bluuebunny/crossref_metadata_2025 huggingface dataset:
High Prevalence of Severe Depression in Mexican Patients Diagnosed with HIV Treated with Efavirenz and Atazanavir: Clinical Follow-Up at Four Weeks and Analysis of TPH2 SNPs
Authors: Rojas-Osornio Sandra Angélica , Guerra-Castillo Francisco , Mata-Marín Antonio , Paredes-Cervantes Vladimir , Aguirre-Alvarado Charmina , Bekker-Méndez Carolina , Pérez-Sánchez Gilberto , Molina-López José , Ortiz-Maganda Mónica , Mercado-Méndez Aurora , Tesoro-Cruz Emiliano
Published: December 2024

Efavirenz (EFV) causes neuropsychiatric effects such as anxiety, depression, and suicidal thoughts in people with HIV (PWH). Depressive disorders have been associated with the Tryptophan hydroxylase type 2 (TPH2) gene. Objectives: This study determines the genotypes and allelic frequencies of three TPH2 single nucleotide polymorphisms (SNPs) in a Mexican cohort of HIV-1 treatment-naïve-patients and the severity of depressive symptoms at baseline and after a four-week clinical follow-up of antiretroviral treatment. Methods: In a pilot prospective study, eighty-one antiretroviral treatment-naïve patients were recruited from the Infectious Disease Hospital, National Medical Center “La Raza”, in Mexico City. Of these, 39 were treated using a set-dose combination regimen of tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) plus EFV and 42 were treated with TDF/FTC plus atazanavir/ritonavir (ATV/r), and fifty-nine control volunteers. Genomic DNA was obtained from peripheral blood mononuclear cells. All DNA samples underwent qPCR utilizing TaqMan probes for the three TPH2 SNPs studied. All participants underwent evaluation utilizing the Beck Depression Inventory. Results: Of the three SNPs examined, none exhibited any notable differences in the distribution of the alleles between the groups; nevertheless, rs4570625 TT and rs1386493 GG presented a twofold and fivefold greater risk of severe depression in PWH, respectively, independently of the treatment. Among PWH, those treated with EFV experienced severe depression at a higher rate of 90.4% after four weeks, compared to 87.5% in those treated with ATV/r. Conclusions: High rates of severe depression were identified in PWH, who presented the rs4570625 TT and rs1386493 GG polymorphic variants. Depression increased after four weeks of treatment and was higher with EFV than ATV/r. It is crucial to emphasize the necessity of conducting psychiatric monitoring for every patient with HIV and administering prompt antidepressant treatment.
Body Positions and Physical Activity Levels Modulate the Ratio of Abdominal to Thoracic Breathing and Respiratory Rate in Young Individuals
Authors: Decker Szonja , Horváth Tamás , Takács Johanna , Koller Akos
Published: December 2024

Background/Objectives: The COVID-19 pandemic highlighted that body positions substantially affected the mortality rate. We hypothesized that body position modulates the contribution of abdominal (AB) and thoracic breathing (TB) to the breathing cycle (BC), as well as respiratory rate (RR). In addition, we hypothesized that physical activity level can increase the contribution of abdominal breathing. Methods: Thus, we used plethysmography respiratory belts to measure changes in abdominal (AB) and thoracic (TB) circumferences, their ratio (AB/TB), and respiratory rate (RR) under resting conditions. Measurements were taken in four body positions—standing (St), sitting (Si), supine (Su), and prone (Pr)—for two groups of young adults (aged 21 ± 2 years) with different physical activity levels (low and high PA). Results: The AB/TB ratios significantly differed between the body positions (Si: 45.5/54.5%, St: 40.5/59.5%, Su: 56.8/43.2%, Pr: 52.2/47.8% (p < 0.001)). AB was significantly the highest in Su and lowest in Si and St (p < 0.001). There was a significant difference in respiratory rate (RR) between the four body positions (p = 0.005). RR in the four body positions was the following: Si: 15.1, St: 15.0, Su: 13.7, and Pr: 14.4. RR was the lowest in Su (13.7), where AB was the highest (56.8%), and RR was the highest in Si (15.1) and St (15.0), where TB was higher compared to Su (p < 0.001). PA significantly affected the various body positions’ AB/TB ratio and RR. The high PA group showed a significant difference in the AB/TB ratio between the body positions (p < 0.001). The low PA group showed a significant difference in RR between the body positions (p = 0.025). Conclusions: In young, healthy adults, we found that body position significantly influenced the abdominal/thoracic breathing ratio during the breathing cycle. The supine position showed the highest contribution of abdominal breathing, which correlated with the lowest respiratory rate. Additionally, a higher level of physical activity increased the contribution of abdominal breathing in the Si, Su, and St positions, suggesting a more energy-efficient breathing pattern. These findings suggest the potentials for breathing pattern monitoring and position-based interventions to improve healthcare outcomes and enhance sports performance and recovery.
Incidence and Outcomes of Vertebral Compression Fracture Among Patients Infected with COVID-19
Authors: Zhang Helen , Balmaceno-Criss Mariah , Fruge Abigail M. , Massey Patrick A. , Daniels Alan H. , Zhang Andrew S.
Published: December 2024

Background/Objectives: Early studies have suggested that the SARS-CoV-2 virus has a deleterious effect on bone mineral density and may increase the risk of pathological fractures. This study characterized vertebral compression fractures in patients with and without a prior diagnosis of COVID-19. Methods: Using a nationwide claims database, this retrospective study used ICD-10 billing codes to identify patients with a diagnosis of vertebral compression fracture from January 2020 to April 2022. Two cohorts were created based on whether the patients had a concurrent diagnosis of COVID-19. Patient demographics, comorbidities, and outcome measures were characterized by descriptive analysis. Results: In total, 413,425 patients met the inclusion criteria. Among them, a total of 23,148 patients (5.60%) had a diagnosis of COVID-19 at the time of their compression fracture. Among the COVID-19 patients, the incidences of vertebral compression fracture were 0.42% in 2020 and 0.33% in 2021, in comparison to the historical average yearly incidence of 0.17% across all patients. The patients with COVID-19 at the time of compression fracture diagnosis had a higher rate of vitamin D deficiency (OR: 1.25) and a lower rate of routine healing (OR: 0.61). The patients without COVID-19 were more likely to be osteoporotic (OR: 0.88), experience additional compression fractures (OR: 0.38), and have kyphoplasty or vertebroplasty (OR: 0.73). Conclusions: Despite lower rates of osteoporosis, patients with a concomitant COVID-19 diagnosis exhibited a higher incidence of compression fractures. Although more research is needed, these results support increasing bone health surveillance in patients with a history of COVID-19 infection.
Regional Variations in the Incidence of Lichen Sclerosus in Sweden: Insights from a Nationwide Register Study (2001–2021)
Authors: Jerkovic Gulin Sandra , Kravvas Georgios , Seifert Oliver
Published: December 2024

Background: Lichen Sclerosus (LSc) is a chronic inflammatory skin condition predominantly affecting the anogenital regions, with a well-recognised potential for malignancy. This study examines the incidence, demographic characteristics, and regional distribution of LSc in Sweden over a 20-year period. The analysis is based on data from the Swedish National Patient Register (NPR), with a focus on cases diagnosed in specialist care settings. Methods: A nationwide register-based study was conducted using data from the NPR, identifying cases of LSc diagnosed between 1 January 2001 and 1 January 2021. Data analysis explored incidence by region, sex, age, and diagnostic care setting. A total of 154,424 patients with LSc were included, and the control group consisted of the general Swedish population without known LSc. Results: The mean annual incidence of LSc was 0.81 per 1000 individuals across Sweden, with higher rates in females (1.14 per 1000) compared to males (0.47 per 1000). Incidence varied significantly across regions, with Blekinge, Kalmar, and Gotland exhibiting the highest rates. This study analysed the distribution of LSc diagnoses across medical specialties, finding that 29.8% of cases were managed by dermatology and venereology, while 17.2% were handled by gynaecology and obstetrics. The analysis of marital status revealed that the proportion of married and divorced LSc patients was significantly lower than the national averages for men and women. Conclusions: This study highlights significant regional variations in LSc incidence. Future research should investigate whether environmental factors, genetic predisposition, socioeconomic disparities, or variations in healthcare access contribute to the variations in incidence. Such insights could lead to more targeted public health strategies for managing LSc across different regions.
Application of Original Prostate Cancer Progression Model Interacting with Fibroblasts in Preclinical Research
Authors: Ishii Kenichiro , Iguchi Kazuhiro , Matsuda Chise , Hirokawa Yoshifumi , Sugimura Yoshiki , Watanabe Masatoshi
Published: December 2024

Prostate cancer (PCa) is a heterogeneous disease that exhibits androgen sensitivity and responsiveness to androgen deprivation therapy (ADT). However, ADT induces only temporary remission, and the majority of PCa cases eventually progress to castration-resistant PCa (CRPC). During the development and progression of CRPC, androgen sensitivity and androgen receptor (AR) dependency in PCa cells are often deceased or lost due to ADT or spontaneously arising AR variants even before starting ADT. To prevent CRPC, a clinical PCa model derived from an AR-positive cancer cell line with weak or no androgen sensitivity is required. The human prostate LNCaP cell line is a good model for PCa because of its androgen sensitivity and AR dependency in terms of cell growth and gene expression. Notably, LNCaP cells are heterogeneous cells comprising different clones with natural variations in androgen sensitivity and AR dependency resulting from spontaneously occurring changes. In our group, to obtain androgen-insensitive or weakly sensitive clones spontaneously derived from parental LNCaP cells, we performed a limiting dilution of parental LNCaP cells and obtained several sublines with varying levels of androgen sensitivity and AR dependency. In addition, we established an androgen-insensitive subline from parental LNCaP cells by continuous passage under hormone-depleted conditions. This article provides a unique perspective on our original PCa progression model interacting with fibroblasts and its application in preclinical research.
First Diagnostic Questionnaire for Assessing Patients’ Social Functioning: Comprehensive DDX3X Syndrome Patient Profile
Authors: Stefaniak-Preis Urszula , Kaczmarek Ada , Andrusiewicz Mirosław , Roszak Magdalena , Trzeszczyńska Natalia , Samborski Włodzimierz , Mojs Ewa , Malak Roksana
Published: December 2024

Background/Objectives: DDX3X syndrome is often misdiagnosed as autism spectrum disorder (ASD, Rett Syndrome, and Dandy–Walker Syndrome). Precise phenotyping is needed with reference to neurodevelopmental diagnosis. Observation of behavior and communication in parents with DDX3X syndrome in the USA, France, and Poland; conversations with the parents of patients; and rudimentary information in evidence-based medical articles prompted us to identify differences in communication, play, and social interaction between children with ASD only, those with both ASD and DDX3X, and those with DDX3X only. Methods: As diagnostic tool for DDX3X patients, we created a questionnaire divided into four sections: medical, social, play, and communication. Results: The results showed inconsistent diagnoses in different countries where children could have been diagnosed with DDX3X. In a comparative analysis, individuals with DDX3X exhibited greater social skills than individuals with ASD. Furthermore, those with DDX3X demonstrated higher levels of social functioning compared to children with ASD. Therefore, parents of children recently diagnosed with ASD or similar conditions are encouraged to complete a survey to determine if their child is likely to have features of DDX3X syndrome. Conclusion: Identification of early behavioral markers that differentiate children with ASD and those with DDX3X could lead to the earliest opportunity for identification and intervention, and can significantly impact developmental trajectories, leading to better long-term outcomes.
Bulgarian Experience in Vaginal Electronic Brachytherapy for Gynecologic Cancers’ Treatment—First Results
Authors: Payakova Virginia , Yordanov Angel , Kostova-Lefterova Desislava , Mutkurov Nikolay , Iliev Ilko , Valkov Marin , Encheva Elitsa , Hitova-Topkarova Desislava
Published: December 2024

Background/Objectives: The objective of this study is to prospectively collect dosimetric and clinical data on vaginal cuff electronic brachytherapy and propose a protocol for the procedure. Methods: Twenty-five patients who had proven endometrial or cervical carcinoma and had undergone radical hysterectomy have been treated with vaginal cuff electronic brachytherapy. Treatment session durations and doses to the targets and the organs at risk have been extracted from the treatment planning software. Patients have been followed up for early side effects for 3 months. Results: Treatment session times ranged from 3.0 to 6.6 min. Mean coverage of the planned treatment volume with 100% of the prescribed dose was 90%, and with 95% of the prescribed dose was 95%. Doses in the bladder were lower than those achieved in previously published studies with a mean D2cc of 4.7 Gy, and doses in the rectum were higher with a mean D2cc of 5.3 Gy. The first-month adverse events included eight G1 and three G2 toxicities, while the events registered on the third month were two G2 vaginal dryness events and one G1 urinary tract obstruction, of which only one patient with vaginal dryness did not respond to local treatment. No local relapses have been detected. Conclusions: Vaginal cuff electronic brachytherapy has demonstrated safety and effectiveness.
Can Multiparametric Ultrasound Analysis Predict Malignancy in Testes? An 11-Year Single Center Experience with Testicular Masses
Authors: Volz Yannic , Brinkmann Isabel K. , Clevert Dirk-André , Pyrgidis Nikolaos , Keller Patrick , Weinhold Philipp , Jokisch Friedrich , Kidess Marc , Chaloupka Michael , Stief Christian G. , Marcon Julian
Published: December 2024

Introduction/Objective: Contrast-enhanced ultrasound (CEUS) is a promising modality for differentiating benign and malignant lesions in various organs, including the testis. Testicular tumors, common in young men, are often treated with radical orchiectomy, which can have significant consequences. This study aimed to analyze CEUS parameters and their association with malignant testicular tumors. Materials and Methods: Between May 2009 and September 2020, 342 patients with suspected testicular lesions underwent CEUS at a tertiary referral center. Multiparametric ultrasound, including B-mode, Color Doppler, CEUS, and elastography, was performed. Exclusion criteria were the absence of a testicular lesion in the CEUS examination. Histological results, CEUS parameters, and elastography data were analyzed, and statistical correlations were evaluated using chi-square and Mann–Whitney U tests, with multivariate logistic regression for significant findings. Results: Of the 342 patients, 114 (33.3%) had suspicious CEUS findings, and 84 underwent surgical exploration. Malignancy was confirmed in 48 cases (57.1%). The sensitivity and specificity of CEUS for detecting malignancy were 93.8% and 85.2%, respectively. Contrast enhancement was observed in 93.3% of malignant tumors, but not statistically significant compared to benign lesions (p = 0.107). However, elastography revealed higher tissue stiffness in 77.8% of malignant tumors versus 41.0% in benign lesions (p = 0.009). Multivariate analysis indicated that tissue stiffness was significantly associated with malignancy (HR 8.29, 95%CI 1.26–54.58, p = 0.028). Conclusions: CEUS is a valuable tool for testicular lesion evaluation, with elastography showing strong potential in predicting malignancy through tissue stiffness. However, contrast enhancement and “wash-in/-out” were not reliable malignancy indicators. Further research is needed to standardize CEUS and elastography techniques for routine clinical use.
The Uric Acid-to-High-Density Lipoprotein Cholesterol Ratio: A New Biomarker for Predicting Arrhythmia Recurrence After Atrial Fibrillation Ablation
Authors: Dervis Emir , Ozkan Eyup , Yakut Idris , Konte Hasan Can , Hakgor Aykun , Alyan Omer , Akgun Taylan , Aras Dursun
Published: December 2024

Background: We aimed to assess the uric acid-to-high-density lipoprotein cholesterol (HDL-C) ratio (UHR) and several other parameters with respect to their performance in detecting recurrence among patients with atrial fibrillation (AF) who underwent ablation. Methods: This retrospective cohort study analyzed data from patients who underwent radiofrequency or cryoablation for paroxysmal, persistent, or long persistent AF between September 2021 and September 2023. After ablation, patients were monitored for 24 h, with an ECG Holter used for symptomatic cases. Follow-up visits occurred at 1, 3, and 12 months. Collected data included demographics, comorbidities, echocardiographic measurements, clinical data, ablation type, medication use, and a comprehensive set of laboratory findings. Results: The study included 163 patients, with AF recurrence in 39 (23.93%) patients. Mean age was 57.49 ± 11.22 years, and 59.51% of participants were male. There was no significant difference between recurrent and non-recurrent groups in terms of age or sex distribution. Univariate analysis showed that recurrent patients had significantly larger left atrium diameter, higher percentages of persistent/long AF, and elevated levels of CRP, uric acid, UHR, and uric acid-to-creatinine ratio (UCR). Logistic regression analysis revealed that high left atrium diameter, long persistent AF presence, high CRP and uric acid levels, and high UCR and UHR values greater than 15.1 were independent predictors of AF recurrence. A UHR value of >15.1 was found to predict recurrence with 61.54% sensitivity and 70.97% specificity. Conclusions: Despite low sensitivity, UHR appears to be an independent biomarker that can predict AF recurrence. Including UHR in future risk assessment tools may be beneficial to enhance their accuracy.
HYSPAIN CLINICAL TRIAL Testing the Efficacy of Paracervical Anesthesia for Pain Control During Office Hysteroscopy: A Randomized, Single-Center, Double-Blind, Placebo-Controlled Clinical Trial
Authors: Adrien-Lara María , Pereira Augusto , Vitale Salvatore Giovanni , Ríos Mar , Pérez-Medina Tirso , Calles-Sastre Laura
Published: December 2024

Introduction: Hysteroscopy is a key gynecological procedure for diagnosing and treating endometrial conditions. While hysteroscopy is often performed in office settings without sedation, patients frequently report significant pain during the procedure. This study aims to evaluate the efficacy of paracervical anesthesia with mepivacaine compared to placebo in managing pain during office hysteroscopy. Methods: This randomized, single-center, double-blind, placebo-controlled trial was conducted at Puerta de Hierro University Hospital (Madrid, Spain) from June 2021 to June 2022. A total of 108 women were randomized to receive either mepivacaine 2% or a saline placebo prior to hysteroscopy. Pain was assessed using a visual analog scale (VAS) at various stages of the procedure. Results: The results showed no significant differences in pain levels between the mepivacaine and placebo groups during the procedure. Both groups exhibited similar rates of complications and procedural difficulties. Factors influencing perceived pain included a history of vaginal delivery and the type of instruments used, but anesthesia did not demonstrate a significant impact on pain reduction in any subgroup. Discussion: Our findings indicate that paracervical anesthesia with mepivacaine does not significantly reduce pain during office hysteroscopy, consistent with previous studies. The variability in pain experiences suggests that individual factors, such as pain thresholds and anxiety, may play a significant role. A more personalized approach to pain management, combining pharmacological and non-pharmacological strategies, may be necessary to enhance patient comfort. Future research should involve larger multicenter trials to further explore these findings.
Impact of the Spinal Instability Neoplastic Score on Postoperative Prognosis in Patients with Metastatic Cancer of the Cervical Spine
Authors: Kang Dong-Ho , Jung Kyunghun , Park Jin-Sung , Kang Minwook , Lee Chong-Suh , Park Se-Jun
Published: December 2024

Background: Although the Spinal Instability Neoplastic Score (SINS) is widely utilized to evaluate spinal instability, its prognostic value for survival in patients with cervical spinal metastases remains unclear. This study investigated the association between the SINS and survival outcomes in patients with metastatic cervical spine cancer. Methods: This retrospective cohort study included 106 patients who underwent surgery for metastatic cervical spine cancer at a single institution between 1995 and 2023. Patients were divided into two groups: high SINS (≥13) and low-to-moderate SINS (0–12). Overall survival (OS) was the primary outcome and was analyzed using Kaplan–Meier estimates and Cox regression. Secondary outcomes included changes in Eastern Cooperative Oncology Group Performance Status (ECOG-PS), operation time, estimated blood loss, and postoperative complications. Results: The median OS was significantly shorter in the high SINS group compared to the low-to-moderate SINS group (5.3 months versus 8.6 months; p = 0.023). A high SINS was independently associated with increased mortality risk (hazard ratio [HR], 1.959; 95% CI, 1.221–3.143; p = 0.005). Lung cancer (HR, 4.004; 95% CI, 1.878–8.535; p < 0.001) and rectal cancer (HR, 3.293; 95% CI, 1.126–9.632; p = 0.029) were predictive of worse survival, whereas postoperative chemotherapy (HR, 0.591; 95% CI, 0.381–0.917; p = 0.019) and radiotherapy (HR, 0.531; 95% CI, 0.340–0.827; p = 0.005) were associated with improved survival. Changes in the ECOG-PS and postoperative complication rates were not significantly different between the groups. Conclusions: A high SINS was associated with significantly shorter survival in patients with metastatic cervical spine cancer, reflecting both mechanical instability and tumor aggressiveness.
Enhancing Surgical Wound Monitoring: A Paired Cohort Study Evaluating a New AI-Based Application for Automatic Detection of Potential Infections
Authors: Craus-Miguel Andrea , Munar Marc , Moyà-Alcover Gabriel , Contreras-Nogales Ana María , González-Hidalgo Manuel , Segura-Sampedro Juan José
Published: December 2024

Background/Objectives: This study assessed the feasibility and security of remote surgical wound monitoring using the RedScar© smartphone app, which employs automated diagnosis for early visual detection of infections without direct healthcare personnel involvement. Additionally, patient satisfaction with telematic care was evaluated as a secondary aim. Surgical site infection (SSI) is the second leading cause of healthcare-associated infections (HAIs), leading to prolonged hospital stays, heightened patient distress, and increased healthcare costs. Methods: The study employed a prospective paired-cohort and single-blinded design, with a sample size of 47 adult patients undergoing abdominal surgery. RedScar© was used for remote telematic monitoring, evaluating the feasibility and security of this approach. A satisfaction questionnaire assessed patient experience. The study protocol was registered at ClinicalTrials.gov under the identifier NCT05485233. Results: Out of 47 patients, 41 successfully completed both remote and in-person follow-ups. RedScar© demonstrated a sensitivity of 100% in detecting SSIs, with a specificity of 83.13%. The kappa coefficient of 0.8171 indicated substantial agreement between the application’s results and human observers. Patient satisfaction with telemonitoring was high: 97.6% believed telemonitoring reduces costs, 90.47% perceived it prevents work/school absenteeism, and 80.9% found telemonitoring comfortable. Conclusions: This is the first study to evaluate an automatic smartphone application on real patients for diagnosing postoperative wound infections. It establishes the safety and feasibility of telematic follow-up using the RedScar© application for surgical wound assessment. The high sensitivity suggests its utility in identifying true cases of infection, highlighting its potential role in clinical practice. Future studies are needed to address limitations and validate the efficacy of RedScar© in diverse patient populations.
Predictors of Postprandial Hyperglycemia in Non-Diabetic Adult Hospital Visitors: A Cross-Sectional Study Across Religious Groups in Northern Israel
Authors: Bashkin Amir , Sharon Osnat , Zur Anita , Nakhleh Afif
Published: December 2024

Background/Objectives: Ethnocultural differences between Jewish and Arab communities in Northern Israel may contribute to disparities in type 2 diabetes prevalence. Widespread screening strategies, including hospital-based initiatives, are crucial for early detection of hyperglycemia. This study aimed to determine the prevalence of postprandial hyperglycemia and identify its associated factors in a diverse population of non-diabetic adults visiting the Galilee Medical Center, a tertiary care hospital in Northern Israel. Methods: Participants were recruited between November 2017 and July 2023 through a voluntary screening program for non-diabetic adult visitors to the hospital. Capillary blood glucose measurements were obtained 1–4 h after a meal using a standardized glucometer. Postprandial hyperglycemia was defined as a blood glucose level ≥147 mg/dL, while postprandial normoglycemia was defined as ≤133 mg/dL. Individuals with glucose levels between 134–146 mg/dL were excluded from the analysis. Additional exclusion criteria included known diabetes, acute illness, corticosteroid use, and pregnancy. Demographic data, lifestyle factors, and health status were recorded. Propensity score matching was employed to ensure comparability between religious groups based on age, gender, and body mass index. Logistic regression analyses were conducted to identify independent predictors of postprandial hyperglycemia. Results: 3457 adult visitors underwent postprandial glucose testing and met eligibility criteria. Following propensity score matching, 1845 participants (615 each from Druze, Jewish, and Muslim religious groups) were included in the final analysis. The prevalence of postprandial hyperglycemia was 9.4% in Druze, 6.0% in Jews, and 8.0% in Muslims (p = 0.08). Age >50 years was significantly associated with postprandial hyperglycemia in all groups. Obesity was associated with postprandial hyperglycemia in Muslims, with a similar non-significant trend in the Jewish cohort. Self-reported poor health was also associated with postprandial hyperglycemia in Muslims. In the Druze cohort, a low daily intake of daily fresh vegetable consumption was significantly associated with postprandial hyperglycemia. Conclusions: This study highlights the feasibility of hospital-based screening for postprandial hyperglycemia among adult visitors and reveals ethnic variations in prevalence and associated risk factors.
Curcumin and Metformin Infinite Coordination Polymer Nanoparticles for Combined Therapy of Diabetic Mice via Intraperitoneal Injections
Authors: Sun Siwei , Hou Xinyi , Li Ke , Huang Chenqi , Rong Yu , Bi Jiao , Li Xueping , Wu Daocheng
Published: December 2024

Metformin (Met) is one of the most commonly prescribed first-line drugs for diabetes treatment. However, it has several issues, including low bioavailability, therapeutic platform, and side effects at high doses. In order to improve the therapeutic efficiency of Met, this study proposes a strategy of using Met and curcumin (Cur) to prepare Cur-Zn(II)-Met infinite coordination polymer nanoparticles (CM ICP NPs), and combining this with intraperitoneal injections, for the treatment of diabetic mice. Fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), nanoparticle analysis, cytotoxicity experiments, and mice experiments were used to investigate structure, properties, and application effects. The results showed that CM ICP NPs exhibit a high drug encapsulation rate (100%), good stability, and an absence of in vivo and in vitro toxicity. The blood glucose level of diabetic mice after treatment was reduced to 6.7 ± 0.65 mmol/L at the seventh week. In terms of therapeutic mechanism, it appears that Met and Cur can synergistically regulate blood glucose in mice from multiple paths. This study provides a promising method for the treatment of diabetes using Met and other drugs.
Single-Leg Balance and Lower Limb Strength: Quantitative Analysis with the Balance Master System
Authors: Delfa-de-la-Morena José Manuel , Paes Pedro Pinheiro , de Oliveira Débora Priscila Lima , Júnior Frederico Camarotti , Lima Bruna Daniele Monteiro , García-González Miriam , Mijarra-Murillo Juan-José , Riquelme-Aguado Víctor
Published: December 2024

Objective: This study investigates the relationship between lower limb strength and postural stability in single-leg stance using the Balance Master system. Methods: The research involved 64 participants divided into sedentary and physically active groups based on metabolic equivalents of task (METs) values, normal weight, overweight, and obese according to body composition. Postural control was evaluated using the Sensory Organization Test. Results: The results showed that there were no significant differences in mean and maximum lower limb strength between the groups. Furthermore, postural stability in open and closed eyes conditions did not show significant differences between the groups. However, a significant positive correlation was observed between lower limb strength and stability in single-leg stance with eyes open. Conclusions: These findings suggest that lower limb muscle strength is essential for postural stability, especially when vision is available to aid balance. The study highlights the importance of interventions focused on strengthening muscles to improve physical functionality in adults.
Arbitrary Optics for Gaussian Splatting Using Space Warping
Authors: Nazarenus Jakob , Kou Simin , Zhang Fang-Lue , Koch Reinhard
Published: December 2024

Due to recent advances in 3D reconstruction from RGB images, it is now possible to create photorealistic representations of real-world scenes that only require minutes to be reconstructed and can be rendered in real time. In particular, 3D Gaussian splatting shows promising results, outperforming preceding reconstruction methods while simultaneously reducing the overall computational requirements. The main success of 3D Gaussian splatting relies on the efficient use of a differentiable rasterizer to render the Gaussian scene representation. One major drawback of this method is its underlying pinhole camera model. In this paper, we propose an extension of the existing method that removes this constraint and enables scene reconstructions using arbitrary camera optics such as highly distorting fisheye lenses. Our method achieves this by applying a differentiable warping function to the Gaussian scene representation. Additionally, we reduce overfitting in outdoor scenes by utilizing a learnable skybox, reducing the presence of floating artifacts within the reconstructed scene. Based on synthetic and real-world image datasets, we show that our method is capable of creating an accurate scene reconstruction from highly distorted images and rendering photorealistic images from such reconstructions.
Explainable AI-Based Skin Cancer Detection Using CNN, Particle Swarm Optimization and Machine Learning
Authors: Shah Syed Adil Hussain , Shah Syed Taimoor Hussain , Khaled Roa’a , Buccoliero Andrea , Shah Syed Baqir Hussain , Di Terlizzi Angelo , Di Benedetto Giacomo , Deriu Marco Agostino
Published: December 2024

Skin cancer is among the most prevalent cancers globally, emphasizing the need for early detection and accurate diagnosis to improve outcomes. Traditional diagnostic methods, based on visual examination, are subjective, time-intensive, and require specialized expertise. Current artificial intelligence (AI) approaches for skin cancer detection face challenges such as computational inefficiency, lack of interpretability, and reliance on standalone CNN architectures. To address these limitations, this study proposes a comprehensive pipeline combining transfer learning, feature selection, and machine-learning algorithms to improve detection accuracy. Multiple pretrained CNN models were evaluated, with Xception emerging as the optimal choice for its balance of computational efficiency and performance. An ablation study further validated the effectiveness of freezing task-specific layers within the Xception architecture. Feature dimensionality was optimized using Particle Swarm Optimization, reducing dimensions from 1024 to 508, significantly enhancing computational efficiency. Machine-learning classifiers, including Subspace KNN and Medium Gaussian SVM, further improved classification accuracy. Evaluated on the ISIC 2018 and HAM10000 datasets, the proposed pipeline achieved impressive accuracies of 98.5% and 86.1%, respectively. Moreover, Explainable-AI (XAI) techniques, such as Grad-CAM, LIME, and Occlusion Sensitivity, enhanced interpretability. This approach provides a robust, efficient, and interpretable solution for automated skin cancer diagnosis in clinical applications.
Deep Learning-Based Diagnosis Algorithm for Alzheimer’s Disease
Authors: Jin Zhenhao , Gong Junjie , Deng Minghui , Zheng Piaoyi , Li Guiping
Published: December 2024

Alzheimer’s disease (AD), a degenerative condition affecting the central nervous system, has witnessed a notable rise in prevalence along with the increasing aging population. In recent years, the integration of cutting-edge medical imaging technologies with forefront theories in artificial intelligence has dramatically enhanced the efficiency of identifying and diagnosing brain diseases such as AD. This paper presents an innovative two-stage automatic auxiliary diagnosis algorithm for AD, based on an improved 3D DenseNet segmentation model and an improved MobileNetV3 classification model applied to brain MR images. In the segmentation network, the backbone network was simplified, the activation function and loss function were replaced, and the 3D GAM attention mechanism was introduced. In the classification network, firstly, the CA attention mechanism was added to enhance the model’s ability to capture positional information of disease features; secondly, dilated convolutions were introduced to extract richer features from the input feature maps; and finally, the fully connected layer of MobileNetV3 was modified and the idea of transfer learning was adopted to improve the model’s feature extraction capability. The results of the study showed that the proposed approach achieved classification accuracies of 97.85% for AD/NC, 95.31% for MCI/NC, 93.96% for AD/MCI, and 92.63% for AD/MCI/NC, respectively, which were 3.1, 2.8, 2.6, and 2.8 percentage points higher than before the improvement. Comparative and ablation experiments have validated the proposed classification performance of this method, demonstrating its capability to facilitate an accurate and efficient automated auxiliary diagnosis of AD, offering a deep learning-based solution for it.
Volumetric Humeral Canal Fill Ratio Effects Primary Stability and Cortical Bone Loading in Short and Standard Stem Reverse Shoulder Arthroplasty: A Biomechanical and Computational Study
Authors: Ritter Daniel , Raiss Patric , Denard Patrick J. , Werner Brian C. , Müller Peter E. , Woiczinski Matthias , Wijdicks Coen A. , Bachmaier Samuel
Published: December 2024

Objective: This study evaluated the effect of three-dimensional (3D) volumetric humeral canal fill ratios (VFR) of reverse shoulder arthroplasty (RSA) short and standard stems on biomechanical stability and bone deformations in the proximal humerus. Methods: Forty cadaveric shoulder specimens were analyzed in a clinical computed tomography (CT) scanner allowing for segmentation of the humeral canal to calculate volumetric measures which were verified postoperatively with plain radiographs. Virtual implant positioning allowed for group assignment (VFR < 0.72): Standard stem with low (n = 10) and high (n = 10) filling ratios, a short stem with low (n = 10) and high filling ratios (n = 10). Biomechanical testing included cyclic loading of the native bone and the implanted humeral component. Optical recording allowed for spatial implant tracking and the quantification of cortical bone deformations in the proximal humerus. Results: Planned filling ratios based on 3D volumetric measures had a good-to-excellent correlation (ICC = 0.835; p < 0.001) with implanted filling ratios. Lower canal fill ratios resulted in significantly higher variability between short and standard stems regarding implant tilt (820 N: p = 0.030) and subsidence (220 N: p = 0.046, 520 N: p = 0.007 and 820 N: p = 0.005). Higher filling ratios resulted in significantly lower bone deformations in the medial calcar area compared to the native bone, while the bone deformations in lower filling ratios did not differ significantly (p > 0.177). Conclusions: Lower canal filling ratios maintain dynamic bone loading in the medial calcar of the humerus similar to the native situation in this biomechanical loading setup. Short stems implanted with a low filling ratio have an increased risk for implant tilt and subsidence compared to high filling ratios or standard stems.
Increasing IQ Test Scores and Decreasing g: The Flynn Effect and Decreasing Positive Manifold Strengths in Austria (2005–2018)
Authors: Andrzejewski Denise , Oberleiter Sandra , Vetter Marco , Pietschnig Jakob
Published: December 2024

After almost a century of global generational IQ test score gains, the Flynn effect has, in the past decades, been observed to show stagnation and reversals in several countries. Tentative evidence from academic achievement data has suggested that these trajectory changes may be rooted in a decreasing strength of the positive manifold of intelligence due to increasing ability differentiation and specialization in the general population. Here, we provide direct evidence for generational IQ test score and positive manifold strength changes based on IQ test standardization data from 1392 Austrian residents between 2005 and 2018. Our analyses revealed positive Flynn effects across all domains of the IQ test (Cohen’s d from 0.21 to 0.91) but a trend toward decreasing strength in the positive manifold of intelligence (R2 from .908 to .892), though these changes were not statistically significant. Our results are consistent with the idea that increasingly inconsistent Flynn effect trajectories may be attributed to increasing ability differentiation and specialization in the general population over time.
Distribution and Long-Term Variation of Wetland Land Cover Types in the Yellow River Delta Remote Sensing Monitoring
Authors: Zhou Chao , Zhao Qian , Wu Tong , Liu Xulong , Chen Yanlong
Published: December 2024

Wetlands are dubbed the “kidneys of the earth” and are involved in climate regulation, carbon sequestration, ecological balance preservation, and reducing the surface water pollution. Ongoing economic development has introduced pressing challenges to wetland environments. In this context, extracting coastal wetland information and monitoring the dynamic changes are essential. Using long-term sequence Sentinel-2 satellite remote sensing images and field observations, this research proposed a Dynamic Bayesian Network classification model framework based on conjugate gradient updates. We compared the wetland feature extraction effects of the Fletcher–Reeves and the Polak–Ribière–Polyak algorithms of the conjugate gradient. Then, remote sensing combined with the FRDBN classification model was used to extract the information pertinent to wetland feature types and changes in wetland areas and analyze alterations in the distribution characteristics of land cover types. The results showed that the FRDBN model achieved high accuracy (above 96%), and kappa coefficients exceeded 0.96. Long-term monitoring revealed that the area of wetlands increased by 0.85 × 104 hm2 from 2016 to 2021. Non-aquatic land cover types exhibited pronounced dynamic changes, with the area of change representing 58–69% of the monitored total. Specifically, the transition between salt marsh vegetation and artificial wetlands was relatively obvious. The FRDBN model provides a new method for extracting wetland feature information. Wetland protection, dynamic monitoring, and carbon sink research can provide robust technology support, facilitating investigations into coastal salt marsh carbon sinks and technological advances in carbon sink assessment.
An Integrative Approach to Assess and Map Zostera noltei Meadows Along the Romanian Black Sea Coast
Authors: Marin Oana Alina , Timofte Florin , Filimon Adrian , Croitoru Alina Mihaela , van Broekhoven Wouter , Harper Charlotte , van Zummeren Roosmarijn
Published: December 2024

Seagrass meadows, including those formed by Zostera noltei, play a crucial role in marine ecosystem health by providing habitat stability and coastal protection. In the Romanian Black Sea, Z. noltei meadows are critically endangered due to pressures from eutrophication, habitat loss, and climate change. This study presents a comprehensive baseline assessment of Z. noltei meadows near Mangalia, Romania, utilizing in situ field methods and UAV mapping conducted in the spring and summer of 2023. Seven meadow sites (Z1–Z7) were identified, with notable variability in density, shoot counts, and coverage across sites. Site Z1 exhibited the highest density (1223 shoots/m−2) and Z5 and Z7 the longest leaves (an average of 60 cm), reflecting possible environmental influences. Statistical analyses revealed significant inter-site differences in shoot density and leaf length, with density emerging as a primary differentiator. Ex situ analyses of epiphyte load indicated a median, balanced epiphyte load. This baseline dataset supported the selection of Z1 as a reference donor site for seagrass relocation activities along the Romanian coast in 2023. By providing critical insights into Z. noltei structure and health, this study supports future conservation efforts and evidence-based management of these vulnerable coastal habitats.
Coastal Protection for Tsunamis
Authors: Santos Angela , Mileu Nelson
Published: December 2024

Previous research showed that a tsunami similar to the 1755 event would inundate Caxias’ low-ground areas in Oeiras municipality, Portugal. However, the streets of downtown Caxias were not well reproduced, which is a limitation of the area’s mitigation strategies and evacuation plan. For these reasons, new Lidar data were used for the first time in Portugal. The new local topography data allowed the construction of a more accurate DEM, which was used in the tsunami numerical model to update and improve the inundation results. As a complement, a field survey was conducted in several locations to assess coastal features and protection. The numerical model results show that low-ground areas up to 6 m in height were inundated by the tsunami, including the residential area, the road, and the railway. To stop the tsunami waves from inundating these areas, it is proposed that the construction of more sea walls up to 7 m in height and a third bridge over the Barcarena Stream, only for pedestrians, ranging from 5 to 7 m in height, which will serve as a gate for the incoming tsunami waves. These coastal protections should be part of the strategy to mitigate coastal overtopping (winter storm surges and tsunamis) not only in Caxias but also in other coastal zones.
Consensus-Based Formation Control and Gyroscopic Obstacle Avoidance for Multiple Autonomous Underwater Vehicles on SE(3)
Authors: Zhen Qingzhe , Wan Lei , Zhang Yuansheng , Jiang Dapeng
Published: December 2024

To address the control challenges posed by increasingly complex mission scenarios, this paper aims to develop an advanced formation control and obstacle avoidance strategy for autonomous underwater vehicles (AUVs) in SE(3). This study establishes a dynamic model for fully actuated AUVs and designs a consensus-based formation control strategy to achieve coordinated movement. Motivated by limitations of existing obstacle avoidance strategies such as local minima issues and mutual interference between formation members in high-density environments, this paper introduces a novel gyroscopic force-based obstacle avoidance method. The proposed approach leverages the principles of rotation and angular momentum conservation to enable effective obstacle avoidance while maintaining formation integrity. Simulation results demonstrate the effectiveness of the proposed methodology in achieving robust formation control and collision avoidance under challenging conditions.
Hydrodynamic Performance and Mooring Safety Assessment of an Offshore Floating Movable Fish Cage
Authors: Kim Sung-Jae , Jeong Seong-Jae , Park Sung-Ju
Published: December 2024

This study evaluates the hydrodynamic performance of a movable fish cage equipped with a spread mooring system in offshore condition. It investigates the global behavior and safety of a mooring system under environmental influences such as waves, currents, and biofouling. A numerical model was developed using the Cummins equation and a lumped-mass line model to capture the coupling effects between the floating structure and mooring lines. The steel frame was modeled using Morison members, whereas fishing nets were represented by a screen model incorporating drag forces. Parametric studies were performed to assess the effects of varying mooring line lengths, current speeds, and biofouling on cage behavior. Evidently, heavier chains reduced excursions but increased tension, whereas high current speeds increased the line tension (owing to increased drift) and mooring line stiffness by up to 66%. Biofouling increased the maximum excursion by 6% and line tension by up to 17%. Safety evaluations based on the American Bureau of Shipping rules examined intact and damaged conditions, comparing estimated line tensions with allowable values. The findings confirm that the mooring system ensures reliable station-keeping performance even under challenging conditions, validating its suitability for offshore deployment and ensuring the safety and stability of floating fish cage systems.