bluuebunny/crossref_metadata_2025 huggingface dataset:
A practical method for reliability evaluation of hybrid system under unit life submitted with different distribution
Authors: Bai Lili , Tian Lei
Published: September 2024

Life-type unit refers to the unit with knowable life distribution type, and hybrid system refers to the system composed of different life-type units. Our aim is to evaluate the hybrid system reliability, which is crucial for improving product competitiveness in heavy industries such as automobile tires and rocket engines, and reducing the maintenance costs. The Mean Confidence Limit Equivalent Folding method is employed in the study. Firstly, extracting a life-type unit and supposing a fitting function, the least squares method combines to verify and modify the supposed fitting function through iterative computations. Then, reliability point estimation and confidence lower limit of each life-type unit are calculated respectively, the formula of turning life-type data into success or failure-type data is derived, and the success or failure-type data is analyzed. Finally, compared with other methods such as the Monte Carlo method and the Levenberg-Marquardt method, the feasibility of the Mean Confidence Limit Equivalent Folding method is verified. The compared results show that a confidence lower limit error based on the method is about 1%, it can meet the parameter evaluation requirement of hybrid systems under constituent units obeying different distribution. The Mean Confidence Limit Equivalent Folding method considers the consistency of the confidence interval of reliability, and it can be suitable for all hybrid systems.
Evaluation of Wear Resistance of CAD/CAM Materials After Artificial Aging: An In Vitro Study
Authors: Sakarya Rüştü Ersoy , Yanikoğlu Nuran Dinçkal
Published: September 2024

Aim:

The purpose of this study is to assess the amount of surface wear and opposing wear of four Computer-Aided Design/Computer-Aided Manufacturing materials consisting of three hybrid materials (Vita Enamic, Cerasmart, Lava Ultimate) and a feldspathic ceramic (CEREC Blocs) after artificial aging.

Materials and Methods:

Samples were 400,000 mechanical loadings simultaneously with 500 thermal cycling, by using antagonist abrasive balls. The surface wear and roughness results were evaluated with one-way variance analysis and multiple comparisons were evaluated using the post-hoc LSD analysis methods ( p = .05).

Results:

The surface wears of Computer-Aided Design/Computer-Aided Manufacturing materials were, in order from lowest to highest, CEREC Blocs, Vita Enamic, Cerasmart, and Lava Ultimate. The differences among all groups wear results were statistically significant ( p < .05). After the chewing simulations of the antagonist balls were evaluated, there was only significant difference between the Cerasmart and Lava Ultimate ( p < .05).

Conclusions:

The hybrid materials showed more surface wear than the feldspathic ceramic.
Step-by-step Stereotactic Radiotherapy Planning of Pituitary Adenoma: A ROSE (Radiation Oncology from Simulation to Execution) Guide to Radiation Oncologists
Authors: Patro Kanhu Charan , Avinash Ajitesh , Naik Banavathu Daya Bharath Singh , Kundu Chitta Ranjan , Bhattacharya Partha Sarathi , Muvvala Mrutyunjayarao , Aketi Srinu , Radhakrishnan Kaviya Lakshmi , Vincent Dona Treesa , Madasu Bhargava Krishna , Tatapudi Priyalice
Published: September 2024

Introduction

Pituitary adenoma accounts for 10%–20% of all intracranial malignancies. The primary modality of treatment is surgery, while pituitary radiation is indicated in residual or recurrent setting post-surgery. Currently, stereotactic radiotherapy (SRT) is one of the main modalities of radiation treatment. The objective of this article is to describe the procedural steps for radiation planning of SRT of pituitary adenoma

Methods

The step-by-step procedure for stereotactic planning of pituitary adenoma has been described using a clinical scenario of pituitary adenoma.

Results

The stereotactic radiation planning of pituitary adenoma starts with the basic history and relevant clinical evaluation that is visual testing. Magnetic resonance imaging (MRI) of the brain is the imaging modality of choice. Evaluation of surgical notes and post-operative histopathology confirmation of diagnosis should also be done. The radiation planning of pituitary adenoma starts with Computed tomography (CT) simulation and MRI of brain that should be done in prescribed format to achieve uniformity in radiation planning. After CT and MRI image fusion, contouring of target, organs at risk (OAR) and radiation planning should be done. The plan evaluation includes target and OAR coverage index, conformity, homogeneity and gradient index and beam arrangement. After radiation plan evaluation, treatment is delivered after quality assurance and dry run.

Conclusion

The article highlights the sequential process of radiation planning for SRT—starting from simulation, planning, evaluation of plan and treatment.
The Ethical Deliberation of Generative AI in Media Applications
Authors: Chen Yen-shen , Tang Yun-Chung , Chen Chen
Published: September 2024

This article explores the triadic relationship between media, the public, and AI technology, focusing on AI's portrayal in news media and ethical controversies depicted in science fiction. It discusses public perceptions of AI through media content and entertainment. Subsequently, the essay analyzes AI's impact on news production and media creation, highlighting the benefits and concerns of AI applications, such as personalization and automation. Four ethical paradoxes of AI in media are presented, addressing human morality, journalism's gatekeeping, the echo chamber effect, and responsible AI. The essay suggests that AI should be viewed as an essential part of the media environment, advocating for meaningful interactions between AI and humans to foster industry development. The intelligence of AI, derived from human-created knowledge, should be leveraged to create a balanced perception of AI.
Hematological biomarkers of systemic inflammation in predicting long-term treatment response of temporomandibular disorders
Authors: Cho Il-San , Jo Jung Hwan , Park Ji Woon
Published: September 2024

Background

Chronic systemic inflammation has been proposed as the underlying mechanism of pain chronicity in several pain conditions. In spite of the growing evidence supporting the role of systemic inflammatory markers as a diagnostic tool, their role has not been analyzed in a well-defined group of temporomandibular disorders (TMD) patients until now. This study aimed to investigate the association between various clinical features and comorbidity levels of TMD in relation to hematological markers and seek its association with long-term treatment response.

Methods

Clinical features and hematological indices including those for systemic inflammation were assessed in TMD patients (n = 154). Examinations were re-done after 6 months of conservative treatment. Patients were divided into pain improved and unimproved groups based on ≥ 2 numeric rating scale improvement in pain intensity at 6 months for final analysis.

Results

The portion of patients with low lymphocyte-to-monocyte ratio (p = 0.026), total protein (p = 0.014), hemoglobin (p = 0.040), and mean corpuscular hemoglobin concentration (p = 0.042) values showed significant differences according to prognosis groups. Low hemoglobin levels were significantly associated with unfavorable response to long-term treatment (β = 1.706, p = 0.018). High pre-treatment pain intensity (β=-0.682, p < 0.001) and low Graded Chronic Pain Scale (β = 1.620, p = 0.002) could predict significant pain improvement with long-term treatment.

Conclusions

Hematologic assessment could be considered in addition to clinical examination to better determine long-term prognosis in TMD patients.
The roles of OGT and its mechanisms in cancer
Authors: Liu Xin , Wang Jing , Xiang Yaoxian , Wang Kangjie , Yan Dong , Tong Yingying
Published: September 2024

O-linked-N-acetylglucosaminylation (O-GlcNAcylation) is a common and important post-translational modification (PTM) linking O-linked β-N-acetylglucosamine (O-GlcNAc) to serine and threonine residues in proteins. Extensive research indicates its impact on target protein stability, activity, and interactions. O-linked N-acetylglucosamine transferase (OGT) is a critical enzyme that catalyzes O-GlcNAc modification, responsible for adding O-GlcNAc to proteins. OGT and O-GlcNAcylation are overexpressed in many tumors and closely associated with tumor growth, invasion, metabolism, drug resistance, and immune evasion. This review delineates the biochemical functions of OGT and summarizes its effects and mechanisms in tumors. Targeting OGT presents a promising novel approach for treating human malignancies.
Double-layer data-hiding mechanism for ECG signals
Authors: Natgunanathan Iynkaran , Karmakar Chandan , Rajasegarar Sutharshan , Zong Tianrui
Published: September 2024

Due to the advancement in biomedical technologies, to diagnose problems in people, a number of psychological signals are extracted from patients. We should be able to ensure that psychological signals are not altered by adversaries and it should be possible to relate a patient to his/her corresponding psychological signal. As far as our awareness extends, none of the existing methods possess the capability to both identify and verify the authenticity of the ECG signals. Consequently, this paper introduces an innovative dual-layer data-embedding approach for electrocardiogram (ECG) signals, aiming to achieve both signal identification and authenticity verification. Since file name-based signal identification is vulnerable to modifications, we propose a robust watermarking method which will embed patient-related details such as patient identification number, into the medically less-significant portion of the ECG signals. The proposed robust watermarking algorithm adds data into ECG signals such that the patient information hidden in an ECG signal can resist the filtering attack (such as high-pass filtering) and noise addition. This is achieved via the use of error buffers in the embedding algorithm. Further, modification-sensitive fragile watermarks are added to ECG signals. By extracting and checking the fragile watermark bits, we can determine whether an ECG signal is modified or not. To ensure the security of the proposed mechanism, two secret keys are used. Our evaluation demonstrates the usefulness of the proposed system.
AI-guided investigation of biochar’s efficacy in Pb immobilization for remediation of Pb contaminated agricultural land
Authors: Cho Yoora , Lim Juin Yau , Igalavithana Avanthi Deshani , Hwang Geonwook , Sang Mee Kyung , Mašek Ondřej , Ok Yong Sik
Published: September 2024

This study evaluated the lead (Pb) immobilization efficiency of biochar in contaminated agricultural soil. The biochar was produced from a range of major biomass residues and pyrolyzed under well-controlled conditions. Ten different types of standard biochar samples were derived from five different feedstocks (i.e., softwood, miscanthus straw, rice husk, oilseed rape straw, wheat straw) and pyrolyzed at 550 ℃ and 700 ℃. Pb-contaminated soil near an abandoned mine was incubated with 2.5% (w w− 1) of biochar. Incubation was conducted for various durations at room temperature under both short-term (21 days) and long-term (214 days) conditions. This variation explicitly accounted for the simulated microplastic contamination during the long-term incubation period. A novel framework has been developed to predict the long-term immobilization effect of various biochar types using a machine-learning approach, following the successful identification of optimal biochar implementations. This prediction method utilizes a small on-field dataset by employing a data augmentation approach, showcasing an innovative approach to forecasting the effects of different biochar types over time. After the incubation period, soil samples were analyzed for their chemical properties. As a result, oil seed rape biochar was the highest in pH, EC, exchangeable Ca2+, Mg2+, and K+, total nitrogen content, soil organic matter content, and available phosphate. In return, OSR 700 treated soils showed the highest content of exchangeable cations and the lowest content of available Pb after the incubation period. The most efficient biochar for immobilizing lead (Pb) in soil appears to be OSR 700, based on the available evidence.
Application of graph neural networks to predict explosion-induced transient flow
Authors: Covoni Ginevra , Montomoli Francesco , Tagarielli Vito L. , Bisio Valentina , Rossin Stefano , Ruggiero Marco
Published: September 2024

We illustrate an application of graph neural networks (GNNs) to predict the pressure, temperature and velocity fields induced by a sudden explosion. The aim of the work is to enable accurate simulation of explosion events in large and geometrically complex domains. Such simulations are currently out of the reach of existing CFD solvers, which represents an opportunity to apply machine learning. The training dataset is obtained from the results of URANS analyses in OpenFOAM. We simulate the transient flow following impulsive events in air in atmospheric conditions. The time history of the fields of pressure, temperature and velocity obtained from a set of such simulations is then recorded to serve as a training database. In the training simulations we model a cubic volume of air enclosed within rigid walls, which also encompass rigid obstacles of random shape, position and orientation. A subset of the cubic volume is initialized to have a higher pressure than the rest of the domain. The ensuing shock initiates the propagation of pressure waves and their reflection and diffraction at the obstacles and walls. A recently proposed GNN framework is extended and adapted to this problem. During the training, the model learns the evolution of thermodynamic quantities in time and space, as well as the effect of the boundary conditions. After training, the model can quickly compute such evolution for unseen geometries and arbitrary initial and boundary conditions, exhibiting good generalization capabilities for domains up to 125 times larger than those used in the training simulations.
Inorganic iodine and bromine speciation in Arctic snow at picogram-per-grams levels by IC-ICP-MS
Authors: Frassati Stefano , Barbaro Elena , Rossetti Claudia , Cozzi Giulio , Turetta Clara , Scoto Federico , Roman Marco , Feltracco Matteo , Kim Kitae , Barbante Carlo , Gambaro Andrea , Spolaor Andrea
Published: September 2024

Iodine and bromine play central roles in polar atmospheric chemistry: iodine influences the atmospheric oxidative capacity and can generate cloud condensation nuclei, while bromine participates in ozone depletion reactions, known as bromine explosions. Here we present a very sensitive analytical method for Br and I speciation by coupling the ion chromatography system (IC) with an inductively coupled plasma sector field mass spectrometer (ICP-SFMS). We achieved sub-picogram-per gram (pg g−1) as limits of detection (LODs) ranging from 0.4 pg g−1 for I−, 0.8 pg g−1 for IO3−, 4 pg g−1 for Br−, and 1 pg g−1 for BrO3−, respectively. These values represent a decrease of up to 30 times compared to the LODs reported in other studies. The method was validated using deep snow samples from the Svalbard Islands, collected at the end of the polar night to quantify various oxidized compounds during their seasonal minimum. In the future, this method could prove useful in the paleoclimatic study of ice cores and snow, as well as in ice chemistry research.
Neuropsychiatric comorbidities in adult patients with new-onset epilepsy
Authors: Nageeb Rania S. , Ismail Adham Mahmoud Mohamad , Youssef Sawsan Abd El Aziz , Mohamed Eman Atef
Published: September 2024

Background

Neuropsychiatric comorbidities in adult patients with new-onset epilepsy in our university hospitals has not been assessed, so the purpose of this study was to identify the neuropsychiatric comorbidities in adult patients with new onset epilepsy in our university hospitals. We recruited one hundred patients, assessed them clinically, radiologically, electrophysiologically, and we performed Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV), Liverpool Seizure Severity Scale (LSSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, Beck’s Depression Inventory II (BDI II) and Quality of Life In Epilepsy-10 Questionnaire (QOLIE-10) to assess cognitive function, seizure severity, anxiety, depression, and quality of life of the patients, respectively.

Results

Older adult age group had higher LSSS than other groups. Middle-aged adults’ group had higher WAIS-IV full scale Intelligence Quotient (IQ) score and lower GAD-7 scale scores than other age groups. Patients regularly on more than one anti-seizure medication had lower IQ results, more seizure severity, depression, anxiety and worse quality of life than those on monotherapy. Males had slightly higher IQ scores. Patients with moderate and severe BDI-II score had significantly higher rate of uncontrolled seizures, higher seizures’ frequency, more abnormal EEG and were regularly on valproate at significantly higher rates as compared to those with minimal BDI-II score. Patients with moderate anxiety were significantly older than those with normal and severe anxiety. Patients with severe anxiety had higher rate of family history of epilepsy, higher rates of uncontrolled seizures and higher seizures’ frequency as compared to those with mild and moderate anxiety. Patients with mild, moderate, and severe score on GAD-7 had more abnormal EEG as compared to those with normal GAD-7 score. Patients with severe and very severe seizures had significantly higher levels of anxiety, depression and impaired quality of life than those with mild and moderate seizure severity.

Conclusions

Most patients with epilepsy had psychiatric comorbidities such as depression and anxiety which strongly reduce their quality of life and interfere with their compliance to anti-seizure medication. Males had slightly higher Intelligence Quotient (IQ) scores on WAIS-IV. Moreover, patients regularly taking more than one anti-seizure medication had a statistically significantly lower IQ score, more seizure severity, higher Beckʼs depression inventory II score, higher generalized anxiety disorder 7-item scale score, and worse quality of life than those on monotherapy.
Implementation of collaborative care for depression in VA HIV clinics: Translating Initiatives for Depression into Effective Solutions (HITIDES): protocol for a cluster-randomized type 3 hybrid effectiveness-implementation trial
Authors: Painter Jacob T. , Pyne Jeffrey , Curran Geoffrey , Raciborski Rebecca A. , Russell Shane , Fortney John , Gifford Allen L. , Ohl Michael , Woodward Eva N.
Published: September 2024

Background

Depression is the most diagnosed mental health condition among people living with HIV. Collaborative care is an effective intervention for depression, typically delivered in primary care settings. The HIV Translating Initiatives for Depression into Effective Solutions (HITIDES) clinical intervention involves a depression care team housed off-site that supports depression care delivery by HIV care providers. In a randomized controlled trial, HITIDES significantly improved depression symptoms for veterans living with HIV and delivered cost savings. However, no HIV clinics in the Veterans Health Administration (VHA) have implemented HITIDES; as such, it is unclear what implementation strategies are necessary to launch and sustain this intervention.

Methods

This hybrid type-3 effectiveness-implementation trial examines the implementation and effectiveness of HITIDES in 8 VHA HIV clinics randomly assigned to one of two implementation arms. Each arm uses a different implementation strategy package. Arm 1 includes an intervention operations guide; an on-site clinical champion who, with the help of a peer community of practice, will work with local clinicians and leadership to implement HITIDES at their site; and patient engagement in implementation tools. Arm 2 includes all strategies from Arm 1 with assistance from an external facilitator. The primary implementation outcomes is reach; secondary outcomes include adoption, implementation dose, depressive symptoms, and suicidal ideation. We will conduct a budget impact analysis of the implementation strategy packages. We hypothesize that Arm 2 will be associated with greater reach and adoption and that Arm 1 will be less costly.

Discussion

Preliminary work identified implementation strategies acceptable to veterans living with HIV and HIV care providers; however, the effectiveness and cost of these strategies are unknown. While the depression care team can deliver services consistently with high quality, the ability of the depression care team to engage with HIV care providers at sites is unknown. Findings from this study will be used to inform selection of implementation strategies for a broad rollout to enhance depression and suicide care for people living with HIV.

Trial registration

ClinicalTrials.gov ID: NCT05901272, Registered 10 May 2023, https://clinicaltrials.gov/study/NCT05901272
Postoperative pain management following laparoscopic cholecystectomy-non-opioid approaches: a review
Authors: Bayoumi Hoda Mohamed , Abdelaziz Doaa Hamed , El Said Nouran Omar , Boraii Sherif , Bendas Ehab Rasmy
Published: September 2024

Background

Gallstone disease with its consequences is a common clinical issue that may necessitate surgical removal. In comparison with traditional open procedures, laparoscopic cholecystectomy (LC) remains the mainstay treatment for symptomatic gallstone disease and can lead to a shorter recovery period, and a shorter hospital stay; yet, severe abdominal and shoulder pain may be experienced.

Main body

Novel drugs and technology for acute and chronic pain management following LC have been studied to improve patient care. The review discusses innovative pain management strategies with non-opioid approaches for laparoscopic surgery, with an emphasis on ensuring speedy and safe recovery.

Conclusion

The key findings state that IV paracetamol is a necessary part of multimodal postoperative pain management. There were several pharmacological interventions found to be effective in pain control: magnesium sulfate and dexamethasone showed anti-inflammatory benefits; ondansetron provided analgesic effects; gabapentinoids and alpha-2-agonists reduced central sensitization; local anesthetics offered targeted pain relief; antidepressants addressed neuropathic pain; NSAIDs proved effective for inflammatory pain. Similarly, non-pharmacological approaches, and emerging technologies, also contributed to the management of post-LC pain underscoring the need for a comprehensive approach to its management. More rigorous research is needed to guide pain management after LC. Future studies should compare multiple treatments simultaneously and involve larger patient groups. This approach will help identify optimal pain control strategies. It will also provide clearer insights into the safety and efficacy of various pain medications under comparable clinical conditions.
Multichannel 3D-printed bionanoparticles-loaded tablet (M3DPBT): designing, development, and in vitro functionality assessment
Authors: Rana Hardik , Pathak Priyanka , Patel Vimal , Thakkar Vaishali , Dholakia Mansi , Dalwadi Saloni , Gandhi Tejal
Published: September 2024

Background

The intersubject variability which was related to the genetic makeup was the major cause of change in pharmacological and pharmacokinetic behavior of same dosage form in varied human being. 3D printing technology will help therapy evolve and eliminate the limitations of conventional technologies. Nebivolol's (NBL)-limited oral bioavailability is mainly due to its poor aqueous solubility. The research aims to combine advanced 3D printing technology and nanotechnology to design customized therapy and enhance the functionality of NBL using a statistical approach.

Results and discussion

The results of the phase solubility indicated that NBL was a poorly aqueous soluble drug. Its solubility was increased by employing nanoparticle drug delivery, which is a promising solubility enhancement technique. The 32 full factorial design was employed to develop and optimize bionanoparticles (BNPs) by solvent evaporation technique using poly (lactic-co-glycolic acid 50:50) (PLGA 50:50) and poloxamer-407 as a surfactant. The BNPs were characterized by % encapsulation efficiency (% EE), Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimeter (DSC), transmission electron microscope (TEM), zeta potential, polydispersity index (PDI), particle size, in vitro drug release, etc. The BNPs loaded of NBL were further incorporated into the multichannel 3D-controlled release tablets made by PVA filaments employing fused deposition modeling (FDM) technology optimized by central composite design (CCD). Multichannel 3D-printed bionanoparticles-loaded tablet (M3DPBT) was optimized using CCD. All designed M3DPBTs were evaluated for post-fabrication parameters. The optimized M3DPBT could release more than 85% NBL within 10 h.

Conclusions

The newly fabricated M3DPBT was found stable. The amount of PLGA 50:50 and Polaxomer was significant for developing BNPs. % infill and layer height were observed as critical for the designing M3DPBT. The combined novel 3D printing and nanotechnology technology will open a new direction for patient compliance and better therapeutic effects.

Graphical abstract

Designing and developing of M3DPBT is substantially improve the patient compliance and therapeutic effectiveness of Nebivolol.
Fourth COVID anniversary: does our practice have changed? The case of ENT outpatient consultations in Cameroon — a national cross-sectional survey
Authors: Mossus Yannick , Ngo Nyeki Adèle-Rose , Mossus Tatiana , Atanga Leonel Christophe , Meva’a Biouélé Roger Christian , Ngaba Mambo Pouka Olive Nicoles , Djomou François , Essi Marie-José , Njock Louis Richard , Ndjolo Alexis
Published: September 2024

Background

In Cameroon, the COVID-19 disease has demonstrated shortcomings in preventing nosocomial infections at both collective and individual levels. This study aimed to identify practice changes in ENT outpatient consultations in Cameroon inducted by the COVID-19 pandemic.

Methods

This was a descriptive cross-sectional study that took place in March 2024. A Google Form was submitted to ENT practitioners online across Cameroon. It consisted of 20 questions grouped into socio-professional and clinical data.

Results

Sixty-four practitioners responded to the questionnaire. The average age of respondents was 36, with extremes of 31 and 70. The sex ratio was 0.35 in favor of women. In terms of experience, 47.7% had been practicing for less than 10 years. A total of 91.3% practiced in public health facilities. Before the COVID-19 outbreak, attitudes towards respiratory diseases were as follows: wearing of masks by suspected patients (4.3%), information posters in waiting rooms (13%), constant use of disinfectant gel (26.1%), wearing of masks by practitioners (0%), wearing of gloves (54.5%), wearing of gowns (87%), constant hand hygiene after each consultation (26.1%), and regular surface hygiene (30.4%). All precautions were improved after 4 years of the pandemic except wearing eye protection.

Conclusion

ENT practice has been strongly impacted by the COVID-19 pandemic, and many measures still need to be taken to improve infection control in hospitals in Cameroon.
Knapsack air assisted electrostatic sprayer for agricultural formulations
Authors: Khatawkar Dipak S. , Dharaneedharan Dhalin , James P. Shaji
Published: September 2024

An experimental prototype of a backpack-type rechargeable battery-powered air-assisted electrostatic sprayer was designed and tested for performance while preserving techno-commercial competence and affordability for India's marginal and small farmer communities. The designed prototype electrostatic sprayer achieved good levels of charge induction on the spray particles at various electrode potentials (1 to 12 kV). At a charging electrode potential of 9 kV and a nozzle discharge rate of 2 mL s
−1
, electrostatically charged spray had a maximum charge to mass ratio (CMR) of 1.79 mC kg
−1
. The Electric Ducted Fan (EDF) used for high velocity air assistance was capable of transporting charged spray droplets onto distant targets such as orchard trees and field crops with a spray throw of up to 5 m. The high-pressure atomization method produced fine droplets within a Volume Median Diameter (VMD) range of 90 to 100 µm, resulting in better charge induction and wrap-around effect. As the prototype features fewer moving mechanical components, reduced total noise and vibrations, it promises operator comfort in the long run while requiring less system maintenance. Environmental contamination can be minimized as the large quantity of harmful chemicals be prevented from drifting into the soil and nearby waterbodies. The competitive performance and lower investment could encourage majority of the Indian famers to upgrade with the developed air assisted electrostatic spraying system contributing to agro-socio-economic welfare.
Hyperinsulinemic Hypoglycemia Due to an Insulinoma in a 2-Year-Old Child
Authors: Mitteer Lauren M , States Lisa , Bhatti Tricia , Adzick N Scott , Lord Katherine , De León Diva D
Published: September 2024

Insulinomas are rare insulin-secreting tumors that most commonly affect adults. A 26-month-old child presented to her local emergency department with severe hypoglycemia. Initial workup was consistent with hyperinsulinemic hypoglycemia. Over the course of 10 months, multiple therapies for hyperinsulinism (HI) were trialed without significant benefit. Genetic testing for genes associated with HI was negative. At age 35 months, the patient was transferred to our center for further treatment. She underwent several imaging tests that revealed a lesion on her pancreas concerning for an insulinoma. The patient underwent surgical intervention to enucleate the lesion. Histopathological review of the specimen confirmed a benign, well-circumscribed insulinoma. A postoperative fasting test proved the patient was cured and she was discharged without the need for further glucose monitoring.
Classifying High-Risk Patients for Persistent Opioid Use After Major Spine Surgery: A Machine-Learning Approach
Authors: Simpson Sierra , Zhong William , Mehdipour Soraya , Armaneous Michael , Sathish Varshini , Walker Natalie , Said Engy T. , Gabriel Rodney A.
Published: September 2024

BACKGROUND:

Persistent opioid use is a common occurrence after surgery and prolonged exposure to opioids may result in escalation and dependence. The objective of this study was to develop machine-learning–based predictive models for persistent opioid use after major spine surgery.

METHODS:

Five classification models were evaluated to predict persistent opioid use: logistic regression, random forest, neural network, balanced random forest, and balanced bagging. Synthetic Minority Oversampling Technique was used to improve class balance. The primary outcome was persistent opioid use, defined as patient reporting to use opioids after 3 months postoperatively. The data were split into a training and test set. Performance metrics were evaluated on the test set and included the F1 score and the area under the receiver operating characteristics curve (AUC). Feature importance was ranked based on SHapley Additive exPlanations (SHAP).

RESULTS:

After exclusion (patients with missing follow-up data), 2611 patients were included in the analysis, of which 1209 (46.3%) continued to use opioids 3 months after surgery. The balanced random forest classifiers had the highest AUC (0.877, 95% confidence interval [CI], 0.834–0.894) compared to neural networks (0.729, 95% CI, 0.672–0.787), logistic regression (0.709, 95% CI, 0.652–0.767), balanced bagging classifier (0.859, 95% CI, 0.814–0.905), and random forest classifier (0.855, 95% CI, 0.813–0.897). The balanced random forest classifier had the highest F1 (0.758, 95% CI, 0.677–0.839). Furthermore, the specificity, sensitivity, precision, and accuracy were 0.883, 0.700, 0.836, and 0.780, respectively. The features based on SHAP analysis with the highest impact on model performance were age, preoperative opioid use, preoperative pain scores, and body mass index.

CONCLUSIONS:

The balanced random forest classifier was found to be the most effective model for identifying persistent opioid use after spine surgery.
Safety and Efficacy of Balloon-Assisted Kyphoplasty Followed by Stereotactic Body Radiation Therapy for Pathological Fractures
Authors: Adida Samuel , Kann Michael R. , Taori Suchet , Bhatia Shovan , Sefcik Roberta K. , Burton Steven A. , Flickinger John C. , Gerszten Peter C.
Published: September 2024

BACKGROUND AND OBJECTIVES:

In patients experiencing pain secondary to pathological compression fractures, balloon-assisted kyphoplasty and subsequent stereotactic body radiation therapy (SBRT) may allow for restoration of vertebral height and irradiation of the underlying malignancy to control local disease progression. The aim of this study was to evaluate the safety and efficacy of kyphoplasty treatment before SBRT in patients with spinal metastases and benign tumors.

METHODS:

An analysis of a prospectively collected database of 70 patients and 75 metastatic and benign spinal lesions that underwent kyphoplasty before SBRT at a single institution (2002-2023) was conducted. Patient characteristics were recorded, including treatment history, dosimetry and fractionation schedule, pain outcomes, local control (LC), and overall survival. The Bilsky score and Spinal Instability Neoplastic Score were calculated to assess epidural involvement and spinal stability, respectively.

RESULTS:

The median time from kyphoplasty to SBRT was 29 days (range: 2-159). Seventy-two lesions (96%) were managed with single-fraction SBRT and 3 lesions (4%) with a multifraction regimen. The median single-fraction prescription dose was 20 Gy (range: 12-25) delivered to a median tumor volume of 35.1 cc (range: 2.2-160). After a median follow-up period of 9 months (range: 1-201), 6 lesions (8%) locally progressed. Pain was reported to improve or remain stable for most patients (88%). The LC rate was 88% at 6 months, 1 year, and 2 years. No prognostic factors were significantly associated with LC. The median overall survival was 11 months (range: 1-201) after radiosurgery. There were no reports of cement extravasation or radiation-induced neurological deficit. Two acute pain flares (3%) were reported 1 and 3 months after radiosurgery.

CONCLUSION:

The combined kyphoplasty and SBRT treatment paradigm can be used to treat patients with painful pathological compression fractures. Long-term LC and patient-reported improvement in pain were observed without the morbidity associated with open surgery.
Evaluation of AJCC Nodal Staging for Intraductal Papillary Mucinous Neoplasm-Derived Pancreatic Ductal Adenocarcinoma
Authors: Habib Joseph R. , Rompen Ingmar F. , Javed Ammar A. , Sorrentino Anthony M. , Riachi Mansour E. , Cao Wenqing , Besselink Marc. G. , Molenaar I. Quintus , He Jin , Wolfgang Christopher L. , Daamen Lois A.
Published: September 2024

Background

The American Joint Committee on Cancer (AJCC) eighth edition is based on pancreatic intraepithelial neoplasia-derived pancreatic ductal adenocarcinoma (PDAC), a biologically distinct entity from intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic cancer. The role of nodal disease and the AJCC’s prognostic utility for IPMN-derived pancreatic cancer are unclear. This study aimed to evaluate the prognostic role of nodal disease and the AJCC eighth-edition N-staging for IPMN-derived pancreatic cancer.

Methods

Upfront-surgery patients with IPMN-derived PDAC from four centers were stratified according to the AJCC eighth-edition N stage. Disease characteristics were compared using descriptive statistics, and both overall survival (OS) and recurrence-free survival (RFS) were evaluated using log-rank tests. Multivariable Cox regression was performed to determine the prognostic value of N stage for OS, presented as hazard ratios with 95 % confidence intervals (95 % CIs). A lowest p value log-rank statistic was used to derive the optimal cutoff for node-positive disease.

Results

For 360 patients, advanced N stage was associated with worse T stage, grade, tubular histology, and perineural and lymphovascular invasion (all p < 0.05). The median OS was 98.3 months (95 % CI 82.8–122.0 months) for N0 disease, 27.8 months (95 % CI 24.4–41.7 months) for N1 disease, and 18.1 months (95 % CI 16.2–25.9 months) for N2 disease (p < 0.001). The AJCC N stage was validated and associated with worse OS (N1 [HR 1.64; range, 1.05–2.57], N2 [HR2.42; range, 1.48–3.96]) and RFS (N1 [HR 1.81; range, 1.23–2.68], N2 [HR 3.72; range, 2.40–5.77]). The optimal cutoff for positive nodes was five nodes.

Conclusion

The AJCC eighth-edition N-staging is valid and prognostic for both OS and RFS in IPMN-derived PDAC.
Μελέτη της αξίας του ποσοτικού προσδιορισμού του ελεύθερου εμβρυικού DNA στη μητρική κυκλοφορία στη διάρκεια του πρώτου τριμήνου στην πρόβλεψη παθολογικών καταστάσεων κύησης
Authors: Κούκου Ζωή
Published: September 2024

Η αναγνώριση εμβρυϊκών κυττάρων και εμβρυϊκού DNA χωρίς κύτταρα (cff-DNA) έχει μεταμορφώσει σημαντικά τον τομέα της μη επεμβατικής προγεννητικής διάγνωσης, παρουσιάζοντας έτσι μια νέα οδό για την πρόοδο στη μαιευτική έρευνα. Η ταυτοποίηση του εμβρυϊκού DNA χωρίς κύτταρα (cff-DNA) με τη σύγχρονη κατανόηση της ποσοτικής αλυσιδωτής αντίδρασης πολυμεράσης (PCR) είναι μια απλή, ταχεία και οικονομικά αποδοτική μέθοδος. Κατά συνέπεια, προσφέρει αξιοσημείωτα οφέλη σε σύγκριση με προηγούμενες μεθοδολογίες που απαιτούσαν την εξαγωγή εμβρυϊκών κυττάρων. Η χρήση αυξημένων επιπέδων εμβρυϊκού DNA χωρίς κύτταρα (cff-DNA) ως προγνωστικός δείκτης για την έγκαιρη αναγνώριση διαταραχών που σχετίζονται με την εγκυμοσύνη, συμπεριλαμβανομένης της προεκλαμψίας, του περιορισμού της ενδομήτριας ανάπτυξης (IUGR), του πρόωρου τοκετού και του προδρομικού πλακούντα έγινε ευρέως αναγνωρισμένο. Ωστόσο, αντικρουόμενα στοιχεία υποδηλώνουν ότι τα επίπεδα cff-DNA μπορεί αρχικά να αυξηθούν κατά τη διάρκεια των πρώιμων φάσεων των παθολογικών αλλαγών και στη συνέχεια να μειωθούν καθώς η νόσος εξελίσσεται. Παρά αυτή τη διαφορά, είναι προφανές ότι οι συγκεντρώσεις του εμβρυϊκού DNA (cff-DNA) χωρίς κύτταρα παρουσιάζουν μια αισθητή αύξηση πριν από την εκδήλωση κλινικών συμπτωμάτων με δυσκολίες που σχετίζονται με την εγκυμοσύνη. Οι μηχανισμοί που διέπουν τις παρατηρούμενες επιδράσεις υποτίθεται ότι περιλαμβάνουν μια πολύπλοκη αλληλεπίδραση αποπτωτικών, απονεκρωτικών και φλεγμονωδών διεργασιών που συμβαίνουν σε όλη τη διάρκεια του σχηματισμού του πλακούντα. Απαιτείται πρόσθετη και πιο ολοκληρωμένη έρευνα για να διευκρινιστούν οι ακριβείς μηχανισμοί που ρυθμίζουν τη θεμελιώδη παθολογία της απελευθέρωσης cff-DNA και τη συσχέτισή της με επιπλοκές που σχετίζονται με την εγκυμοσύνη. Ωστόσο, τα τρέχοντα ευρήματα υποδηλώνουν ότι το cff-DNA έχει σημαντική δυνατότητα ως πολύτιμη προσθήκη στον μη επεμβατικό προγεννητικό έλεγχο. Η εγκυρότητα του cffDNA ως δείκτη για την αξιολόγηση σοβαρών επιπλοκών κατά τη διάρκεια της εγκυμοσύνης παραμένει αβέβαιη με τεράστιο επιστημονικό ενδιαφέρον για μελλοντικές έρευνες.
Διερεύνηση Διδακτικών Παρεμβάσεων σε Μαθητές Λυκείου, σε θέματα σύγχρονης φυσικής, με αξιοποίηση πολλαπλών αναπαραστάσεων
Authors: Κλαυδιανού Στυλιανή , Αναστάσιος Μολοχίδης
Published: September 2024

Είναι αναμφισβήτητο γεγονός ότι τα θέματα της σύγχρονης φυσικής που περιλαμβάνονται έως τώρα στα αναλυτικά προγράμματα της δευτεροβάθμιας εκπαίδευσης είναι ελάχιστα. Στην μελέτη εργασιών που αναφέρονται σε σχετική θεματολογία διαπιστώθηκε ότι η εισαγωγή της σύγχρονης φυσικής στην εκπαίδευση, αποτελεί ένα καίριο ερευνητικό ερώτημα στην διδακτική της φυσικής. Η παρούσα εργασία επικεντρώνεται στην φυσική στοιχειωδών σωματιδίων και στην ένταξη της στην εκπαίδευση. Στα ερευνητικά ερωτήματα της εργασίας περιλαμβάνονται η επίτευξη γνωστικών και επιστημονικών στόχων, μέσα από κατάλληλα διαμορφωμένη Διδακτική Μαθησιακή Ακολουθία (ΔΜΑ), με αξιοποίηση των πολλαπλών αναπαραστάσεων. Στο πρώτο στάδιο της εργασίας γίνεται διερεύνηση για το επίπεδο γνώσεων των μαθητών σχετικά με την σωματιδιακή φυσική (ΣΦ) και το κατά πόσο μπορεί να αποτελέσει πηγή ενδιαφέροντος για την φυσική γενικότερα.
Ανάπτυξη και αξιολόγηση διδακτικού υλικού με επίκεντρο το «infographic», για τη STEM εκπαίδευση στην κλιματική αλλαγή
Authors: Σαμπροβαλάκη Έλλη , Σταύρου Δημήτριος
Published: September 2024

H αξιοποίηση καινοτόμων τεχνολογικών μέσων ως παιδαγωγικά εργαλεία, βρίσκεται στο επίκεντρο της εκπαιδευτικής έρευνας τα τελευταία χρόνια. Σύμφωνα με αυτήν, η αξιοποίηση των οπτικών διδακτικών υλικών (εννοιολογικοί χάρτες, βίντεο, εικόνες, διαφάνειες παρουσιάσεων και infographics) έχει αποτελέσει αντικείμενο μεγάλου ενδιαφέροντος, καθώς στο πλαίσιο της εκπαίδευσης αποτελούν ένα ισχυρό εργαλείο για τη μάθηση. Στο πλαίσιο της παρούσας εργασίας, αναπτύχθηκε ένα διδακτικό υλικό για διδασκαλία στην Κλιματική Αλλαγή με επίκεντρο το Infographic, και στη συνέχεια ακολούθησε η αξιολόγηση αυτού από μελλοντικούς εκπαιδευτικούς της Πρωτοβάθμιας Εκπαίδευσης. Από τα αποτελέσματα της έρευνας, προκύπτει πως οι μελλοντικοί εκπαιδευτικοί αναγνωρίζουν τις δυνατότητες κατανόησης ταυτόχρονα όμως, και τους περιορισμούς ως προς τη διερεύνηση που προσφέρουν τα διαφορετικά είδη Infographics και οι αναπαραστάσεις που αξιοποιήθηκαν.
Συνεργατική Συνοχή Ομάδων Συνεργατικής Μάθησης στην Περιβαλλοντική Εκπαίδευση
Authors: Χρυσανθόπουλος Χρήστος , Παπαδοπούλου Πηνελόπη , Μπεκιάρη Αλεξάνδρα , Μαλανδράκης Γεώργιος
Published: September 2024

Η παρούσα εργασία αποτελεί τμήμα διδακτορικής διατριβής η οποία επικεντρώνεται στην μελέτη της συνεργατικής μάθησης στην Περιβαλλοντική Εκπαίδευση (ΠΕ) με ανάλυση κοινωνικών δικτύων (ΑΚΔ). Προκειμένου να διερευνηθεί η συνεργατική συνοχή ομάδων συνεργατικής μάθησης στην ΠΕ, ομάδες μαθητών που επισκέπτονται Κέντρο Περιβαλλοντικής Εκπαίδευσης (ΚΠΕ), συμπληρώνουν, πριν και μετά το Πρόγραμμα Περιβαλλοντικής Εκπαίδευσης (ΠΠΕ), ερωτηματολόγια καταγραφής ενδο-ομαδικών αλληλεπιδράσεων συνεργατικών σχέσεων. Από τις απαντήσεις των μαθητών, με την μεθοδολογία της ΑΚΔ, δημιουργούνται δίκτυα συνεργατικών σχέσεων ανά ομάδα, υπολογίζονται δικτυακοί δείκτες συνοχής των αλληλεπιδράσεων ανά δίκτυο και ομάδα, η ανάλυση των οποίων δείχνει αύξηση της συνεργατικής συνοχής των ομάδων μετά το ΠΠΕ.
Optimal timing for lithium levels
Authors: Black Kevin J
Published: September 2024

Reddy and Reddy (2014) discuss the optimal timing for lithium levels in patients taking once-daily extended-release lithium formulations. They argue for blood sampling 24 h after the previous dose rather than the standard 12 h. I interpret the data quite differently. The authors start with the assumption that the clinician wants a trough level. I disagree. What one wants is to be able to compare a patient’s lithium level to the large body of published knowledge about lithium dosing. Almost all of that data comes from standard 12-h blood draws with plain (immediate-release) lithium carbonate or lithium citrate. So, the real question of interest is, with extended-release lithium formulations, at what time point does one draw the lithium level to compare most accurately with a standard 12-h blood draw with plain lithium carbonate? The answer is not obvious because extended-release formulations affect only the absorption and not the excretion of lithium. Their primary benefit is reducing the transient peak lithium serum concentration, not delaying the (already relatively slow) elimination of lithium. Emami and colleagues (2004) provide the needed data. First they show that 90% of the administered dose of a commercial extended-release formulation (Eskalith CR®) is absorbed by 4 h after a dose, and ~100% is absorbed by 8 h (their Figure 2A). Second, they show that at 12 h after a dose, the blood levels for immediate and extended release formulations are essentially identical (their Figure 3).  Thus 12 h after the previous dose is the ideal time for drawing blood levels for extended-release lithium tablets.
Floating photovoltaic systems: photovoltaic cable submersion testing and potential impacts
Authors: Rebelo Ricardo , FIALHO Luis , Novais Maria Helena
Published: September 2024

Background Floating photovoltaics (FPV) is an emerging technology that is gaining attention worldwide. However, little information is still available on its possible impacts in the aquatic ecosystems, as well as on the durability of its components. Therefore, this work intends to provide a contribution to this field, analysing possible obstacles that can compromise the performance of this technology, adding to an increase of its reliability and assessing possible impacts. The problem under study is related to the potential submersion of photovoltaic cables, that can lead to a degradation of its electrical insulation capabilities and, consequently, higher energy production losses and water contamination. Methods In the present study, the submersion of photovoltaic cables (with two different insulation materials) in freshwater and artificial seawater was tested, in order to replicate real life conditions, when FPV systems are located in reservoirs or in the marine environment. Electrical insulation tests were carried out weekly to assess possible cable degradation, the physical-chemical characteristics of the water were also periodically monitored, complemented by analysis to detect traces of copper and microplastics in the water. Results The results showed that the submersion of photovoltaic cables with rubber sheath in saltwater can lead to a cable accelerated degradation, with reduction of its electrical insulation and, consequently, copper release into the aquatic environment. Conclusions The test results pointed a probable relationship between submersion of cables with rubber outer shell and water freezing temperatures and the occurrence of accelerated degradation of the cable insulation layer. Reduced insulation resistance values were measured in this cable type after the occurrence of such temperatures, both in salt and freshwater, the cable presented visible exterior degradation signs. For this case copper residues were detected in the water.
Probing Digital Footprints and Reaching for Inherent Preferences: A Cause-Disentanglement Approach to Personalized Recommendations
Authors: Wang Cong , Shi Yansong , Guo Xunhua , Chen Guoqing
Published: September 2024

This study introduces DISC (Disentangling consumers’ Inherent preferences, item Salience effect, and Conformity effect), a novel personalized recommendation approach that leverages disentangled representation learning and causal graph modeling to provide interpretable and effective recommendations. By analyzing consumer behavior across various shopping stages, DISC identifies and differentiates the inherent factors that influence purchasing decisions. DISC cuts through biases to pinpoint consumers’ inherent preferences driving purchases, empowering platforms with the ability to deliver tailored recommendations that resonate deeply with users. Through extensive experiments on real-world data sets, DISC significantly outperforms existing methods, demonstrating its superiority in both in-sample prediction and generating recommendations that align with consumers’ true interests. With its robust performance and theoretical underpinnings, DISC holds promising implications for e-commerce platforms seeking to enhance recommendation accuracy, interpretability, and user engagement.