bluuebunny/crossref_metadata_2025 huggingface dataset:
Building an Expert System through Machine Learning for Predicting the Quality of a Website Based on Its Completion
Authors: Biyyapu Vishnu Priya , Jammalamadaka Sastry Kodanda Rama , Jammalamadaka Sasi Bhanu , Chokara Bhupati , Duvvuri Bala Krishna Kamesh , Budaraju Raja Rao
Published: September 2023

The main channel for disseminating information is now the Internet. Users have different expectations for the calibre of websites regarding the posted and presented content. The website’s quality is influenced by up to 120 factors, each represented by two to fifteen attributes. A major challenge is quantifying the features and evaluating the quality of a website based on the feature counts. One of the aspects that determines a website’s quality is its completeness, which focuses on the existence of all the objects and their connections with one another. It is not easy to build an expert model based on feature counts to evaluate website quality, so this paper has focused on that challenge. Both a methodology for calculating a website’s quality and a parser-based approach for measuring feature counts are offered. We provide a multi-layer perceptron model that is an expert model for forecasting website quality from the “completeness” perspective. The accuracy of the predictions is 98%, whilst the accuracy of the nearest model is 87%.
Sleep Disorders Associated with Neurodegenerative Diseases
Authors: Anghel Lucreția , Ciubară Anamaria , Nechita Aurel , Nechita Luiza , Manole Corina , Baroiu Liliana , Ciubară Alexandru Bogdan , Mușat Carmina Liana
Published: September 2023

Sleep disturbances are common in various neurological pathologies, including amyotrophic lateral sclerosis (ALS), multiple system atrophy (MSA), hereditary ataxias, Huntington’s disease (HD), progressive supranuclear palsy (PSP), and dementia with Lewy bodies (DLB). This article reviews the prevalence and characteristics of sleep disorders in these conditions, highlighting their impact on patients’ quality of life and disease progression. Sleep-related breathing disorders, insomnia, restless legs syndrome (RLS), periodic limb movement syndrome (PLMS), and rapid eye movement sleep behavior disorder (RBD) are among the common sleep disturbances reported. Both pharmacological and non-pharmacological interventions play crucial roles in managing sleep disturbances and enhancing overall patient care.
Clinical Usefulness of Immune Profiling for Differential Diagnosis between Crohn’s Disease, Intestinal Tuberculosis, and Behcet’s Disease
Authors: Yoo Ji Won , Jo Su In , Shin Dong Woo , Park Ji Won , Kim Sung-Eun , Lim Hyun , Kang Ho Suk , Moon Sung-Hoon , Kim Min Kyu , Kim Sang-Yeob , Hwang Sung Wook , Soh Jae Seung
Published: September 2023

It is important to make a differential diagnosis between inflammatory diseases of the bowel with similar clinical and endoscopic features. The profiling of immune cells could be helpful for accurately diagnosing inflammatory bowel diseases. We compared immune marker expression between Crohn’s disease (CD), intestinal Behcet’s disease (BD), and intestinal tuberculosis (TB) and evaluated the usefulness of immune profiling in differentiating between these diseases. Biopsy specimens were acquired around ulcerations on the terminal ileum or cecum from five patients with each disease. Panel 1 included multiplex immunohistochemistry staining for CD8, CD4, Foxp3, CD20, programmed death-1, and granzyme B. CD56, CD68, CD163, CD11c, and HLA-DR were analyzed in panel 2. The differences in cytotoxic T cells (CD8+CD4−Fopx3−CD20−), helper T cells (CD8−CD4+Fopx3−CD20−), and regulatory T cells (CD8−CD4+Fopx3+CD20−) were also not significant. However, M1 macrophage (CD68+CD163−HLA−DR−) cell densities were significantly higher in intestinal BD than in other diseases. The expression level of dendritic cells (CD56−CD68−CD163−CD11c+HLA-DR+) was highest in intestinal TB and lowest in intestinal BD. The expression of immune cells, including M1 macrophages and dendritic cells, was different between CD, intestinal BD, and intestinal TB. Immune profiling can be helpful for establishing differential diagnoses of inflammatory bowel diseases.
Inflammatory Status Assessment by Machine Learning Techniques to Predict Outcomes in Patients with Symptomatic Aortic Stenosis Treated by Transcatheter Aortic Valve Replacement
Authors: Stan Alexandru , Călburean Paul-Adrian , Drinkal Reka-Katalin , Harpa Marius , Elkahlout Ayman , Nicolae Viorel Constantin , Tomșa Flavius , Hadadi Laszlo , Brînzaniuc Klara , Suciu Horațiu , Mărușteri Marius
Published: September 2023

(1) Background: Although transcatheter aortic valve replacement (TAVR) significantly improves long-term outcomes of symptomatic severe aortic stenosis (AS) patients, long-term mortality rates are still high. The aim of our study was to identify potential inflammatory biomarkers with predictive capacity for post-TAVR adverse events from a wide panel of routine biomarkers by employing ML techniques. (2) Methods: All patients diagnosed with symptomatic severe AS and treated by TAVR since January 2016 in a tertiary center were included in the present study. Three separate analyses were performed: (a) using only inflammatory biomarkers, (b) using inflammatory biomarkers, age, creatinine, and left ventricular ejection fraction (LVEF), and (c) using all collected parameters. (3) Results: A total of 338 patients were included in the study, of which 56 (16.5%) patients died during follow-up. Inflammatory biomarkers assessed using ML techniques have predictive value for adverse events post-TAVR with an AUC-ROC of 0.743 and an AUC-PR of 0.329; most important variables were CRP, WBC count and Neu/Lym ratio. When adding age, creatinine and LVEF to inflammatory panel, the ML performance increased to an AUC-ROC of 0.860 and an AUC-PR of 0.574; even though LVEF was the most important predictor, inflammatory parameters retained their value. When using the entire dataset (inflammatory parameters and complete patient characteristics), the ML performance was the highest with an AUC-ROC of 0.916 and an AUC-PR of 0.676; in this setting, the CRP and Neu/Lym ratio were also among the most important predictors of events. (4) Conclusions: ML models identified the CRP, Neu/Lym ratio, WBC count and fibrinogen as important variables for adverse events post-TAVR.
Assessing Teachers’ Practices in Providing Inclusive Online Education: Development and Validation of an Instrument Based on Inclusive Practices among Teachers in Malaysia
Authors: Bong Way Kiat , Chua Kah Heng
Published: September 2023

All students should have equal opportunities to pursue education. When the COVID-19 pandemic began, almost all teaching activities had to be switched from the traditional face-to-face format to digital platforms. Although it is now the post-pandemic period, many online teaching and learning practices have been maintained. It is, therefore, crucial to ensure that teachers are doing their best to make online teaching inclusive, and an instrument assessing their practices is essential. This study aims to develop this instrument and validate it. Referring to relevant works and universal design for learning (UDL) guidelines, we developed an instrument that consists of five domains: affective, behavioural, cognitive, competence and awareness. Through expert assessment of face, content and construct validity, a pilot study, and data analysis of 505 respondents teaching in different educational levels from primary schools to higher institutions in Malaysia, using exploratory factor analysis (EFA) and correlational testing, the findings show that the instrument has high validity and reliability in assessing teachers’ practices in delivering inclusive online education. While the instrument has implications for policymakers and researchers, it needs further validation in the context of different countries. Necessary amendments might be required to make it more context specific.
Building Mathematics Learning through Inquiry Using Student-Generated Data: Lessons Learned from Plan-Do-Study-Act Cycles
Authors: Rakes Christopher R. , Wesneski Angela , Laws Rebecca
Published: September 2023

This paper describes how plan-do-study-act cycles engaged a classroom mentor teacher and student teacher in a professional collaboration that resulted in two inquiry activities for high-school geometry classes. The PDSA cycles were carried out in four high school geometry classes, each with 30 to 35 students, in a mid-Atlantic urban school district in the U.S. The four geometry classes were co-taught by the second and third authors of this paper. The data consisted of classroom documents (e.g., activity prompts, tasks), classroom observations, student feedback about activities, and monthly PDSA reports. The PDSA cycles had a direct effect on the professional learning of the teachers. The resultant classroom activities used a data collection approach to engaging students in inquiry to learn about trigonometry functions and density. Student learning behaviors were noticeably improved during these activities compared with traditional mathematics instruction. We concluded that the data collection sequence provided an accessible entry point for students to begin scientific inquiry in mathematics. The process opened the conceptual space for students to develop curiosity about mathematical phenomena and to explore their own research questions. The use of culturally relevant topics was especially compelling to students, and the open-ended nature of these exploratory activities allowed students to see mathematics through their own cultural lenses.
Exploring Computer Science Students’ Perception of ChatGPT in Higher Education: A Descriptive and Correlation Study
Authors: Singh Harpreet , Tayarani-Najaran Mohammad-Hassan , Yaqoob Muhammad
Published: September 2023

ChatGPT is an emerging tool that can be employed in many activities including in learning/teaching in universities. Like many other tools, it has its benefits and its drawbacks. If used properly, it can improve learning, and if used irresponsibly, it can have a negative impact on learning. The aim of this research is to study how ChatGPT can be used in academia to improve teaching/learning activities. In this paper, we study students’ opinions about how the tool can be used positively in learning activities. A survey is conducted among 430 students of an MSc degree in computer science at the University of Hertfordshire, UK, and their opinions about the tool are studied. The survey tries to capture different aspects in which the tool can be employed in academia and the ways in which it can harm or help students in learning activities. The findings suggest that many students are familiar with the tool but do not regularly use it for academic purposes. Moreover, students are skeptical of its positive impacts on learning and think that universities should provide more vivid guidelines and better education on how and where the tool can be used for learning activities. The students’ feedback responses are analyzed and discussed and the authors’ opinions regarding the subject are presented. This study shows that ChatGPT can be helpful in learning/teaching activities, but better guidelines should be provided for the students in using the tool.
Multimodal Interaction Evaluation and Optimization Design of Smart Landscape Devices for Elderly People in Seaside Parks
Authors: Yuan Jingwen , Zhang Longlong , Kim Chul-Soo
Published: September 2023

With the rapid development of science and technology, an era of intelligence has started in people’s lives, and intelligent robots, intelligent home systems, intelligent parking systems and other products of intelligent technologies have been quietly applied to all aspects of modern life. Experiential and interactive media landscape installations based on intelligent technologies have also been introduced into seaside parks in this context. Intelligent technologies are utilized to innovate traditional landscape installations, break the traditional limitations of thinking, and change the way of interaction between landscape installations and the public in seaside parks. Thus, the public can create an interesting connection with the landscape installations to enhance the participation and experience of the public. Emotion recognition, as an integral part of AI, has received more and more attention from experts and scholars at home and abroad. The landscape installations in domestic seaside parks are becoming more and more intelligent, and are customized to meet the needs of special target groups, such as the elderly. In this paper, the intelligent setting of landscape installations is investigated using multimodal interaction. First, it explains in detail the multimodal interaction, landscape installations, and intelligence. It innovatively combines experiential and interactive media landscape installations based on intelligent technologies with seaside city parks and analyzes and summarizes the cases in China and abroad. Furthermore, it explores how interactive media landscape installations work in different seaside parks, and examines how they are designed and technically implemented. At the same time, a plan is formulated to optimize the landscape installations for different groups of people in the seaside parks. Finally, the key points for optimizing the design of intelligent landscape installations for the elderly are proposed, and experiments are conducted to analyze how the design of multimodal interaction enhances the consumption perceptions of the elderly consumer groups. The experiment demonstrates the superiority of multimodal interaction for intelligent landscape installations.
Paralleling of IGBT Power Semiconductor Devices and Reliability Issues
Authors: Tripathi Ravi Nath , Omura Ichiro
Published: September 2023

Paralleling of power semiconductor devices is inevitable considering their widespread application and exploitation in the extended horizon of these applications. However, paralleling of power semiconductor devices is prone to severe unbalancing corresponding to the non-idealities of device parameters, which leads to non-identical dynamic and static characteristics of the power devices, as well as the operating conditions and aging. Therefore, the currents are generally non-uniform and cause the derating of the system. This paper discusses and analyzes issues associated with the paralleling of IGBT power devices, which can evoke serious reliability issues. Furthermore, the paper examines the techniques and methodologies that have been proposed to reduce the issue of current unbalancing of parallel-connected power devices.
High-Level K-Nearest Neighbors (HLKNN): A Supervised Machine Learning Model for Classification Analysis
Authors: Ozturk Kiyak Elife , Ghasemkhani Bita , Birant Derya
Published: September 2023

The k-nearest neighbors (KNN) algorithm has been widely used for classification analysis in machine learning. However, it suffers from noise samples that reduce its classification ability and therefore prediction accuracy. This article introduces the high-level k-nearest neighbors (HLKNN) method, a new technique for enhancing the k-nearest neighbors algorithm, which can effectively address the noise problem and contribute to improving the classification performance of KNN. Instead of only considering k neighbors of a given query instance, it also takes into account the neighbors of these neighbors. Experiments were conducted on 32 well-known popular datasets. The results showed that the proposed HLKNN method outperformed the standard KNN method with average accuracy values of 81.01% and 79.76%, respectively. In addition, the experiments demonstrated the superiority of HLKNN over previous KNN variants in terms of the accuracy metric in various datasets.
Dynamic-RPL: Enhancing RPL-Based IoT Networks with Effective Support of Dynamic Topology Management
Authors: Alsukayti Ibrahim S.
Published: September 2023

The inherent characteristics and limitations of Internet of Things networks make it hard to avoid facing adverse network conditions. Addressing high performance in extreme situations still remains a challenge even for a standardized routing protocol like the IPv6 Routing Protocol for Low Power and Lossy Networks (RPL). No effective support is provided by the design of RPL to guarantee high network performance in the presence of such challenging conditions. To address such a compelling need, an innovative approach referred to as Dynamic-RPL is proposed in this research paper. With only limited in-protocol modifications to RPL, Dynamic-RPL provides effective support of dynamic topology management in a distributed manner. Seamless optimization of network topology is realized with dynamic topological adjustments to sustain high network performance and stability. It incorporates modified RPL topology establishment, customized RPL objective function and parent selection, a new dynamic topology management algorithm, and additional inter-routing support. The evaluation results demonstrated the ability of Dynamic-RPL to maintain high overall network performance irrespective of the adversity of ongoing network conditions. Considering varying-scale experimental setups, high QoS performance and low energy consumption were achieved without much increase in network overhead. Dynamic-RPL succeeded in adapting responsively with little time required to have the network performance successfully restored and network topology completely converged.
Sweet Sorghum as a Potential Fallow Crop in Sugarcane Farming for Biomethane Production in Queensland, Australia
Authors: Mathias Divya Joslin , Edwiges Thiago , Ketsub Napong , Singh Rajinder , Kaparaju Prasad
Published: September 2023

Biogas from lignocellulosic feedstock is a promising energy source for decentralized renewable electricity, heat, and/or vehicle fuel generation. However, the selection of a suitable energy crop should be based on several factors such as biomass yields and characteristics or biogas yields and economic returns if used in biorefineries. Furthermore, the food-to-fuel conflict for the use of a specific energy crop must be mitigated through smart cropping techniques. In this study, the potential use of sweet sorghum as an energy crop grown during the fallow periods of sugarcane cultivation was evaluated. Nine sweet sorghum cultivars were grown on sandy loam soil during September 2020 in North Queensland, Australia. The overall results showed that the crop maturity had a profound influence on chemical composition and biomass yields. Further, the total insoluble and soluble sugar yields varied among the tested cultivars and were dependent on plant height and chemical composition. The biomass yields ranged from 46.9 to 82.3 tonnes/hectare (t/ha) in terms of the wet weight (w/w) of the tested cultivars, with the SE-81 cultivar registering the highest biomass yield per hectare. The gross energy production was determined based on the chemical composition and methane yields. Biochemical methane potential (BMP) studies in batch experiments at 37 °C showed that methane yields of 175 to 227.91 NmL CH4/gVSadded were obtained from the tested cultivars. The maximum methane yield of 227.91 NmL CH4/gVSadded was obtained for cultivar SE-35. However, SE-81 produced the highest methane yields on a per hectare basis (3059.18 Nm3 CH4/ha). This is equivalent to a gross energy value of 761.74 MWh/year or compressed biomethane (BioCNG) as a vehicle fuel sufficient for 95 passenger cars travelling at 10,000 km per annum. Overall, this study demonstrated that sweet sorghum is a potential energy crop for biogas production that could be cultivated during the fallow period of sugarcane cultivation in Queensland.
Spatiotemporal Analysis of Vegetation Cover in Relation to Its Driving Forces in Qinghai–Tibet Plateau
Authors: Xu Tong , Wu Hua
Published: September 2023

The Tibet Plateau of Qinghai supports complex vegetation types that are ecologically fragile and sensitive to climatic factors. Therefore, it is important to understand the changes in vegetation and the factors responsible for these changes and to maintain the ecosystem balance and promote sustainable development in the region. Therefore, this paper is based on annual SPOT/VEG NDVI (Normalized Difference Vegetation Index) data, land use data, topographic data, temperature data, and precipitation data from 1999 to 2019. The spatiotemporal variation in the NDVI over the Tibetan Plateau in the last 21 years and its response to different driving factors were investigated by using the Theil–Sen slope method, Mann–Kendall test, partial correlation analysis, and geographical detector method. The results showed that (1) the vegetation coverage on the Qinghai–Tibet Plateau showed an increasing trend from 1999 to 2019, with increases in approximately 67.00% of the plateau area. (2) The spatial differences in vegetation coverage were large; notably, low-density vegetation areas decreased obviously, moderate-density vegetation areas accounted for approximately 50% of the total area, high-density vegetation areas were the least common, and the overall growth rate was significant. (3) The NDVI was positively correlated with temperature and precipitation, and a positive correlation was observed in more than 66% of the region. (4) The order of the influence of single driving factors on the NDVI was as follows: precipitation > soil type > altitude > temperature > gradient > slope > population density > GDP. (5) The combined effect of the factors was significantly higher than that of single driving factors, with a notable nonlinear influence. The interactions between meteorological factors, such as precipitation, and topographic factors, such as altitude, were important, with a q-value over 0.79. The results of this study provide some methodological support for the ecological conservation of the Tibetan Plateau, and at the same time establish a scientific and reasonable strategy for vegetation restoration.
Application of Analytic Hierarchy Process to Rank Fire Safety Factors for Assessing the Fire Probabilistic Risk in School for the Blind Building: A Case Study in Thailand
Authors: Ketsakorn Arroon , Phangchandha Rujipun
Published: September 2023

Fires are the leading cause of death, serious injury, and property damage. In the past, schools, temples, and government offices had more frequent fires than they should. Statistics showed that the number of fires between 2017 to 2022 amounted to 13,593 cases which mostly occurred in schools, temples, and government offices (40.0% of all buildings). Moreover, it causes more damage among the blind, who have limited vision. Therefore, the cross-sectional purpose of this study was to assess the fire risk in school for the blind. The fire checklists, brainstorming, and analytic hierarchy process (AHP) were applied to estimate the fire risk in the school for the blind building. The findings revealed an inherent fire hazard factor (fire probabilistic risk scores = 3.2830) and evacuation factor (fire probabilistic risk scores = 3.3178) that were acceptable risks, except the fire control factor (fire probabilistic risk scores = 1.4320) was an unacceptable risk (score of less than 2.5). The unacceptable risk may cause impacts to life, health, property, and public communities. Eventually, efforts should be made to supervise those risk factors by designing suitable activities to reduce undesirable conditions in schools for the blind.
Spice and Herb Frauds: Types, Incidence, and Detection: The State of the Art
Authors: Velázquez Rocío , Rodríguez Alicia , Hernández Alejandro , Casquete Rocío , Benito María J. , Martín Alberto
Published: September 2023

There is a necessity to protect the quality and authenticity of herbs and spices because of the increase in the fraud and adulteration incidence during the last 30 years. There are several aspects that make herbs and spices quite vulnerable to fraud and adulteration, including their positive and desirable sensorial and health-related properties, the form in which they are sold, which is mostly powdered, and their economic relevance around the world, even in developing countries. For these reasons, sensitive, rapid, and reliable techniques are needed to verify the authenticity of these agri-food products and implement effective adulteration prevention measures. This review highlights why spices and herbs are highly valued ingredients, their economic importance, and the official quality schemes to protect their quality and authenticity. In addition to this, the type of frauds that can take place with spices and herbs have been disclosed, and the fraud incidence and an overview of scientific articles related to fraud and adulteration based on the Rapid Alert System Feed and Food (RASFF) and the Web of Science databases, respectively, during the last 30 years, is carried out here. Next, the methods used to detect adulterants in spices and herbs are reviewed, with DNA-based techniques and mainly spectroscopy and image analysis methods being the most recommended. Finally, the available adulteration prevention measurements for spices and herbs are presented, and future perspectives are also discussed.
Do You Know What You Eat? Kebab Adulteration in Poland
Authors: Szyłak Artur , Kostrzewa Wiktoria , Bania Jacek , Tabiś Aleksandra
Published: September 2023

In recent years, consumer interest in meat authenticity has increased. Fraudulent claims are most likely to be regarding meat origin, meat substitution, meat processing treatment, and non-meat ingredient additions. This study focuses on the substitution of meat species in processed kebab-like food sales in Poland. The growing popularity of kebab-like foods and the limited number of official inspections of this type of food make this topic interesting. In this study, the results reveal that 60% of the foods analyzed contain an undeclared ingredient or the substitution of an expensive ingredient with a cheaper option.
Targeting Collagen Pathways as an HFpEF Therapeutic Strategy
Authors: Bonanni Alice , Vinci Ramona , d’Aiello Alessia , Grimaldi Maria Chiara , Di Sario Marianna , Tarquini Dalila , Proto Luca , Severino Anna , Pedicino Daniela , Liuzzo Giovanna
Published: September 2023

Heart failure with preserved ejection fraction (HFpEF) is a complex and heterogeneous clinical syndrome. The prevalence is expected to increase in the coming years, resulting in heart failure with reduced ejection fraction (HFrEF). This condition poses a burden to the global health care system as the number of patients affected by this condition is constantly increasing due to a rising average lifespan. The absence of validated drugs effective in reducing hospitalization rates and mortality may reflect the impossibility of applying a one size fits all approach as in HFrEF, heading for a personalized approach. Available evidence demonstrated the link between collagen quantity and quality alterations, and cardiac remodeling. In the context of fibrosis, collagen cross-linking is strictly involved, displaying two types of mechanisms: enzymatic and non-enzymatic. In the murine model, enzymatic inhibition of fibrosis-inducing protease-activated receptor-1 (PAR1) and transforming growth factor (TGF)-β signaling appeared to reduce cardiac fibrosis. On the other hand, in the case of non-enzymatic cross-linking, sodium glucose co-transporter type 2 inhibitors (SGLT2is), appeared to counteract the deposition of advanced glycation end-products (AGEs), which in turn contributed to ventricular remodeling. In this review, we address the mechanisms associated with collagen alterations to identify potential targets of cardiac fibrosis in HFpEF patients.
The Influence of TEP1 and TERC Genetic Variants on the Susceptibility to Multiple Sclerosis
Authors: Rumšaitė Gintarė , Gedvilaitė Greta , Balnytė Renata , Kriaučiūnienė Loresa , Liutkevičienė Rasa
Published: September 2023

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. According to recent studies, cellular senescence caused by telomere shortening may contribute to the development of MS. Aim of the study: Our aim was to determine the associations of TEP1 rs1760904, rs1713418, TERC rs12696304, rs35073794 gene polymorphisms with the occurrence of MS. Methods: The study included 200 patients with MS and 230 healthy controls. Genotyping of TEP1 rs1760904, rs1713418 and TERC rs12696304, rs35073794 was performed using RT-PCR. The obtained data were analysed using the program “IBM SPSS Statistics 29.0”. Haplotype analysis was performed using the online program “SNPStats”. Results: The TERC rs12696304 G allele of this SNP is associated with 1.4-fold lower odds of developing MS (p = 0.035). TERC rs35073794 is associated with approximately 2.4-fold reduced odds of MS occurrence in the codominant, dominant, overdominant, and additive models (p < 0.001; p < 0.001; p < 0.001; p < 0.001, respectively). Haplotype analysis shows that the rs1760904-G—rs1713418-A haplotype is statistically significantly associated with 1.75-fold increased odds of developing MS (p = 0.006). The rs12696304-C–rs35073794-A haplotype is statistically significantly associated with twofold decreased odds of developing MS (p = 0.008). In addition, the rs12696304-G—rs35073794-A haplotype was found to be statistically significantly associated with 5.3-fold decreased odds of developing MS (p < 0.001). Conclusion: The current evidence may suggest a protective role of TERC SNP in the occurrence of MS, while TEP1 has the opposite effect.
Determination of the Optimal Wavelength of the Hemolysis Index Measurement
Authors: Ishiguro Akiyo , Nishioka Mitsuaki , Morishige Akihiro , Yoneshiro Mai , Shinkawa Kanae , Fujinaga Aki , Kobayashi Toshihiko , Suehiro Yutaka , Yamasaki Takahiro
Published: September 2023

Many biochemical auto-analyzers have methods that measure the hemolysis index (HI) to quantitatively assess the degree of hemolysis. Past reports on HI are mostly in vitro studies. Therefore, we evaluated the optimal wavelength of HI measurement ex vivo using clinical samples. Four different wavelengths (410/451 nm: HI-1, 451/478 nm: HI-2, 545/596 nm: HI-3 and 571/596 nm: HI-4) were selected for HI measurement, and correlations were examined from the measurement results of 3890 clinical samples. Another set of 9446 clinical samples was used to examine the correlation of HI with lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and potassium (K). Strong correlations were found between HI-4 and HI-1 and between HI-4 and HI-3. HI-1 and HI-2 cannot correctly assess hemolysis for high bilirubin samples, and HI-3 cannot correctly assess hemolysis for high triglyceride samples. LDH, AST and K correlated positively with HI-4 in clinical samples. For every 1-unit increase in HI-4, LDH increased by 19.51 U/L, AST by 1.03 U/L and K by 0.061 mmol/L, comparable to reports of other studies. In clinical samples, HI-4 was less susceptible to bilirubin and chyle and reflected well the changes in LDH, AST and K caused by hemolysis. This suggested that the optimal wavelength for HI measurement is 571 nm.
Inverted U-Shaped Relationship between Obesity Parameters and Bone Mineral Density in Korean Adolescents
Authors: Lee Jongseok , Yoon Insang , Cha Hwajung , Kim Ho-Jung , Ryu Ohk-Hyun
Published: September 2023

As the association between obesity and bone health remains controversial in children and adolescents, we investigate the effects of obesity parameters on bone mineral density (BMD) in 2060 Korean adolescents who participated in the 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES). Multiple regression analysis and analysis of covariance (ANCOVA) were conducted to examine both the linear and non-linear associations between total-body-less-head (TBLH) BMD and four obesity parameters: body mass index, waist circumference, waist-to-height ratio, and total-body fat mass (FM). In a multiple linear regression analysis adjusted for age, menarcheal status (in females only), and total-body lean mass, there was no significant linear association between obesity parameters and TBLH BMD, except for total-body FM in males. However, upon adding a second-order polynomial term for each obesity parameter, a significant quadratic relationship between all obesity parameters and TBLH BMD was observed, with the corresponding quadratic term being negative. The results of ANCOVA also revealed an inverted U-shaped relationship between each obesity parameter and TBLH BMD. Our findings suggest the existence of an optimal range of obesity parameters for developing or maintaining optimal bone health in Korean Adolescents. Deviation from this range, in either direction (being underweight or having obesity), may compromise bone health.
Functional Postoperative Outcome for 92 Cases of Radial Head Fractures: A PROM-Based Retrospective Study
Authors: Müller Michael , Mann Verena , Zapf Julian , Kirchhoff Konstantin , Zyskowski Michael , Biberthaler Peter , Kirchhoff Chlodwig , Wurm Markus
Published: September 2023

Background: Fractures of the radial head are common injuries, whereas, in the case of displaced fractures, surgical treatment using screw or plate osteosynthesis, excision, or replacement of the radial head is required. However, data about patient-related outcomes (PROM) for different types of radial head fractures is limited in the current literature. Therefore, this study was conducted to evaluate the functional outcome after operatively treated radial head fractures and to further correlate these results with the initial modified Mason classification. Methods: In this retrospective study, all suitable patients with surgical treatment of a radial head fracture were identified. Only patients with Mason II-IV fractures were included. All patients completed the Elbow Self-Assessment Score (ESAS) questionnaire. Data on fracture classification, type of surgery, and revision operations (if needed) were assessed. Results: A total of 92 patients suffering from fractures of the radial head (57 Mason II, 35 Mason III-fractures) who were operatively treated at our institution were enrolled. There were 42 (47.7%) female and 50 (54.3%) male patients with an average age of 47.5 ± 14.1 years. Screw osteosynthesis was performed in 67 patients, plate osteosynthesis in 20 patients, and five patients received radial head arthroplasty. The average ESAS score accounted for 89.7 ± 16.7. Mason II fractures showed significantly better functional results with higher ESAS scores (92.3 ± 13.9 vs. 85.4 ± 20.1) as well as significantly lower rates of necessary implant removal (0 vs. 5 (14.3%) than Mason III fractures. Screw osteosynthesis showed significantly better functional ESAS scores, 91.0 ± 16.5, than plate osteosynthesis, with 85.3 ± 17.6 (p = 0.041), but was predominantly used in Mason II fractures. Conclusions: Surgical treatment using screw- and plate osteosynthesis of radial head fractures provides a good overall outcome. The postoperative function is associated with the initial Mason classification as the patients’ reported outcome was worse in Mason III fractures compared to Mason type II fractures. In this context, the ESAS score can be considered a useful tool for the assessment of the patient-based functional outcome.
Current Views on Pathophysiology and Potential Therapeutic Targets in Sjögren’s Syndrome: A Review from the Perspective of Viral Infections, Toll-like Receptors, and Long-Noncoding RNAs
Authors: Horai Yoshiro , Shimizu Toshimasa , Umeda Masataka , Nishihata Shin-Ya , Nakamura Hideki , Kawakami Atsushi
Published: September 2023

Sjögren’s syndrome (SS) is a rheumatic disease characterized by sicca and extraglandular symptoms, such as interstitial lung disease and renal tubular acidosis. SS potentially affects the prognosis of patients, especially in cases of complicated extraglandular symptoms; however, only symptomatic therapies against xerophthalmia and xerostomia are currently included in the practice guidelines as recommended therapies for SS. Considering that SS is presumed to be a multifactorial entity caused by genetic and environmental factors, a multidisciplinary approach is necessary to clarify the whole picture of its pathogenesis and to develop disease-specific therapies for SS. This review discusses past achievements and future prospects for pursuing the pathophysiology and therapeutic targets for SS, especially from the perspectives of viral infections, toll-like receptors (TLRs), long-noncoding RNAs (lncRNAs), and related signals. Based on the emerging roles of viral infections, TLRs, long-noncoding RNAs and related signals, antiviral therapy, hydroxychloroquine, and vitamin D may lower the risk of or mitigate SS. Janus-kinase (JAK) inhibitors are also potential novel therapeutic options for several rheumatic diseases involving the JAK-signal transducer and activator of transcription pathways, which are yet to be ascertained in a randomized controlled study targeting SS.
Peripheral Artery Disease Diagnosed by Pulse Palpation as a Predictor of Coronary Artery Disease in Patients with Chronic Kidney Disease
Authors: Dos Santos Daniel B. C. , Gowdak Luis Henrique W. , David-Neto Elias , Nataniel Felizardo A. , De Lima José J. G. , Bortolotto Luiz A.
Published: September 2023

There is a need of simple, inexpensive, and reliable noninvasive testing to predict coronary artery disease (CAD) in patients with chronic kidney disease (CKD), where the prevalence of cardiovascular (CV) events and death is elevated. We analyzed the association between peripheral artery disease (PAD) and CAD in 201 patients with stage 5 CKD on dialysis using a prospective observational cohort. Diagnosis of PAD by both palpation and USD were significantly correlated. In patients with PAD diagnosed by palpation, CAD was observed in 80%, while in those diagnosed by USD, CAD was present in 79.1%. The absence of a pulse by palpation predicted CAD with a sensitivity of 55% and a specificity of 76%; USD showed a sensitivity of 62% and specificity of 60% to predict CAD. The risk of combined serious CV events and death was significantly higher in subjects with PAD diagnosed by palpation, but not by USD. PAD assessed by palpation also correlated with the occurrence of multivessel CAD and with the probability of coronary intervention. Both methods are moderately useful for predicting CAD, but PAD diagnosis by palpation was a better predictor of combined CV events and death and was also associated with CAD severity and likelihood of intervention.
Surgical Challenges in Infective Endocarditis: State of the Art
Authors: Iaccarino Alessandra , Barbone Alessandro , Basciu Alessio , Cuko Enea , Droandi Ginevra , Galbiati Denise , Romano Giorgio , Citterio Enrico , Fumero Andrea , Scarfò Iside , Manzo Rossella , La Canna Giovanni , Torracca Lucia
Published: September 2023

Infective endocarditis (IE) is still a life-threatening disease with frequent lethal outcomes despite the profound changes in its clinical, microbiological, imaging, and therapeutic profiles. Nowadays, the scenario for IE has changed since rheumatic fever has declined, but on the other hand, multiple aspects, such as elderly populations, cardiovascular device implantation procedures, and better use of multiple imaging modalities and multidisciplinary care, have increased, leading to escalations in diagnosis. Since the ESC and AHA Guidelines have been released, specific aspects of diagnostic and therapeutic management have been clarified to provide better and faster diagnosis and prognosis. Surgical treatment is required in approximately half of patients with IE in order to avoid progressive heart failure, irreversible structural damage in the case of uncontrolled infection, and the prevention of embolism. The timing of surgery has been one of the main aspects discussed, identifying cases in which surgery needs to be performed on an emergency (within 24 h) or urgent (within 7 days) basis, irrespective of the duration of antibiotic treatment, or cases where surgery can be postponed to allow a brief period of antibiotic treatment under careful clinical and echocardiographic observation. Mainly, guidelines put emphasis on the importance of an endocarditis team in the handling of systemic complications and how they affect the timing of surgery and perioperative management. Neurological complications, acute renal failure, splenic or musculoskeletal manifestations, or infections determined by multiresistant microorganisms or fungi can affect long-term prognosis and survival. Not to be outdone, anatomical and surgical factors, such as the presence of native or prosthetic valve endocarditis, a repair strategy when feasible, anatomical extension and disruption in the case of an annular abscess (mitral valve annulus, aortic mitral curtain, aortic root, and annulus), and the choice of prosthesis and conduits, can be equally crucial. It can be hard for surgeons to maneuver between correct pre-operative planning and facing unexpected obstacles during intraoperative management. The aim of this review is to provide an overview and analysis of a broad spectrum of specific surgical scenarios and how their challenging management can be essential to ensure better outcomes and prognoses.
The Usefulness of Intracoronary Imaging in Patients with ST-Segment Elevation Myocardial Infarction
Authors: Karamasis Grigoris V. , Varlamos Charalampos , Benetou Despoina-Rafailia , Kalogeropoulos Andreas S. , Keeble Thomas R. , Tsigkas Grigorios , Xenogiannis Iosif
Published: September 2023

Intracoronary imaging (ICI) modalities, namely intravascular ultrasound (IVUS) and optical coherence tomography (OCT), have shown to be able to reduce major adverse cardiovascular events in patients undergoing percutaneous coronary intervention (PCI). Nevertheless, patients with ST-segment elevation myocardial infarction (STEMI) have been practically excluded from contemporary large randomized controlled trials. The available data are limited and derive mostly from observational studies. Nevertheless, contemporary studies are in favor of ICI utilization in patients who undergo primary PCI. Regarding technical aspects of PCI, ICI has been associated with the implantation of larger stent diameters, higher balloon inflations and lower residual in-stent stenosis post-PCI. OCT, although used significantly less often than IVUS, is a useful tool in the context of myocardial infarction without obstructive coronary artery disease since, due to its high spatial resolution, it can identify the underlying mechanism of STEMI, and, thus, guide therapy. Stent thrombosis (ST) is a rare, albeit a potential lethal, complication that is expressed clinically as STEMI in the vast majority of cases. Use of ICI is encouraged with current guidelines in order to discriminate the mechanism of ST among stent malapposition, underexpansion, uncovered stent struts, edge dissections, ruptured neoatherosclerotic lesions and coronary evaginations. Finally, ICI has been proposed as a tool to facilitate stent deferring during primary PCI based on culprit lesion characteristics.
Fatigue and Physical Activity in People after COVID-19 in Poland
Authors: Zalewska Anna , Gałczyk Monika
Published: September 2023

Objectives: The purpose of this research was to look at the amount of fatigue and physical activity (PA) in individuals after COVID-19 in Poland and the correlation between fatigue and PA. Methods: The online research was carried out among adult Polish residents (122 women and 82 men) who had tested positive for SARS-CoV-2 during the previous year. The level of fatigue was measured using the Modified Fatigue Impact Scale (MFIS). The PA level was assessed using the International Physical Activity Questionnaire (IPAQ). Results: A total of 46.6% of the subjects had been ill with COVID-19 for more than 6 months before the time of the survey response. The MFIS total measure is 77 of the maximum score, and the median is 17. A total of 26% of respondents reported low activity, while 41% of respondents reported high activity. A statistically significant negative relationship was found between PA level and total fatigue score. The best scores for fatigue and PA were obtained by the subjects with mild COVID-19. The time since diagnosis (as opposed to older age and female sex) was not clearly associated with most measures. Conclusions: PA may play an important role in regulating the severity of fatigue; it should be increased, especially in patients after COVID. Further studies are also needed to investigate the mechanism of differences in fatigue and PA.
Land Use Change and Landscape Ecological Risk Assessment Based on Terrain Gradients in Yuanmou Basin
Authors: Zhao Lei , Shi Zhengtao , He Guangxiong , He Li , Xi Wenfei , Jiang Qin
Published: September 2023

Investigating the distribution characteristics of landscape ecological risk (LER) on terrain gradients is of great significance for optimizing the landscape pattern of ecologically vulnerable areas in mountainous regions and maintaining the sustainable development of the ecological environment. The Yuanmou Basin is a typical ecologically vulnerable area in the southwestern mountainous region of China, where issues such as soil erosion are pronounced, becoming one of the main factors restricting regional economic development. This study selected the Yuanmou Basin as the study area, and, using land use data from 2000, 2010, and 2020, constructed an LER assessment model based on disturbance and vulnerability. By integrating elevation and topographic position index data, we examined the spatiotemporal evolution characteristics of LER under different terrain gradients. The LER assessment results are summarized as follows: (1) From 2000 to 2020, the land use types of the Yuanmou Basin were mainly grassland, forest land and cropland. The land use showed a sharp increase in the cropland area and a simultaneous decrease in the grassland area, indicating a main land use evolution direction from grassland to cropland. (2) Over the span of 20 years, the average landscape ecological risk in the Yuanmou Basin slightly increased, specifically manifesting as a significant reduction in low ecological risk areas, while areas of medium and slightly lower ecological risks saw an increase. (3) The spatial distribution of LER in the Yuanmou Basin presents a pattern of being low on the periphery and high in the center, with significant positive spatial correlation, obvious spatial aggregation, as well as “high-high” and “low-low” clustering. (4) Low- and lower-risk areas in the Yuanmou Basin are distributed in the non-arid thermal zone and the medium–high terrain zone, while areas of medium, higher and high risk levels are mainly distributed in the arid thermal zone and the low terrain zone. The research results provide a scientific basis for optimizing and developing the land resources of the Yuanmou Basin.