc, a surrogate marker of SORE6 activity, compared to pre-treatment blasts. To conclude, using our in vitro model, we have provided evidence that CSL cells contribute to AML relapse.
Scavenging of Cation Radicals of the Visual Cycle Retinoids by Lutein, Zeaxanthin, Taurine, and Melanin
Authors: Rozanowska Malgorzata , Edge Ruth , Land Edward J. , Navaratnam Suppiah , Sarna Tadeusz , Truscott T. George
Published: December 2023

In the retina, retinoids involved in vision are under constant threat of oxidation, and their oxidation products exhibit deleterious properties. Using pulse radiolysis, this study determined that the bimolecular rate constants of scavenging cation radicals of retinoids by taurine are smaller than 2 × 107 M−1s−1 whereas lutein scavenges cation radicals of all three retinoids with the bimolecular rate constants approach the diffusion-controlled limits, while zeaxanthin is only 1.4–1.6-fold less effective. Despite that lutein exhibits greater scavenging rate constants of retinoid cation radicals than other antioxidants, the greater concentrations of ascorbate in the retina suggest that ascorbate may be the main protectant of all visual cycle retinoids from oxidative degradation, while α-tocopherol may play a substantial role in the protection of retinaldehyde but is relatively inefficient in the protection of retinol or retinyl palmitate. While the protection of retinoids by lutein and zeaxanthin appears inefficient in the retinal periphery, it can be quite substantial in the macula. Although the determined rate constants of scavenging the cation radicals of retinol and retinaldehyde by dopa-melanin are relatively small, the high concentration of melanin in the RPE melanosomes suggests they can be scavenged if they are in proximity to melanin-containing pigment granules.
Germination and Vegetative Propagation of the Wild Species Cuphea pulchra Moric. (Lythraceae), a Potential Ornamental Crop
Authors: Corsino Ana Luísa , Alves-da-Silva Dulce , Palhares-Melo Luis Alberto M. , Cavalcanti Taciana Barbosa
Published: December 2023

Cuphea pulchra Moric. is a species native to the Cerrado and Caatinga biomes that grows in environments with high temperatures and low rainfall and can be adapted as an ornamental plant for pots. Tests were carried out on C. pulchra seeds, as well as the cultivation of plants from both seeds and cuttings in a greenhouse. Seeds at different stages of maturity (green, almost ripe, and mature) were placed on agar and paper for germination tests. The cultivated plants were pruned as necessary. Two cutting tests were carried out according to the age of the donor plant. The flowering period was monitored. Germination was successful with the almost ripe seeds. Drastic pruning was able to produce compact plants in pots. Cutting tests had greater sprouting with younger donor plants. Cuphea pulchra stood out in terms of the length of the flowering period, which lasted up to ten months. Greenhouse cultivation produced viable plants for the ornamental plant market.
The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance
Authors: Kouvelos George , Volakakis George , Dakis Konstantinos , Spanos Konstantinos , Giannoukas Athanasios
Published: December 2023

There has been a debate about whether maximum diameter can be solely used to assess the natural history of abdominal aortic aneurysm. The aim of the present review is to collect all the available evidence on the role of abdominal aortic aneurysm (AAA) volume in the natural history of AAAs, including small untreated AAAs and AAAs treated by EVAR. The current literature appears to reinforce the role of volume as a supplementary measure for evaluating the natural history of AAA, in both intact AAAs and after EVAR. The clinical impact of AAA volume measurements remains unclear. Several studies show that volumetric analysis can assess changes in AAAs and predict successful endoluminal exclusion after EVAR more accurately than diameter. However, most studies lack strict standardized measurement criteria and well-defined outcome definitions. It remains unclear whether volumetry could replace diameter assessment in defining the risk of rupture of AAAs and identifying clinically relevant sac growth.
Outcomes Following Closure of Secundum Atrial Septal Defect in Children ≤ 15 kg in a French Tertiary Centre
Authors: Pilard Claire-Marie , Villemain Olivier , Laforest Gérald , Roubertie François , Thambo Jean-Benoit , Jalal Zakaria
Published: December 2023

Secundum atrial septal defects (sASDs) are common congenital cardiac defects mostly treated using a transcatheter approach. However, small children (<15 kg) are still undergoing surgical sASD closure in many centres. Although both options have been proved to have excellent results in children, comparative data of the two techniques are missing for patients ≤ 15 kg. The medical records of children ≤ 15 kg who underwent sASD surgical (group A) and transcatheter (group B) closure between 2010 and 2023 were reviewed retrospectively. Twenty-five children in group A and twenty-two in group B were included (mean weight 8.9 kg in group A and 10.3 kg in group B). The main indications for closure were right heart enlargement and failure to thrive. Major complications occurred in two patients in group A and none in group B. Minor complications occurred in eight patients in group A and one in group B. At last follow-up, symptoms resolved completely or improved significantly for all infants, with the exception of failure to thrive in the sub-population of children with extra-cardiac comorbidities. sASD closure can be performed safely in symptomatic infants ≤ 15 kg, even in the presence of comorbidity, and should not be postponed. However, in patients with extra-cardiac comorbidities, the only indication of growth retardation must be carefully evaluated.
Number Bias in Clinicians’ Documentation of Actinic Keratosis Removal
Authors: Holovach Phillip G. , Hsu Wei-Wen , Fleischer Alan B.
Published: December 2023

Background: Actinic keratosis (AK) is a pre-cancerous skin condition caused by sun exposure. Number bias, a phenomenon that occurs when meaning other than numerical value is associated with numbers, may influence the reporting of AK removal. The present study aims to determine if number bias is affecting healthcare providers’ documentation of patient-provider encounters. Methods: A single-center retrospective chart review of 1415 patients’ charts was conducted at the University of Cincinnati Medical Center. To determine if there was a significant difference between even and odd-numbered AK removals reported, an exact binomial test was used. The frequency of removals per encounter was fitted to a zero-truncated negative binomial distribution to predict the number of removals expected. All data were analyzed with RStudio. Results: There were 741 odd and 549 even encounters. Odd removals were reported at a significantly greater frequency than even p < 0.001. Age may be contributing to the observed number bias (p < 0.001). One, two, and eight were reportedly removed more frequently, while nine, 13, and 14 were reportedly removed less frequently than expected, respectively. Conclusion: Number bias may be affecting clinicians’ documentation of AK removal and should be investigated in other clinical settings.
Atrial Fibrillation Ablation with a Novel Fully 3D-Mapping-Integrated Multi-Electrode Radiofrequency Balloon Catheter
Authors: Teumer Yannick , Miesbichler Clemens , Hauke Andreas , Katov Lyuboslav , Bothner Carlo , Pott Alexander , Müller Martin , Walter Benjamin , Rottbauer Wolfgang , Dahme Tillman , Weinmann Karolina
Published: December 2023

Pulmonary vein isolation (PVI), as the cornerstone of atrial fibrillation (AF) ablation, has emerged a widely used therapy for patients suffering from AF. To improve PVI efficiency, single-shot catheters (SSCs) have been developed. Regrettably, SSCs are not integrated into 3D-mapping technology. In that regard, a novel radiofrequency balloon catheter (RFBC, Heliostar, Biosense Webster) with full integration into 3D-mapping technology has been developed. The aim of this study was to assess operative and follow-up outcomes of the RFBC in AF patients. In this monocentric prospective registry, patients with a first-time PVI using the RFBC were included. Follow-up visits were scheduled 3, 6, 12 and 24 months after ablation and in case of symptoms. A total of 171 patients (36.8% female) were included, with a mean age of 68.5 ± 10.2 years. Among them, 63 patients (36.8%) presented with persistent AF. Notably, no major periprocedural complications were observed. The mean follow-up period was 287 ± 157 days. In the Kaplan–Meier analysis, the estimated recurrence-free survival after 12 months was 81.8%. Based on our data, PVI with the fully 3D-mapping-integrated RFBC seems to be safe and effective and to have a favorable 12-month outcome in patients with paroxysmal and persistent AF.
Long Stent Implantation on the Left Anterior Descending Coronary Artery at a Follow-Up of More Than Five Years
Authors: Sticchi Alessandro , Tatali Concetta , Ferraro Massimo , Khokhar Arif A. , Scoccia Alessandra , Cereda Alberto , Toselli Marco , Gallo Francesco , Laricchia Alessandra , Mangieri Antonio , Grigioni Francesco , Ussia Gian Paolo , Giannini Francesco , Colombo Antonio
Published: December 2023

Background: Stent implantation represents the standard of care in coronary intervention. While a short stent implanted on a focal lesion located on the left anterior descending artery (LAD) seems a reasonable alternative to an internal mammary implant, the same for long stents is still debated. Methods: We reported the long-term data of 531 consecutive patients who underwent Percutaneous Coronary Intervention (PCI) with long stents in two highly specialized centres. The main inclusion criteria were the implantation of stents longer than 30 mm on the LAD and a minimum follow-up (FU) of five years. The primary endpoint was mortality, and the secondary endpoints were any myocardial infarction (MI), target vessel and lesion revascularization (TVR and TLR, respectively), and stent thrombosis (ST) observed as definite, probable, or possible. Results: In this selected population with characteristics of complex PCI (99.1%), the long-term follow-up (mean 92.18 ± 35.5 months) estimates of all-cause death, cardiovascular death, and any myocardial infarction were 18.3%, 10.5%, and 9.3%, respectively. Both all-cause and cardiovascular deaths are significantly associated with three-vessel disease (HR 6.8; confidence of interval (CI) 95% 3.844–11.934; p < 0.001, and HR 4.7; CI 95% 2.265–9.835; p < 0.001, respectively). Target lesion (TLR) and target vessel revascularization (TVR) are associated with the presence of three-lesion disease on the LAD (HR 3.4; CI 95% 1.984–5.781; p < 0.001; HR 3.9 CI 95% 2.323–6.442; p < 0.001, respectively). Re-PCI for any cause occurred in 31.5% of patients and shows an increased risk for three-lesion stenting (HR 4.3; CI 95% 2.873–6.376; p < 0.001) and the treatment of bifurcation with two stents (HR 1.6; 95% CI 1.051–2.414; p = 0.028). Stent thrombosis rate at the 5-year FU was 4.4% (1.3% definite; 0.9% probable; 2.1% possible), including a 1.7% rate of very-late thrombosis. The stent length superior to 40 mm was not associated with poor outcomes (all-cause death p = 0.349; cardiovascular death p = 0.855; MI p = 0.691; re-PCI p = 0.234; TLR p = 0.805; TVR p = 0.087; ST p = 0.189). Conclusion: At an FU of longer than five years, patients treated with stents longer than 30 mm in their LAD showed acceptable procedural results but poor outcomes.
Adaptive Illuminance Effects on Retinal Morphology and Refraction: A Comprehensive Study of Night Myopia
Authors: Orduna-Hospital Elvira , Crespo-Castan Cynthia , Ávila Francisco J. , Sanchez-Cano Ana
Published: December 2023

Background: We aimed to study the optical and retinal modifications that occur after adapting to different lighting conditions including photopic, mesopic, scotopic, blue light and red light conditions. Methods: Thirty young healthy subjects with a mean age of 23.57 ± 3.45 years were involved in the study (both eyes included). They underwent aberrometry and optical coherence tomography at both the central and peripheral retina with the 3 × 3 mm2 macular cube protocol before starting adaptation to the illuminations (baseline) and after remaining for 5 min under the five different lighting conditions inside a controlled lighting cabinet. Results: Significant myopization (p = 0.002) was observed under scotopic and mesopic lighting conditions, while hypermetropization occurred under the influence of blue LED light. In the central retina, a significant thickening of the inner temporal (p = 0.025) and outer inferior (p = 0.021) areas was observed in the scotopic area, and the thickening increased even more under blue and red light. The mean central thickness decreased significantly under photopic lighting conditions (p = 0.038). There was an increase in the mean volume of the central retinal area with red light and a reduction in the volume under photopic lighting (p = 0.039). In the peripheral retina, no significant thickness changes were observed after adapting to any of the lighting conditions (p > 0.05). Regarding morphological changes, a significant increase in retinal eccentricity (p = 0.045) and the shape factor (p = 0.036) was found. In addition, a significant correlation was found only between the eccentricity and volume of the central retina in scotopic conditions (r = −0.265; p = 0.041), meaning that a higher volume was associated with lower retinal eccentricity. Conclusions: When exposed to different lighting conditions, the retina changes in shape, and ocular refraction is modified to adapt to each condition, revealing the phenomenon of night myopia when transitioning from photopic to scotopic regimes.
Frailty and Increased Levels of Symptom Burden Can Predict the Presence of Each Other in HNSCC Patients
Authors: Kunz Viktor , Wichmann Gunnar , Wald Theresa , Dietz Andreas , Wiegand Susanne
Published: December 2023

Frailty is an important risk factor for adverse events (AEs), especially in elderly patients. Therefore, assessing frailty before therapy is recommended. In head and neck squamous cell carcinoma (HNSCC) patients, frailty is prognostic for severe postoperative complications and declining quality of life (QoL) after HNSCC treatment. Thus, assessment of frailty may help to identify individuals at risk for AE caused by oncologic therapy. We investigated the relationship between frailty and symptom burden to better understand their interaction and impact on HNSCC patients. In this prospectively designed cross-sectional study, the presence of frailty and symptom burden was assessed by using the Geriatric 8 (G8) and Minimal Documentation System (MIDOS2) questionnaires. A total of 59 consecutively accrued patients with a first diagnosis of HNSCC before therapy were evaluated. Patients were considered frail at a total G8 score ≤ 14. The MIDOS2 symptom burden score was considered pathological with a total score ≥ 4 or any severe symptom (=3). Statistical correlations were analyzed using Spearman and Pearson correlation. Receiver operator characteristic (ROC) curves were used to analyze the potential of predicting frailty and MIDOS2. p-values < 0.05 were considered significant. A total of 41 patients (69.5%) were considered frail, and 27 patients (45.8%) had increased symptom burden. “Tiredness” was the most common (overall rate 57.8%) and “Pain” was the most often stated “severe” symptom (5 patients, 8.5%). G8 and MIDOS2 correlated significantly (ρ = −0.487, p < 0.001; r = −0.423, p < 0.001). Frailty can be predicted by MIDOS2 symptom score (AUC = 0.808, 95% CI 0.698–0.917, p < 0.001). Vice versa, the G8 score can predict pathological symptom burden according to MIDOS2 (AUC = 0.750, 95% CI 0.622–0.878, p < 0.001). Conclusions: The strong link between frailty and increased symptom burden assessed by G8 or MIDOS2 indicates a coherence of both risk factors in HNSCC patients. Considering at least one of both scores might improve the identification of individuals at risk and achieve higher QoL and reduced complication rates by decision making for appropriate therapy regimens.
How Early Is Early Multiple Sclerosis?
Authors: Stavropoulou De Lorenzo Sotiria , Bakirtzis Christos , Konstantinidou Natalia , Kesidou Evangelia , Parissis Dimitrios , Evangelopoulos Maria Eleptheria , Elsayed Dina , Hamdy Eman , Said Sameh , Grigoriadis Nikolaos
Published: December 2023

The development and further optimization of the diagnostic criteria for multiple sclerosis (MS) emphasize the establishment of an early and accurate diagnosis. So far, numerous studies have revealed the significance of early treatment administration for MS and its association with slower disease progression and better late outcomes of the disease with regards to disability accumulation. However, according to current research results, both neuroinflammatory and neurodegenerative processes may exist prior to symptom initiation. Despite the fact that a significant proportion of individuals with radiologically isolated syndrome (RIS) progress to MS, currently, there is no available treatment approved for RIS. Therefore, our idea of “early treatment administration” might be already late in some cases. In order to detect the individuals who will progress to MS, we need accurate biomarkers. In this review, we present notable research results regarding the underlying pathology of MS, as well as several potentially useful laboratory and neuroimaging biomarkers for the identification of high-risk individuals with RIS for developing MS. This review aims to raise clinicians’ awareness regarding “subclinical” MS, enrich their understanding of MS pathology, and familiarize them with several potential biomarkers that are currently under investigation and might be used in clinical practice in the future for the identification of individuals with RIS at high risk for conversion to definite MS.
Effects of Novel Dental Composites on Streptococcus mutans Biofilms
Authors: Yaghmoor Rayan B. , Abdel-Hadi Mohammad , Petridis Haralampos , Allan Elaine , Young Anne M.
Published: December 2023

With the phase-out of amalgam and the increase in minimally invasive dentistry, there is a growing need for high-strength composite materials that can kill residual bacteria and promote tooth remineralization. This study quantifies how antibacterial polylysine (PLS) and re-mineralizing monocalcium phosphate monohydrate (MCPM) affect Streptococcus mutans biofilms and the strength of dental composites. For antibacterial studies, the MCPM-PLS filler percentages were 0-0, 8-4, 12-6, and 16-8 wt% of the composite filler phase. Composite discs were immersed in 0.1% sucrose-supplemented broth containing Streptococcus mutans (UA159) and incubated in an anaerobic chamber for 48 h. Surface biomass was determined by crystal violet (CV) staining. Growth medium pH was measured at 24 and 48 h. Biofilm bacterial viability (CFU), exo-polysaccharide (water-soluble glucan (WSG) and water-insoluble glucan (WIG)), and extracellular DNA (eDNA) were quantified. This was by serial dilution plate counting, phenol-sulfuric acid microassay, and fluorometry, respectively. The biaxial flexural strengths were determined after water immersion for 1 week, 1 month, and 1 year. The MCPM-PLS wt% were 8-4, 8-8, 16-4 and 16-8. The normalized biomass, WSG, and WIG showed a linear decline of 66%, 64%, and 55%, respectively, as the PLS level increased up to 8%. The surrounding media pH (4.6) was all similar. A decrease in bacterial numbers with the 12-6 formula and a significant reduction with 16-8 compared to the 0-0 formulation was observed. The eDNA concentrations in biofilms formed on 12-6 and 16-8 formulations were significantly less than the 0-0 control and 8-4 formulations. Doubling MCPM and PLS caused a 14 and 19% reduction in strength in 1 week, respectively. Average results were lower at 1 month and 1 year but affected less upon doubling MCPM and PLS levels. Moreover, a 4% PLS may help to reduce total biomass and glucan levels in biofilms on the above composites. Higher levels are required to reduce eDNA and provide bactericidal action, but these can decrease early strength.
Perspectives on Post-COVID-19 Pulmonary Fibrosis Treatment
Authors: Cojocaru Elena , Cojocaru Tudor , Pînzariu Giulia Mihaela , Vasiliu Ioana , Armașu Ioana , Cojocaru Cristian
Published: December 2023

Pulmonary fibrosis, a critical outcome of chronic inflammatory diseases, has gained prominence in the context of post-coronavirus (post-COVID-19) complications. This review delves into the multifaceted landscape of post-COVID-19 pulmonary fibrosis, elucidating the intricate molecular mechanisms underlying its pathogenesis and highlighting promising therapeutic avenues. Examining the aftermath of severe acute respiratory syndrome-2 (SARS-CoV-2) infection, the review reveals key signaling pathways implicated in the fibrotic cascade. Drawing parallels with previous coronavirus outbreaks enhances our understanding of the distinctive features of post-COVID-19 fibrosis. Antifibrotic drugs, like pirfenidone and nintedanib, take center stage; their mechanisms of action and potential applications in post-COVID-19 cases are thoroughly explored. Beyond the established treatments, this review investigates emerging therapeutic modalities, including anti-interleukin agents, immunosuppressants, and experimental compounds, like buloxybutide, saracatinib, sirolimus, and resveratrol. Emphasizing the critical importance of early intervention, this review highlights the dynamic nature of post-COVID-19 pulmonary fibrosis research. In conclusion, the synthesis of current knowledge offers a foundation for advancing our approaches to the prevention and treatment of these consequential sequelae of COVID-19.
The Buzz Surrounding Precision Medicine: The Imperative of Incorporating It into Evidence-Based Medical Practice
Authors: Muharremi Guido , Meçani Renald , Muka Taulant
Published: December 2023

Precision medicine (PM), through the integration of omics and environmental data, aims to provide a more precise prevention, diagnosis, and treatment of disease. Currently, PM is one of the emerging approaches in modern healthcare and public health, with wide implications for health care delivery, public health policy making formulation, and entrepreneurial endeavors. In spite of its growing popularity and the buzz surrounding it, PM is still in its nascent phase, facing considerable challenges that need to be addressed and resolved for it to attain the acclaim for which it strives. In this article, we discuss some of the current methodological pitfalls of PM, including the use of big data, and provide a perspective on how these challenges can be overcome by bringing PM closer to evidence-based medicine (EBM). Furthermore, to maximize the potential of PM, we present real-world illustrations of how EBM principles can be integrated into a PM approach.
Robust ISAC Localization in Smart Cities: A Hybrid Network Approach for NLOS Challenges with Uncertain Parameters
Authors: Althobaiti Turke , Khalil Ruhul Amin , Saeed Nasir
Published: December 2023

Accurate localization holds paramount importance across many applications within the context of smart cities, particularly in vehicular communication systems, the Internet of Things, and Integrated Sensing and Communication (ISAC) technologies. Nonetheless, achieving precise localization remains a persistent challenge, primarily attributed to the prevalence of non-line-of-sight (NLOS) conditions and the presence of uncertainties surrounding key wireless transmission parameters. This paper presents a comprehensive framework tailored to address the intricate task of localizing multiple nodes within ISAC systems significantly impacted by pervasive NLOS conditions and the ambiguity of transmission parameters. The proposed methodology integrates received signal strength (RSS) and time-of-arrival (TOA) measurements as a strategic response to effectively overcome these substantial challenges, even in situations where the precise values of transmitting power and temporal information remain elusive. An approximation approach is judiciously employed to facilitate the inherent non-convex and NP-hard nature of the original estimation problem, resulting in a notable transformation, rendering the problem amenable to a convex optimization paradigm. The comprehensive array of simulations conducted within this study corroborates the efficacy of the proposed hybrid cooperative localization method by underscoring its superior performance relative to conventional approaches relying solely on RSS or TOA measurements. This enhancement in localization accuracy in ISAC systems holds promise in the intricate urban landscape of smart cities, offering substantial contributions to infrastructure optimization and service efficiency.
Evaluation of Site Suitability for Photovoltaic Power Plants in the Beijing–Tianjin–Hebei Region of China Using a Combined Weighting Method
Authors: Liang Lijiang , Chen Zhen , Chen Shijin , Zheng Xinqi
Published: December 2023

As the construction of photovoltaic power plants continues to expand, investors have placed great importance on the suitability assessment of site selection. In this study, we have developed a multi-level evaluation system and proposed an AHP–XGBoost–GIS comprehensive evaluation model for assessing site suitability in the Beijing–Tianjin–Hebei region. The findings revealed that approximately 48,800 km2 (21.59% of the total area) constituted a suitable area in this region, surpassing previous research results. Generally suitable areas accounted for the largest proportion at 35.89%. Suitable areas in Beijing and Tianjin were relatively limited, with most of them concentrated in Baoding City, Zhangjiakou City, and Chengde City on the northwest side of the “Yanshan-Taihang Mountains”, where there are ample wastelands with gentle slopes conducive to constructing photovoltaic power plants southeast of the “Yanshan-Taihang Mountains”, and solar radiation conditions were better. However, ecological and economic factors restricted suitable areas resulting in smaller coverage including cities such as Handan, Xingtai, Qinhuangdao, and Tangshan, among others. This study successfully overcame limitations associated with traditional subjective evaluation methods by providing decision support for regional energy allocation planning and spatial planning efforts, as well as environmental protection endeavors.