bluuebunny/crossref_metadata_2025 huggingface dataset:
An Approach to Maximize the Admitted Device-to-Device Pairs in MU-MIMO Cellular Networks
Authors: Wang Yubo , Liu Fang , Li Zhixin , Chen Songchao , Zhao Xu
Published: March 2024

Due to the shortage of wireless resources and the emergence of a large number of users, determining how to guarantee the quality-of-service (QoS) requirements of users and make more users work in the same spectrum has become an urgent research topic. In this paper, we study a multi-user MIMO (MU-MIMO) cellular network system model in which cellular users (CUs) share the same spectrum resource with multiple device-to-device (D2D) pairs. To maximize the number of admitted D2D pairs sharing the same spectrum with the CUs, a joint power allocation and channel gain (JPACG) algorithm is proposed. The optimization problem is divided into two steps to be solved. First, the power allocation of CUs without D2D pairs admitted is solved. Then, the optimization problem is transformed into minimizing the interference to CUs when CUs are treated as primary users. The admittance order of D2D pairs is determined by the transmission power and channel gain. The proposed algorithm uses a convex optimization algorithm to solve the problem of power allocation joint interference channel gain in order to maximize the number of admitted D2D pairs under the constraints of the signal-to-interference-plus-noise ratio (SINR) threshold and maximum transmission power. In addition, the effect of the number of admitted D2D pairs on the total sum rate of all users is also analyzed. The simulation results show that the proposed JPACG algorithm can achieve better performance in admitting D2D pairs.
Heat Consumer Model for Robust and Fast Simulations of District Heating Networks Using Modelica
Authors: Zipplies Johannes , Orozaliev Janybek , Jordan Ulrike , Vajen Klaus
Published: March 2024

Dynamic thermo-hydraulic simulations of district heating networks (DHN) are essential to investigate novel concepts for their sustainable design and operation. To develop solutions for a particular case study, numerous long-term simulations are required. Therefore, computational effort for simulation is critical. Heat consumers (HC) are numerous and determine the dynamics of mass flows and return temperatures in the DHN. Thus, the way in which HCs are modeled has significant impact on the computational effort and the results of the simulation. This article presents a novel Modelica-based model for HCs that builds on an existing simplified modeling approach (open-loop design). The calculation of mass flow and return temperature is improved in terms of robustness, plausible behavior and low computational effort. In particular, the model reacts to limited differential pressure and supply temperatures to ensure plausible behavior across all operating conditions, including undersupply situations. The model is successfully tested using an exemplary DHN. The analysis proves that the HC model itself requires little time to simulate. Nevertheless, it significantly influences the simulation time for the entire DHN, which varies by a factor of five for the investigated system depending on the HC model. Fast dynamics, including a bypass in the model and correction of deviations between set point and actual heat load increase the simulation time, so users should sensibly choose how to use these options. HC models triggering many state events result in high computational effort. Compared to other simple HC models, the proposed model produces more plausible results while maintaining at least equal simulation performance (for models without bypass) or even improving it (for models with bypass, CPU time is reduced by at least 35%).
Highly Reliable Short-Circuit Protection Circuits for Gallium Nitride High-Electron-Mobility Transistors
Authors: Kim Chul-Min , Yoon Hyun-Soo , Kim Jong-Soo , Kim Nam-Joon
Published: March 2024

This paper presents a circuit for detecting and protecting against short circuits in E-mode gallium nitride high-electron-mobility transistors (GaN HEMTs) and analyzes the protection performance of the circuit. GaN HEMTs possess fast switching characteristics that enable high efficiency and power density in power conversion devices. However, these characteristics also pose challenges in protecting against short circuits and overcurrent situations. The proposed method detects short-circuit events by monitoring an instantaneous drop in the DC bus voltage of a circuit with GaN HEMTs applied and uses a bandpass filter to prevent the malfunction of the short-circuit protection circuit during normal switching and ensure highly reliable operation. Using this method, the short-circuit detection time of E-mode GaN HEMTs can be reduced to 257 ns, successfully protecting the device without malfunctions even in severe short-circuit situations occurring at high DC link voltages.
Wind Mapping of Malaysia Using Ward’s Clustering Method
Authors: Azhar Amar , Hashim Huzaifa
Published: March 2024

Malaysian wind maps used in wind analysis and engineering design are dated back to the last 50 years of wind data. Cotemporally, the mean wind speed was used as the basic wind design and due to changes in the weather condition worldwide, wind monitoring assumption and structure design are jeopardized. Therefore, this study aims to map the wind based on the trend of the highest wind speed recorded. The wind speed was analyzed based on a trend basis. The study included 42 Malaysian Metrological Department weather stations and the annual wind speed was acquired based on the monthly highest wind speed (1990–2019). The data were then processed using the 95% confidence interval method to determine the mean of the month, and the annual wind trendline was obtained. The trendline was then clustered using Ward’s method with the assistance of the high-level programming language, PYTHON v3.11.6. The clustering analysis produced two clusters for the Malaysian Peninsula and two for Sabah and Sarawak. The recommendation is to use the highest wind speed recorded on the map as the design wind speed. The recommendation is expected to help experts to compensate for the uncertainties in wind speed during the design stage and avoid incidents in the field.
Effects of Root Architecture on Uprooting Properties between Deciduous and Evergreen Species with Different Growth Habits
Authors: Pang Zhonglin , Zhang Yang , Han Shaojie , Wang Enheng , Chen Xiangwei
Published: March 2024

Roots anchor plants firmly to the soil, enabling them to effectively resist soil erosion and shear failure. Vegetation restoration has been acknowledged as one of the most useful measures for controlling soil loss; however, which root system characteristics were most beneficial for plant anchoring in the soil remains unclear. In the black soil region of northeastern China, which frequently experiences serious soil erosion, pullout tests were carried out on six species of soil and water conservation woody plants with different growth habits (deciduous shrubs, deciduous trees and evergreen trees), and the root geometry and topology of each species were determined. The results showed that the maximum uprooting force and activation displacement (the displacement at the maximum peak in the relationship curve between pulling force and displacement) of shrubs were significantly greater than those of trees, while deciduous trees were significantly greater than evergreen trees. Therefore, the ability of the whole root system to anchor the soil was the largest for shrubs, followed by deciduous trees, and the smallest for evergreen trees. The uprooting force and activation displacement were mainly affected by the root topological index, total root length and the number of inclined roots. The total root length had the greatest influence on the maximum uprooting force, and the root topology had the greatest influence on the activation displacement, both of which can be used as important predictors of plant root anchorage strength. In addition, the plants with the R-type root structure may have a greater ability to anchor the soi, and can be prioritized for vegetation restoration with black soils. These findings provide references and implications for identifying the effective plant strategies for eroded soil restoration in the black soil region of northeastern China and other areas with similar soil types and bioclimates.
Nature-Based Tourism in National and Natural Parks in Europe: A Systematic Review
Authors: Donici Delia S. , Dumitras Diana E.
Published: March 2024

Considered among the fastest-growing industries in the world, tourism brings immense benefits but also creates certain challenges. Conservation of natural resources is a stringent necessity, without which the extraordinary ecosystems’ attributes that create the premises for nature-based tourism would reduce, alter, and subsequently disappear. The aim of the present review is twofold: gaining a general understanding of what nature-based tourism is and providing a systematic literature review of articles on nature-based tourism in European national and natural parks, with emphasis on their applicability. The articles included in the present review were selected based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review accounts for research conducted between 2000 and 2021 and is divided into two sections: articles aimed at understanding tourists’ behaviour and articles that are focused on other stakeholders or have the local communities in the foreground. While many studies are aimed at understanding tourists’ behaviour as a means of improving parks’ management, participatory strategies including local communities are often indicated as beneficial. The results of this paper can facilitate future research in the field and provide valuable knowledge to policymakers and any interested parties.
Identification of Pine Wilt Disease-Infested Stands Based on Single- and Multi-Temporal Medium-Resolution Satellite Data
Authors: Kuang Jinjia , Yu Linfeng , Zhou Quan , Wu Dewei , Ren Lili , Luo Youqing
Published: March 2024

Pine wilt disease (PWD) is known for its high lethality and rapid transmission, earning it the name “cancer of the pine tree”. The prompt removal of infested pine trees is an effective measure for preventing and controlling pine wilt disease. Accurate and efficient monitoring technologies are crucial for the scientific prevention and control of this plant disease. Currently, numerous remote sensing monitoring studies have been conducted on pine wilt disease. However, there is limited research on the temporal identification of PWD-infested forest stands over large areas. To build classification models, this study utilized three machine learning algorithms: artificial neural network (ANN), random forest (RF), and support vector machine (SVM). We aimed to investigate the effectiveness of single-temporal and multi-temporal Landsat and Sentinel-2 satellite images PWD-infested forest stands detection. The results indicated that, at a spatial resolution of 30 m, Landsat-9 and Sentinel-2 remote sensing images effectively identified PWD-infested forest stands, with classification accuracies of 77.87% and 78.91%, respectively. Higher spatial resolutions in Sentinel-2 remote sensing images were associated with improved identification capabilities. Furthermore, multi-temporal Landsat satellite data (with a classification accuracy of 85.95%) significantly enhanced the performance of the monitoring model compared to single-temporal Landsat satellite data (with a classification accuracy of 77.87%). The RGI difference was found to be the optimal vegetation index. In conclusion, by combining multi-temporal and single-time-phase Landsat remote sensing data, a monitoring model for PWD-infested forest stands was constructed. It achieved a classification accuracy of 88.26%. In this study, a higher accuracy in identifying pine wilt disease and a lower economic cost were achieved by Landsat and Sentinel images, offering valuable insights for the management of pine wilt disease.
A Novel Edge Platform Streamlining Connectivity between Modern Edge Devices and the Cloud
Authors: Carvalho Anderson , Riordan Daniel , Walsh Joseph
Published: March 2024

This study presents a newly developed edge computing platform designed to enhance connectivity between edge devices and the cloud in the agricultural sector. Addressing the challenge of synchronizing a central database across 850 remote farm locations in various countries, the focus lies on maintaining data integrity and consistency for effective farm management. The incorporation of a new edge device into existing setups has significantly improved computational capabilities for tasks like data synchronization and machine learning. This research highlights the critical role of cloud computing in managing large data volumes, with Amazon Web Services hosting the databases. This paper showcases an integrated architecture combining edge devices, networks, and cloud computing, forming a seamless continuum of services from cloud to edge. This approach proves effective in managing the significant data volumes generated in remote agricultural areas. This paper also introduces the PAIR Mechanism, which is a solution developed in response to the unique challenges of agricultural data management, emphasizing resilience and simplicity in data synchronization between cloud and edge databases. The PAIR Mechanism’s potential for robust data management in IoT and cloud environments is explored, offering a novel perspective on synchronization challenges in edge computing.
Identification and Potential Roles of Human MicroRNAs in Ebola Virus Infection and Disease Pathogenesis
Authors: Mensah-Bonsu Melvin , Doss Christopher , Gloster Clay , Muganda Perpetua
Published: March 2024

Ebola virus (EBOV) is a highly pathogenic virus that causes a severe illness called Ebola virus disease (EVD). EVD has a high mortality rate and remains a significant threat to public health. Research on EVD pathogenesis has traditionally focused on host transcriptional responses. Limited recent studies, however, have revealed some information on the significance of cellular microRNAs (miRNAs) in EBOV infection and pathogenic mechanisms, but further studies are needed. Thus, this study aimed to identify and validate additional known and novel human miRNAs in EBOV-infected adult retinal pigment epithelial (ARPE) cells and predict their potential roles in EBOV infection and pathogenic mechanisms. We analyzed previously available small RNA-Seq data obtained from ARPE cells and identified 23 upregulated and seven downregulated miRNAs in the EBOV-infected cells; these included two novel miRNAs and 17 additional known miRNAs not previously identified in ARPE cells. In addition to pathways previously identified by others, these miRNAs are associated with pathways and biological processes that include WNT, FoxO, and phosphatidylinositol signaling; these pathways were not identified in the original study. This study thus confirms and expands on the previous study using the same datasets and demonstrates further the importance of human miRNAs in the host response and EVD pathogenesis during infection.
Contemporary Insights into the Biological Mechanisms of Parkia biglobosa
Authors: Komolafe Kayode , Olaleye Mary Tolulope , Huang Hung-Chung , Pacurari Maricica
Published: March 2024

For a long time, traditional medicine has relied on the use of medicinal plants and herbal products which have served as the basis for numerous pharmaceuticals. Parkia biglobosa (Jacq) R.Br.ex. G. Don., commonly called the African locust bean tree, is a perennial deciduous plant native to West Africa where it is highly esteemed for its nutritional and traditional medicinal benefits. Parkia biglobosa’s ethnomedicinal uses include microbial infections such as diarrhea and chronic diseases like hypertension and type 2 diabetes mellitus. This article presents the current understanding of the molecular mechanisms underlying Parkia biglobosa’s biological effects. An electronic database search was conducted using P. biglobosa and its synonyms as keywords in Scientific Electronic Library Online, ISI Web of Knowledge, PubMed, Scopus, Science Direct, and Google Scholar. Consistently, scientific research has confirmed the medicinal effects of the plant’s extracts and active phytochemicals, including antimicrobial, analgesic, antidiabetic, antihypertensive, hypolipidemic, and neuroprotective properties, among others. It highlights the contributions of identified innate phytochemicals and existing limitations to therapeutic applications, as well as the need for and prospects for further research. Advancing our understanding of the medicinal plant’s biological mechanisms and the contributions of the active phytochemicals would allow for more effective exploration of its vast pharmacological potential and facilitate clinical applications.
Leveraging the TOE Framework: Examining the Potential of Mobile Health (mHealth) to Mitigate Health Inequalities
Authors: Bin Naeem Salman , Azam Mehreen , Kamel Boulos Maged N. , Bhatti Rubina
Published: March 2024

(1) Aims and Objectives: Mobile health (mHealth) is increasingly becoming a favorite healthcare delivery solution in underserved areas around the globe. This study aims to identify the influence of technology–organization–environment (TOE) factors on mHealth adoption and to assess the influence of mHealth on the reduction in health disparities in the context of healthcare delivery in low-resource settings. (2) Methods: A cross-sectional survey of physicians and nurses was carried out at six hospitals in the public and private health sectors in Pakistan. The survey’s theoretical foundation is based on the technology–organization–environment (TOE) framework. TOE constructs (relative advantage, compatibility, management support, organizational readiness, external support, and government regulations) were used to develop hypotheses. The hypotheses were tested using structural equation modeling (SEM). (3) Results: Findings from this study show that management support and external support are the two main predictors of mHealth adoption among healthcare professionals. The study proposes an mHealth adoption model that can significantly contribute towards improving medical outcomes, reducing inefficiencies, expanding access, lowering costs, raising quality, making medicine more personalized for patients, and gaining advantages from mHealth solutions in order to reduce health disparities. (4) Conclusion: The study suggests that there is no single approach that could support mHealth adoption. Instead, a holistic approach is required that considers cultural, economic, technological, organizational, and environmental factors for successful mHealth adoption in low-resource settings. Our proposed mHealth model offers guidance to policymakers, health organizations, governments, and political leaders to make informed decisions regarding mHealth implementation plans.
A Cloud-Based Deep Learning Framework for Downy Mildew Detection in Viticulture Using Real-Time Image Acquisition from Embedded Devices and Drones
Authors: Kontogiannis Sotirios , Konstantinidou Myrto , Tsioukas Vasileios , Pikridas Christos
Published: March 2024

In viticulture, downy mildew is one of the most common diseases that, if not adequately treated, can diminish production yield. However, the uncontrolled use of pesticides to alleviate its occurrence can pose significant risks for farmers, consumers, and the environment. This paper presents a new framework for the early detection and estimation of the mildew’s appearance in viticulture fields. The framework utilizes a protocol for the real-time acquisition of drones’ high-resolution RGB images and a cloud-docker-based video or image inference process using object detection CNN models. The authors implemented their framework proposition using open-source tools and experimented with their proposed implementation on the debina grape variety in Zitsa, Greece, during downy mildew outbursts. The authors present evaluation results of deep learning Faster R-CNN object detection models trained on their downy mildew annotated dataset, using the different object classifiers of VGG16, ViTDet, MobileNetV3, EfficientNet, SqueezeNet, and ResNet. The authors compare Faster R-CNN and YOLO object detectors in terms of accuracy and speed. From their experimentation, the embedded device model ViTDet showed the worst accuracy results compared to the fast inferences of YOLOv8, while MobileNetV3 significantly outperformed YOLOv8 in terms of both accuracy and speed. Regarding cloud inferences, large ResNet models performed well in terms of accuracy, while YOLOv5 faster inferences presented significant object classification losses.
Seasonal Variability in the Prevalence of DWV Strains in Individual Colonies of European Honeybees in Hawaii
Authors: Zhang Zhening , Villalobos Ethel M. , Nikaido Scott , Martin Stephen J.
Published: March 2024

The most prevalent viral pathogen of honeybees is Deformed Wing Virus (DWV) and its two most widely studied and common master-variants are DWV-A and DWV-B. The prevalence of DWV variants in the UK and in the US is changing, with the prevalence of the DWV-A strain declining and DWV-B increasing over time. In 2012, only DWV-A was detected on the Hawaiian Islands of Oahu. In this study we focused on a colony-level survey of DWV strains in a single apiary and examined the prevalence of DWV variants over the course of two years. In 2018 and 2019, a total of 16 colonies underwent viral testing in January, May, and September. Of those 16 colonies, four were monitored in both 2018 and 2019. Individual colonies showed variability of DWV master variants throughout the sampling period. DWV-A was consistently detected; however, the detection of DWV-B was variable across time in individual colonies. Ultimately, this study demonstrated a seasonal variation in both viral prevalence and load for DWV-B, providing a perspective on the dynamic nature of DWV master variants emerging in Hawaii.
Sensitivity of Vanessa cardui to Temperature Variations: A Cost-Effective Experiment for Environmental Education
Authors: Granato Carmella , Campera Marco , Bulbert Matthew
Published: March 2024

Temperature increases mediated through climate change threaten the survival of species. It is of foremost importance to engage citizens and future generations in understanding the mechanisms through which temperatures impose their effects. For educators, this is not straightforward, as tools for examining the impact of temperature over the lifetime of an animal are prohibitively expensive. At the same time, environmental educators need guidance on the appropriate study systems to use with a balance between the species having an obvious response and ensuring the outcomes are ethical and sustainable. In our study, we created and tested a cost-effective experiment meant to be used for environmental education purposes. More specifically, we tested the sensitivity of the painted lady butterfly Vanessa cardui to temperature variations using a homemade incubator. We describe the design of this experiment and report findings on survival rate, morphological variations, development time of various stages and wingspan of adults across a range of biologically relevant temperatures. The information provided gives educators options for testing a variety of hypotheses with regards to the impacts of temperature using an affordable and flexible set-up. Furthermore, the findings can be used by students to develop an understanding of the ramifications of the butterflies’ responses in an ecological context.
Contralateral Facial Innervation in Healthy Subjects and in Patients with Peripheral Facial Palsy
Authors: Güllüoğlu Halil , Uysal Hasan Armağan , Uludağ Burhanettin
Published: March 2024

Background: We aimed to investigate the extent of the response of the orbicularis oris muscle to stimulation of the contralateral facial nerve both in patients with peripheral facial palsy (PFP) and in healthy subjects. Methods: EMG was performed at 2–6 weeks after the onset of PFP in the patient group and at any time in the healthy control group. We performed nerve conduction testing, electroneurography, and surface and needle EMG. Results: A total of 276 participants (patients/healthy controls: 218/58) were analyzed. The extent of the response of the contralateral orbicularis oris muscles to facial nerve stimulation was higher in healthy controls compared to that in the affected group. The response of the contralateral orbicularis oris muscles to stimulation of the paralyzed facial nerve was more extensive in those patients to whom glucocorticoid or physical therapy had been given. Cross-facial innervation in the orbicularis oris muscle extended up to 1.5 cm in one-third of healthy controls and was higher than that in those with PFP. Glucocorticoid or physical therapy seemed to improve cross-innervation in facial palsy. Conclusions: Our findings suggest that the stimulus leading to the contralateral muscular response is mediated through crossing axons rather than muscular fibers.
The Possible Effect of β-Blocker Use on the Circulating MMP-2/TIMP-2 System in Patients with Chronic Kidney Disease on Conservative Treatment
Authors: Kopańko Magdalena , Zabłudowska Magdalena , Pawlak Dariusz , Sieklucka Beata , Krupa Anna , Sokołowska Katarzyna , Ziemińska Marta , Pawlak Krystyna
Published: March 2024

Background: The purpose of the study was to determine whether the use of β-adrenoceptor antagonists (β-blockers) can affect metalloproteinase 2 (MMP-2) and its tissue inhibitor (TIMP-2) in patients with chronic kidney disease (CKD) on conservative treatment. Methods: The circulating MMP-2/TIMP-2 system, proinflammatory cytokines (tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), and the marker of oxidative stress—Cu/Zn superoxide dismutase (Cu/Zn SOD)—were measured in 23 CKD patients treated with β-blockers [β-blockers (+)] and in 27 CKD patients not receiving the above medication [β-blockers (−)]. Results: The levels of MMP-2, TIMP-2, and IL-6 were significantly lower in the β-blockers (+) than in the β-blockers (−) group, whereas Cu/Zn SOD concentrations were not affected by β-blocker use. There was a strong, independent association between MMP-2 and TIMP-2 in both analyzed patient groups. In the β-blockers (+) group, MMP-2 levels were indirectly related to the signs of inflammation, whereas in the β-blockers (−) group, the alterations in the MMP-2/TIMP-2 system were associated with the oxidative stress marker and CKD etiology. Conclusions: This study is the first to suggest that the use of β-blockers was associated with the reduction in IL-6 and the MMP-2/TIMP-2 system in CKD, providing a pharmacological rationale for the use of β-blockers to reduce inflammation and abnormal vascular remodeling in CKD.
Innovations to Improve Lung Isolation Training for Thoracic Anesthesia: A Narrative Review
Authors: Grandjean Corinne , Casso Gabriele , Noirez Leslie , Granell Gil Manuel , Savoldelli Georges L. , Schoettker Patrick
Published: March 2024

A double-lumen tube or bronchial blocker positioning using flexible bronchoscopy for lung isolation and one-lung ventilation requires specific technical competencies. Training to acquire and retain such skills remains a challenge in thoracic anesthesia. Recent technological and innovative developments in the field of simulation have opened up exciting new horizons and possibilities. In this narrative review, we examine the latest development of existing training modalities while investigating, in particular, the use of emergent techniques such as virtual reality bronchoscopy simulation, virtual airway endoscopy, or the preoperative 3D printing of airways. The goal of this article is, therefore, to summarize the role of existing and future applications of training models/simulators and virtual reality simulators for training flexible bronchoscopy and lung isolation for thoracic anesthesia.
Neutrophil Gelatinase-Associated Lipocalin as a Biomarker in Post-Acute COVID-19 Syndrome
Authors: Żmudka Karol , Gałeczka-Turkiewicz Alicja , Wroniecka Aleksandra , Włosowicz Aleksandra , Sobala-Szczygieł Barbara , Mrochem-Kwarciak Jolanta , Czuba Zenon P. , Jaroszewicz Jerzy
Published: March 2024

Background: Neutrophil gelatinase-associated lipocalin (NGAL) is part of the innate immune system and acute-phase protein. Current data state that acute COVID-19 patients have higher levels of serum NGAL (sNGAL), but it is not known if higher protein levels are maintained in the convalescents. As post-COVID complications are currently the most important aspect of the disease, further research into metabolic and immunological consequences of the disease is needed. Methods: We aimed to determine the levels of sNGAL in a patient population 3 months after the acute phase of the disease and to identify the factors that may be related to the elevation of sNGAL levels in the mentioned cohort. The study included 146 patients diagnosed with COVID-19 in different stages of the disease. Three months after COVID-19 diagnosis, patients’ sera were sampled and tested. Results: We demonstrate an association between the severity of the disease in the acute phase and elevated sNGAL levels three months after recovery, with the exception of the most severe hospitalized patients, who received early treatment. Moreover, we establish that sNGAL levels could be associated with prolonged dyspnea and the regulation of hunger and satiety in COVID-19 convalescents. Conclusions: These observations support the view that the introduction of antiviral treatment, steroids, and intense oxygen therapy reduces post-COVID immune-associated complications.
Autonomic Function in Obese Children and Adolescents: Systematic Review and Meta-Analysis
Authors: Papadopoulos Georgios E. , Balomenou Foteini , Sakellariou Xenofon M. , Tassopoulos Christos , Nikas Dimitrios N. , Giapros Vasileios , Kolettis Theofilos M.
Published: March 2024

Background: Obesity is invariably accompanied by autonomic dysfunction, although data in pediatric populations are conflicting. Methods: We conducted a systematic review and meta-analysis of 12 studies (totaling 1102 participants) comparing obese and normal-weight subjects (5–18 years of age), defined as body mass index >95th or <85th percentile, respectively. Using a random-effects model, we report the standardized mean differences (SMD) of sympathetic and vagal indices of heart rate variability. Results: Autonomic dysfunction was present in the obesity group, based on the average SMD in the standard deviation of sinus intervals (at −0.5340), and on the ratio of low (LF)- to high (HF)-frequency spectra (at 0.5735). There was no difference in sympathetic activity, but the heterogeneity among the relevant studies weakens this result. SMD in HF (at 0.5876), in the root mean square of successive differences between intervals (at −0.6333), and in the number of times successive intervals exceeded 50 ms divided by the total number of intervals (at −0.5867) indicated lower vagal activity in the obesity group. Conclusions: Autonomic dysfunction is present in obese children and adolescents, attributed to lower vagal activity. Further studies are needed in various pediatric cohorts, placing emphasis on sympathetic activity.
Early Administration of Intravenous Hydration and Opioid Analgesics Is Correlated with Decreased Admission Rates during Vaso-Occlusive Episodes in Sickle Cell Disease
Authors: Joung Bowon , Miles Ethan , Al-Manaseer Farris , Jeon Won Jin , Wijaya Darren , Moon Jin Hyun , Han Philip , Lee Jae , Mehta Akhil , Tseng Alan , Ngo Kaylin , Cao Huynh , Chong Esther G.
Published: March 2024

Background: Painful vaso-occlusive episodes (VOEs) are the hallmark of sickle cell disease (SCD) and account for frequent visits to the emergency department (ED) or urgent care (UC). Currently, the early administration of analgesics is recommended as initial management; however, there is a need for further understanding of the effect of prompt analgesics and hydration during VOEs. The objective of this study is to analyze the factors associated with the rate of hospital admission in the setting of time to intravenous (IV) analgesics and hydration. Method: This retrospective single-institution study reviewed adult and pediatric patients with SCD who presented with VOEs from January 2018 to August 2023. Results: Of 303 patient encounters, the rates of admission for the overall group, the subgroup which received IV hydration within 60 min of arrival, and the subgroup which received both IV analgesics and hydration within 60 min were 51.8%, 25.6% (RR = 0.46), and 18.2% (RR = 0.33), respectively. Further, factors such as gender and the use of hydroxyurea were found to be significantly associated with the rate of admission. Conclusions: This signifies the importance of standardizing the management of VOEs through the timely administration of IV analgesics and hydration in both adult and pediatric ED/UC.
Left Atrium Volume Measured with Multislice Computed Tomography as a Prognostic Predictor for Atrial Fibrillation Catheter Ablation Outcomes
Authors: Park Jae-Hong , Yang Dong-Hyun , Kim Ji-Hyun , Kim Yoo-Ri
Published: March 2024

Background: Current guidelines consider atrial fibrillation (AF) type as the prognostic factor for a recommendation of catheter ablation. We aimed to determine whether LA and LA appendage (LAA) volumes measured using multislice computed tomography (MSCT) were related to long-term outcomes in AF following radiofrequency catheter ablation (RFCA). Methods: We evaluated 152 consecutive patients with drug-refractory AF (median age, 55.8 ± 9.6 years), including 110 male patients, who underwent RFCA in a single center. All patients underwent MSCT imaging for anatomical assessment. The endpoint of this study was documented AF recurrence after RFCA. Results: The overall procedure success rate was 77.6% (n = 118) during a mean follow-up period of 12.6 months. The LA volume was significantly larger for those who experienced AF recurrence after RFCA than for the patients without recurrent AF after the procedure (153.8 ± 29.9 mL vs. 139.2 ± 34.1 mL, p = 0.025). However, LAA volumes were nearly equivalent between the patients with and without AF recurrence after RFCA (16.2 ± 6.3 mL and 14.7 ± 6.5 mL, respectively; p = 0.235). LA volume ≥ 153.2 mL was the optimal cutoff value for estimating AF recurrence after RFCA, with 94% sensitivity and 66% specificity. LA volume remained an independent predictor of both AF recurrence and permanent AF. Conclusions: LA volume as assessed by MSCT might be helpful for identifying patients likely to achieve successful AF ablation. LA volume ≥ 153.2 mL, but not LAA volume, showed good accuracy in predicting AF recurrence after RFCA.
Arrhythmias in Patients with Pulmonary Hypertension and Right Ventricular Failure: Importance of Rhythm Control Strategies
Authors: Anand Suneesh , Cronin Edmond M.
Published: March 2024

Arrhythmias frequently complicate the course of advanced pulmonary hypertension, often leading to hemodynamic compromise, functional impairment, and mortality. Given the importance of right atrial function in this physiology, the restoration and maintenance of sinus rhythm are of critical importance. In this review, we outline the pathophysiology of arrhythmias and their impact on right heart performance; describe considerations for antiarrhythmic drug selection, anesthetic and periprocedural management; and discuss the results of catheter ablation techniques in this complex and challenging patient population.
The Impact of Geriatric Conditions in Elderly Patients with Coronary Heart Disease: A State-of-the-Art Review
Authors: Alonso Salinas Gonzalo Luis , Cepas-Guillén Pedro , León Amaia Martínez , Jiménez-Méndez César , Lozano-Vicario Lucia , Martínez-Avial María , Díez-Villanueva Pablo
Published: March 2024

The growing geriatric population presenting with coronary artery disease poses a primary challenge for healthcare services. This is a highly heterogeneous population, often underrepresented in studies and clinical trials, with distinctive characteristics that render them particularly vulnerable to standard management/approaches. In this review, we aim to summarize the available evidence on the treatment of acute coronary syndrome in the elderly. Additionally, we contextualize frailty, comorbidity, sarcopenia, and cognitive impairment, common in these patients, within the realm of coronary artery disease, proposing strategies for each case that may assist in therapeutic approaches.
Sagittal Balance Parameters and Proximal Junctional Kyphosis in Adolescent Idiopathic Scoliosis
Authors: Katzouraki Galateia , Vasiliadis Elias S. , Kaspiris Angelos , Evangelopoulos Dimitrios-Stergios , Grivas Theodoros B. , Pneumatikos Spiros G.
Published: March 2024

Background: To review and evaluate multiple preoperative and postoperative sagittal parameters and their association with the risk of developing proximal junctional kyphosis (PJK) in patients with adolescent idiopathic scoliosis (AIS) who undergo correction surgery. Methods: A systematic search was performed in December 2022 in PubMed, Embase and the Cochrane Library to retrieve all the studies relevant to our research. After the study selection and data extraction following PRISMA guidelines, RevMan 5.3 was used for statistical analysis. All the analyzed factors were evaluated by using odds ratios and weighted mean differences with 95% confidence intervals. Moreover, the meta-analysis of proportions via MedCalc was used for analyzing quantitative data from the studies. Results: A total of 22 studies were included in our meta-analysis. All the available values of sagittal parameters were evaluated. Among all the potential risk factors, higher preoperative thoracic kyphosis (Test for overall effect Z = 11.79, p < 0.00001), higher preoperative sagittal vertical axis (SVA) (test for overall effect Z = 11.19, p < 0.00001), greater thoracic kyphosis change post-op. compared to pre-op. (test for overall effect Z = 6.02, p < 0.00001), increased postoperative lumbar lordosis (test for overall effect Z = 3.65, p = 0.0003), higher post-op. SVA (test for overall effect Z = 24.93, p < 0.00001) and a larger pelvic incidence/lumbar lordosis (PI/LL) mismatch (test for overall effect Z = 20.50, p < 0.00001) were found to be the risk factors for PJK after AIS surgery. Moreover, a decreased rod contour angle (RCA) (test for overall effect Z = 3.79, p < 0.0002) and higher proximal junctional angle–rod contour angle (PJA-RCA) (test for overall effect Z = 39.18, p < 0.00001) play a significant role in the risk of developing PJK after AIS correction. Conclusions: Sagittal balance is of great importance when considering the surgical correction of AIS. Many factors in our meta-analysis were found to increase the incidence for PJK such as higher preoperative thoracic kyphosis and pre-op. SVA. Furthermore, increased thoracic kyphosis change, increased post-operative lumbar lordosis, SVA and PI/LL mismatch are also factors that influence the possibility of post-op. PJK. Lastly, RCA and PJA-RCA are two important factors that need attention during AIS, as over-contouring of the rod could lead to PJK in AIS patients.
Reconstruction of Orbital Wall Fractures with a Combination of Resorbable Plates and Antibiotic-Impregnated Collagen Sheets
Authors: Kim Jeeyoon , Chang Jihyoung , Lee Junho , Rha Eun-Young , Byeon Jun-Hee , Shin Jongweon
Published: March 2024

(1) Background: Orbital wall fractures are common in maxillofacial trauma, and artificial implants are often used for reconstruction. However, there has always been concern about infection because implants are directly exposed to the airway. This study was conducted to determine the effectiveness of a combination of resorbable plates and antibiotic-impregnated collagen sheets in reconstructions of orbital fractures and to determine whether it had an effect in reducing postoperative antibiotic use. (2) Methods: The retrospective study was conducted on 195 patients who underwent orbital wall reconstruction from March 2019 to August 2022. The 176 patients in the control group underwent reconstruction using only resorbable plates and were administered postoperative antibiotics for 5 to 7 days. On the other hand, the 19 patients in the experimental group underwent reconstruction using a combination of resorbable plates and antibiotic-impregnated collagen sheets and only received antibiotics once before surgery. The occurrence of ocular complications, the length of hospitalization, the infection incidence rate, and the adverse effects of antibiotics were investigated. (3) Results: significant ocular complications were observed in the experimental group during a follow-up period of more than 1 year. Regarding postoperative infections, there were two cases of infection in the control group (infection rate: 1.14%), while no infection was found in the experimental group. The hospitalization period of the experimental group was significantly shorter than that of the control group (p < 0.01), and the incidence of total adverse effects of antibiotics, especially nausea, was lower in the experimental group (p = 0.02). (4) Conclusions: The combined use of resorbable plates and antibiotic-impregnated collagen sheets allows effective orbital wall reconstruction without infection, with a shorter hospital stay, and with fewer antibiotic adverse effects.
Return to Work after Primary Total Knee Arthroplasty: The First Polish Pilot Retrospective Study
Authors: Drużbicki Mariusz , Kitrys Łucja , Jabłoński Jarosław , Filip Damian , Perenc Lidia , Guzik Agnieszka
Published: March 2024

(1) Background: Total knee arthroplasty (TKA) performed on working-age patients significantly affects the participation of such patients in social life. A retrospective study was conducted to determine the return to work (RTW) rate after TKA. The goal of this study was to provide reference data for the Polish population and identify the factors impacting patients’ decisions to return to or resign from work, relative to their functional performance. (2) Methods: This retrospective study involved 48 patients. An interview related to RTW was carried out to identify the factors impacting a patient’s decision to return to or resign from work. Functional performance was assessed using the Knee Outcome Survey–Activities of Daily Living (KOS-ADL) scale. (3) Results: Before TKA, 15 individuals (31.25%) qualified for the study did not work and were receiving welfare benefits. After the surgery, 23 individuals (47.9% of those working prior to TKA) did not return to work. The number of those who did not work after TKA increased to 38 (79.17%), which was a significant change. The mean level of functional performance after TKA assessed using KOS-ADL was 75.89. (4) Conclusions: The findings show that the rate of RTW after TKA in Poland is significantly lower than that in other countries. The reasons for this situation, as shown in the study, may be related to the lack of an occupational rehabilitation system, resulting in a paucity of information about the possibility to return to work and about opportunities for retraining.
Graphene in 3D Bioprinting
Authors: Patil Rahul , Alimperti Stella
Published: March 2024

Three-dimensional (3D) bioprinting is a fast prototyping fabrication approach that allows the development of new implants for tissue restoration. Although various materials have been utilized for this process, they lack mechanical, electrical, chemical, and biological properties. To overcome those limitations, graphene-based materials demonstrate unique mechanical and electrical properties, morphology, and impermeability, making them excellent candidates for 3D bioprinting. This review summarizes the latest developments in graphene-based materials in 3D printing and their application in tissue engineering and regenerative medicine. Over the years, different 3D printing approaches have utilized graphene-based materials, such as graphene, graphene oxide (GO), reduced GO (rGO), and functional GO (fGO). This process involves controlling multiple factors, such as graphene dispersion, viscosity, and post-curing, which impact the properties of the 3D-printed graphene-based constructs. To this end, those materials combined with 3D printing approaches have demonstrated prominent regeneration potential for bone, neural, cardiac, and skin tissues. Overall, graphene in 3D bioprinting may pave the way for new regenerative strategies with translational implications in orthopedics, neurology, and cardiovascular areas.
An Integrated Framework with ADD-LSTM and DeepLabCut for Dolphin Behavior Classification
Authors: Tseng Shih-Pang , Hsu Shao-En , Wang Jhing-Fa , Jen I-Fan
Published: March 2024

Caring for dolphins is a delicate process that requires experienced caretakers to pay close attention to their behavioral characteristics. However, caretakers may sometimes lack experience or not be able to give their full attention, which can lead to misjudgment or oversight. To address these issues, a dolphin behavior analysis system has been designed to assist caretakers in making accurate assessments. This study utilized image preprocessing techniques to reduce sunlight reflection in the pool and enhance the outline of dolphins, making it easier to analyze their movements. The dolphins were divided into 11 key points using an open-source tool called DeepLabCut, which accurately helped mark various body parts for skeletal detection. The AquaAI Dolphin Decoder (ADD) was then used to analyze six dolphin behaviors. To improve behavior recognition accuracy, the long short-term memory (LSTM) neural network was introduced. The ADD and LSTM models were integrated to form the ADD-LSTM system. Several classification models, including unidirectional and bidirectional LSTM, GRU, and SVM, were compared. The results showed that the ADD module combined with a double-layer bidirectional LSTM method achieved high accuracy in dolphin behavior analysis. The accuracy rates for each behavior exceeded 90%.
Similar Short-Term Outcomes of Adolescent Idiopathic Scoliosis Surgery with or without Drainage: A Systematic Review of the Literature and Meta-Analysis
Authors: Ruffilli Alberto , Traversari Matteo , Viroli Giovanni , Manzetti Marco , Ialuna Marco , Morandi Guaitoli Manuele , Mazzotti Antonio , Artioli Elena , Zielli Simone Ottavio , Arceri Alberto , Faldini Cesare
Published: March 2024

The use of closed suction drains post posterior spinal fusion for adolescent idiopathic scoliosis (AIS) is common practice, although evidence on its impact is limited compared to that for knee and hip arthroplasty. This study aimed to assess the effect of closed suction drainage on short-term post-operative outcomes in AIS surgery. A systematic review following PRISMA guidelines was conducted, including studies comparing outcomes with and without drainage. Data on blood loss, transfusions, hospital stay, and complications were collected and subjected to meta-analysis. Five studies involving 772 patients were analyzed. The meta-analysis found no significant difference in blood transfusion rates (p = 0.107) or hospital stay (p = 0.457) between groups. Complications, including surgical site infections, were more common without drainage, though not statistically significant (p = 0.356). Reintervention rates were higher in the no-drainage group, but not significantly (p = 0.260). Overall, this review found no significant short-term outcome differences, suggesting clinical judgment should guide drainage decisions. Further research, particularly with enhanced recovery protocols, is warranted to clarify drainage’s role in AIS surgery.