bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Psychometric Properties of the Movement Assessment Battery Second Edition (M-ABC2): A Cross-Sectional Study
Authors: Scarfò Eleonora , Ranucci Michela , Berardi Anna , Simeon Rachele , Galeoto Giovanni
Published: May 2024

This cross-sectional study assessed the psychometric properties of the movement assessment battery for children second edition (M-ABC2) in Italian children with typical development, focusing on reliability and percentile rank establishment. The M-ABC2 is widely utilized but lacks validation in Italian populations. One hundred and eight children were recruited. Test-retest reliability was evaluated using intra-class correlation coefficients (ICCs), indicating good to excellent reliability across age groups, albeit with outliers requiring further scrutiny. Standard scores and percentile ranks were established, revealing age-related variations in motor performance. Noteworthy differences in completion times and error rates were observed among the age groups, highlighting the dynamic nature of motor development. While the findings provide valuable insights for clinicians and researchers, limitations such as sample size and geographic representation should be addressed in future studies. This study underscores the importance of employing reliable assessment tools for comprehensive understanding and effective intervention in pediatric motor development.
Land Use Impact on Water Quality and Phytoplankton Community Structure in Danjiangkou Reservoir
Authors: Zhu Yanrong , Gao Jing , Zhao Hongbing , Deng Shijiang , Lin Mengran , Wang Nenghan , Liu Minxuan , Hu Sheng , Luo Laibo
Published: May 2024

The composition and intensity of land use significantly influence the aquatic ecological environment, further affecting the physicochemical attributes of the water body, and indirectly modulating the phytoplankton community structure. This study centers around the Danjiangkou Reservoir, investigating the correlation between land use, water environment, and phytoplankton alongside varying intensities of anthropogenic activities, based on the review of land use, phytoplankton, and water quality data of 2021. Firstly, an analysis was conducted over five circular buffer zones generated around sampling points with radii set at 500 m, 1000 m, 1500 m, 2000 m, and 2500 m, wherein the intensity of human activity was categorized into low, medium, and high, in accordance with the human activity intensity level score (HAILS). This study proceeded to explore the correlation between land use and the water environment across different scales, compared phytoplankton density and community structure differences across varied levels of human activity, and analyzed the association between phytoplankton communities in the Danjiangkou Reservoir and environmental variables under various intensities. The findings showed: The land use within the 500 m circular buffer zone has the greatest impact on the water quality of the Danjiangkou Reservoir, especially with the increase in human activities leading to elevated nutrient levels in the water, thereby promoting the growth and reproduction of algae, and increasing the risk of algal blooms. This research scrutinizes the relationship between land use, water environment, and plankton under varying human activity intensities, serving as a foundation for environmental management sectors to make informed decisions and promote the sustainable development of the catchment water environment.
Predictive Modeling for Spinal Metastatic Disease
Authors: Shah Akash A. , Schwab Joseph H.
Published: May 2024

Spinal metastasis is exceedingly common in patients with cancer and its prevalence is expected to increase. Surgical management of symptomatic spinal metastasis is indicated for pain relief, preservation or restoration of neurologic function, and mechanical stability. The overall prognosis is a major driver of treatment decisions; however, clinicians’ ability to accurately predict survival is limited. In this narrative review, we first discuss the NOMS decision framework used to guide decision making in the treatment of patients with spinal metastasis. Given that decision making hinges on prognosis, multiple scoring systems have been developed over the last three decades to predict survival in patients with spinal metastasis; these systems have largely been developed using expert opinions or regression modeling. Although these tools have provided significant advances in our ability to predict prognosis, their utility is limited by the relative lack of patient-specific survival probability. Machine learning models have been developed in recent years to close this gap. Employing a greater number of features compared to models developed with conventional statistics, machine learning algorithms have been reported to predict 30-day, 6-week, 90-day, and 1-year mortality in spinal metastatic disease with excellent discrimination. These models are well calibrated and have been externally validated with domestic and international independent cohorts. Despite hypothesized and realized limitations, the role of machine learning methodology in predicting outcomes in spinal metastatic disease is likely to grow.
Unravelling the Triad of Lung Cancer, Drug Resistance, and Metabolic Pathways
Authors: Mohanty Pratik , Pande Babita , Acharya Rakesh , Bhaskar L V K S , Verma Henu Kumar
Published: May 2024

Lung cancer, characterized by its heterogeneity, presents a significant challenge in therapeutic management, primarily due to the development of resistance to conventional drugs. This resistance is often compounded by the tumor’s ability to reprogram its metabolic pathways, a survival strategy that enables cancer cells to thrive in adverse conditions. This review article explores the complex link between drug resistance and metabolic reprogramming in lung cancer, offering a detailed analysis of the molecular mechanisms and treatment strategies. It emphasizes the interplay between drug resistance and changes in metabolic pathways, crucial for developing effective lung cancer therapies. This review examines the impact of current treatments on metabolic pathways and the significance of considering metabolic factors to combat drug resistance. It highlights the different challenges and metabolic alterations in non-small-cell lung cancer and small-cell lung cancer, underlining the need for subtype-specific treatments. Key signaling pathways, including PI3K/AKT/mTOR, MAPK, and AMPK, have been discussed for their roles in promoting drug resistance and metabolic changes, alongside the complex regulatory networks involved. This review article evaluates emerging treatments targeting metabolism, such as metabolic inhibitors, dietary management, and combination therapies, assessing their potential and challenges. It concludes with insights into the role of precision medicine and metabolic biomarkers in crafting personalized lung cancer treatments, advocating for metabolic targeting as a promising approach to enhance treatment efficacy and overcome drug resistance. This review underscores ongoing advancements and hurdles in integrating metabolic considerations into lung cancer therapy strategies.
Biological Evaluation of Oral Care Products Using 3D Tissue-Engineered In Vitro Models of Plaque-Induced Gingivitis
Authors: Barker Emilia , AlQobaly Lina , Shaikh Zahab , Franklin Kirsty , Thurlow Johanna , Moghaddam Behfar , Pratten Jonathan , Moharamzadeh Keyvan
Published: May 2024

Background: The aim of this study was to investigate and visualize the anti-inflammatory and anti-bacterial effects of different oral care products using an infected and inflamed 3D tissue-engineered gingival mucosal model. Methods: A 3D full-thickness oral mucosal model was engineered inside tissue culture inserts using collagen hydrogels populated with human gingival fibroblasts and THP-1 monocytes and layered with oral epithelial cell lines. Oral saliva bacteria were cultured and added to the surface of the models and inflammation was further simulated with lipopolysaccharide (LPS) of Escherichia coli. The 3D models were exposed to three different types of toothpastes, a chlorhexidine antiseptic mouthwash, different antibiotics, and a mechanical rinse with phosphate-buffered saline (PBS) prior to biological evaluation using the PrestoBlue tissue viability assay, histology, optical coherence tomography (OCT), confocal microscopy, and measurement of the release of the inflammatory markers IL-1β, IL-6, and IL-8 with ELISA. Results: Multiple-endpoint analyses of the infected oral mucosal models treated with different anti-bacterial agents showed consistent outcomes in terms of tissue viability, histology, OCT, and confocal microscopy findings. In terms of anti-inflammatory testings, the positive control group showed the highest level of inflammation compared with all other groups. Depending on the anti-bacterial and anti-inflammatory potential of the test groups, different levels of inflammation were observed in the test groups. Conclusions: The inflamed 3D oral mucosal model developed in this study has the potential to be used as a suitable in vitro model for testing the biocompatibility, anti-inflammatory, and anti-bacterial properties of oral care products including mouthwashes and toothpastes. The results of this study indicate that the chlorhexidine mouthwash has both anti-bacterial and cytotoxic effects on the 3D oral mucosal model. Hyaluronic-acid-containing toothpaste has significant anti-bacterial and anti-inflammatory effects on the 3D oral mucosal model.
Detracking Autoencoding Conditional Generative Adversarial Network: Improved Generative Adversarial Network Method for Tabular Missing Value Imputation
Authors: Liu Jingrui , Duan Zixin , Hu Xinkai , Zhong Jingxuan , Yin Yunfei
Published: May 2024

Due to various reasons, such as limitations in data collection and interruptions in network transmission, gathered data often contain missing values. Existing state-of-the-art generative adversarial imputation methods face three main issues: limited applicability, neglect of latent categorical information that could reflect relationships among samples, and an inability to balance local and global information. We propose a novel generative adversarial model named DTAE-CGAN that incorporates detracking autoencoding and conditional labels to address these issues. This enhances the network’s ability to learn inter-sample correlations and makes full use of all data information in incomplete datasets, rather than learning random noise. We conducted experiments on six real datasets of varying sizes, comparing our method with four classic imputation baselines. The results demonstrate that our proposed model consistently exhibited superior imputation accuracy.
Importance of Characteristic Features and Their Form for Data Exploration
Authors: Stańczyk Urszula , Zielosko Beata , Baron Grzegorz
Published: May 2024

The nature of the input features is one of the key factors indicating what kind of tools, methods, or approaches can be used in a knowledge discovery process. Depending on the characteristics of the available attributes, some techniques could lead to unsatisfactory performance or even may not proceed at all without additional preprocessing steps. The types of variables and their domains affect performance. Any changes to their form can influence it as well, or even enable some learners. On the other hand, the relevance of features for a task constitutes another element with a noticeable impact on data exploration. The importance of attributes can be estimated through the application of mechanisms belonging to the feature selection and reduction area, such as rankings. In the described research framework, the data form was conditioned on relevance by the proposed procedure of gradual discretisation controlled by a ranking of attributes. Supervised and unsupervised discretisation methods were employed to the datasets from the stylometric domain and the task of binary authorship attribution. For the selected classifiers, extensive tests were performed and they indicated many cases of enhanced prediction for partially discretised datasets.
A Three-Level Neutral-Point-Clamped Converter Based Standalone Wind Energy Conversion System Controlled with a New Simplified Line-to-Line Space Vector Modulation
Authors: Ghennam Tarak , Belhadji Lakhdar , Rizoug Nassim , Francois Bruno , Bacha Seddik
Published: May 2024

Wind power systems, which are currently being constructed for the electricity worldwide market, are mostly based on Doubly Fed Induction Generators (DFIGs). To control such systems, multilevel converters are increasingly preferred due to the well-known benefits they provide. This paper deals with the control of a standalone DFIG-based Wind Energy Conversion System (WECS) by using a three-level Neutral-Point-Clamped (NPC) converter. The frequency and magnitude of the stator output voltage of the DFIG are controlled and fixed at nominal values despite the variable rotor speed, ensuring a continuous AC supply for three-phase loads. This task is achieved by controlling the DFIG rotor currents via a PI controller combined with a new Simplified Direct Space Vector Modulation strategy (SDSVM), which is applied to the three-level NPC converter. This strategy is based on the use of a line-to-line three-level converter space vector diagram without using Park transformation and then simplifying it to that of a two-level converter. The performance of the proposed SDSVM technique in terms of controlling the three-level NPC-converter-based standalone WECS is demonstrated through simulation results. The whole WECS control and the SDSVM strategy are implemented on a dSPACE DS 1104 board that drives a DFIG-based wind system test bench. The obtained experimental results confirm the validity and performance in terms of control.
Voltage Control Strategy for Large-Scale Wind Farm with Rapid Wind Speed Fluctuation
Authors: Cai Xi , Yang Zhangbin , Liu Pan , Lian Xueguang , Li Zhuang , Zhu Guorong , Geng Hua
Published: May 2024

In large-scale wind farms, the voltage fluctuations caused by the uncertainty of wind speed at the turbine terminals pose a pressing challenge. This article presents a localized voltage control strategy tailored toward rapid adjustments in turbine terminal voltage in wind turbine generators. Based on relative voltage observation, this strategy achieves voltage coordination between the high and low ends of the transformer in wind turbine generators. Firstly, the overall structure of the wind farm and the characteristics of terminal voltage are analyzed. Secondly, the principles and feasibility of the relative voltage control strategy are examined. Finally, the effectiveness of the proposed control strategy is validated through simulation results from a specific wind farm. The results demonstrate its capability to achieve a fast and stable voltage dynamic response within the wind farm based on local information, thus mitigating the risk of voltage out of limit.
An Experimental Direct Model for the Sky Temperature Evaluation in the Mediterranean Area: A Preliminary Investigation
Authors: De Cristo Edoardo , Evangelisti Luca , Guattari Claudia , De Lieto Vollaro Roberto
Published: May 2024

Since the beginning of the 20th century, many studies have focused on the possibility of considering the sky as a body characterized by an apparent temperature, and several correlations to quantify the apparent sky temperature have been proposed. However, the different models were obtained for specific meteorological conditions and through measurements at specific sites. The available models do not cover all locations in the world, although the evaluation of the sky temperature is fundamental for estimating the net radiative heat transfer between surfaces and the sky. Here, experimental data logged from a regional micrometeorological network (in Italy, within the Lazio region) were processed and used to identify an empirical model for the estimation of the sky temperature in the Mediterranean area. Data relating to atmospheric infrared radiation were used to compute the sky temperature, aiming at identifying a direct correlation with the ambient temperature. Climatic data acquired during 2022 were processed. The proposed correlations were compared with other models available in the literature, including the standard ISO 13790. This study proposes an annual-based direct correlation in its initial phase, demonstrating a superior fit to the measured data compared to well-known direct empirical models from the literature. Subsequently, quarterly-based correlations are introduced further in a secondary phase of the work to improve the model’s adaptation to experimental observations. The results reveal that quarterly-based correlations improve goodness-of-fit indexes compared to annual-based and well-known direct empirical correlations. Finally, a detached building was modeled via a dynamic code to highlight the influence of different correlations on annual energy needs.
Ventilation Methods for Improving the Indoor Air Quality and Energy Efficiency of Multi-Family Buildings in Central Europe
Authors: Ferdyn-Grygierek Joanna , Grygierek Krzysztof
Published: May 2024

In Poland and other countries in Central Europe, residential buildings from the second half of the 20th century dominate, which have recently undergone deep thermomodernisation. Research on the retrofitting of residential buildings has focused mainly on energy efficiency, with only a few studies on indoor air quality. The aim of this study was to present a comparative analysis of the impact of five ventilation scenarios (three natural and two mechanical) on CO2 concentration and energy demand for heating and ventilation in residential spaces of a multi-family building located in Poland. The analyses were based on the results of building performance co-simulation using the EnergyPlus and CONTAM programs carried out under dynamic conditions with a 5 min time step for the entire heating season. The calculations took into account the instantaneous occupancy variability of twenty apartments. In the buildings equipped with new tight windows, the natural ventilation system provided extremely low air exchange (on average 0.1 h−1) and poor indoor air quality (average CO2 concentration at the level of 2500 ppm). Opening windows to ventilate the rooms generated a multiple increase (up to 8 times) in heating demand during these periods, but average CO2 concentration was on the level of 930 ppm. The use of mechanical ventilation was profitable both in terms of energy savings (at the level of 50%) and improvement in the indoor air.
Spatio−Temporal Changes and Key Driving Factors of Urban Green Space Configuration on Land Surface Temperature
Authors: Huang Junda , Lu Xinghao , Wang Yuncai
Published: May 2024

Changes in land cover by rapid urbanization have diminished the cooling effect of urban green spaces (UGS), exacerbating the upward trend of land surface temperature (LST). A thorough and precise understanding of the spatio-temporal characteristics of UGS and LST is essential for mitigating localized high temperatures in cities. This study identified the spatio-temporal changes in UGS configuration and LST in Shanghai from 2003 to 2022. The correlation between UGS configuration and LST was explored using spatial autocorrelation analysis and causal inference. The results show that (1) the high-temperature space had grown from 721 km2 in 2003 to 3059 km2 in 2022; (2) in suburbs, the largest area of UGS tended to decrease, while the number of patches tended to increase, indicating a distinct feature of suburbanization; (3) changes in the largest area of UGS had more significant spatial correlation, indicating that urban sprawl primarily impacts large UGSs; and (4) compared to the number and shape of UGS, changes in the largest area are the key factor influencing regional LST. These findings enrich the knowledge of the spatio−temporal relationship between the UGS configuration and its cooling effect in urbanization, offering valuable insights for building cooler cities.
Exploring Spontaneous Combustion Characteristics and Structural Disparities of Coal Induced by Igneous Rock Erosion
Authors: Zhang Mingqian , Li Zongxiang , Chen Zhifeng , Gao Lun , Qi Yun , Hu Haifeng
Published: May 2024

The erosion of igneous rocks affects the structural and spontaneous combustion characteristics of coal. A series of tests were conducted, including programmed heating, thermogravimetric analysis, FT-IR spectroscopy, low-temperature nitrogen adsorption, and pressed mercury experiments on samples from primary coal and coal eroded by igneous rocks from the Tashan Mine and Xiaonan Mine within the same coal seam. Based on these experiments, we analyzed various properties of coal, such as the oxidation characteristics, spontaneous combustion limit, active functional group content, chemical structure, and pore structure, from both macroscopic and microscopic perspectives. The results indicated significant trends after the erosion of igneous rocks: (1) there were increases in the oxygen consumption rate, as well as the CO and CO2 release rates; (2) the upper limit of air leakage intensity increased, the minimum thickness of floating coal decreased, and the lower limit of oxygen volume fraction decreased; (3) there was a decrease in the activation energy required for coal ignition; (4) there was a decrease in the active functional group content while improving the structural stability; and (5) there were the alterations in the pore structure of coal. These promoted the oxidation reactions between oxygen and the active groups within the coal matrix, increasing the propensity for spontaneous combustion, particularly in the igneous rocks with low oxidation activity.
Circularity Assessment in Aquaculture: The Case of Integrated Multi-Trophic Aquaculture (IMTA) Systems
Authors: Checa Daniel , Macey Brett M. , Bolton John J. , Brink-Hull Marissa , O’Donohoe Pauline , Cardozo Alessandro , Poersch Luis Henrique , Sánchez Inmaculada
Published: May 2024

Aquaculture is a strategic sector that aims to meet the increased demands for healthy food for current and future populations. However, this progression needs to be sustainable, which can potentially be achieved by the implementation of circular practices. Integrated multi-trophic aquaculture (IMTA) systems promote the incorporation of circular principles. Nevertheless, the lack of harmonized definitions and standards impedes the quantification of these circular attributes. This study aims to explore the potential principles embedded in IMTA and the existing alternatives to quantify circularity. Two basic pillars (nutrient management and resource use efficiency) were identified as the most relevant circularity attributes for IMTA systems and were quantified through aquaculture-specific indicators. Bioremediation indicators, together with the efficiency indicators in terms of feed, water, energy, and infrastructure materials used, were selected to evaluate the circularity performance of four IMTA trials in three aquaculture facilities in Ireland, Brazil, and South Africa. Salmon, white shrimp, tilapia, abalone, and sea urchins were studied and cultivated together in various combinations with several low-trophic species in these IMTA trials to evaluate the improvement in circularity compared with corresponding monoculture conditions. The results showed an increase in circularity of up to 90% in terms of water recirculation, as well as bioremediation, which was improved by 80%–90%, providing evidence for the potential role of IMTA in the circularity transition.
Nutritional Quality and Socio-Ecological Benefits of Mare Milk Produced under Grazing Management
Authors: Blanco-Doval Ana , Barron Luis Javier R. , Aldai Noelia
Published: May 2024

This review discusses the scientific evidence that supports the nutritional value of mare milk and how its properties are essentially achieved when mares are managed under grazing conditions. Mare milk’s similarity with the chemical composition of human milk makes this food and its derived products not only suitable for human consumption but also an interesting food regarding human health. The contribution of horse breeding under grazing management to other socio-ecological benefits generated by equine farms is also highlighted. Both the high added value of mare milk and the socio-ecological benefits derived from pasture-based systems could be explored to improve the performance of equine farms located in arid and semi-arid areas or in regions with moderately harsh environmental conditions as equids have a strong adaptation capacity.
Microalgae Biomass Production from Rice Husk as Alternative Media Cultivation and Extraction of Phycocyanin Using 3D-Printed Ohmic Heating Reactor
Authors: Cid-Ibarra Gabriela , Rodríguez-Jasso Rosa M. , Rosero-Chasoy Gilver , Belmares Ruth , Carlos Contreras-Esquivel Juan , Machado-Cepeda Samanta , Cabello-Galindo Alejandra , Ruiz Héctor A.
Published: May 2024

Phycocyanin is a highly valued pigment present in Spirulina platensis biomass with applications in the food industry in terms of biorefinery concepts; specifically, its antioxidant and antimicrobial capacity are an advantage that could be incorporated into a food matrix. This study aims to use rice husk as an alternative culture medium for S. platensis biomass growth and phycocyanin extraction by ohmic heating processing using a 3D-printed reactor. S. platensis was cultivated in rice husk extract (RHE) from 0–100% (v/v). The highest content of microalgal biomass was 1.75 ± 0.01 g/L, with a specific growth rate of 0.125 ± 0.01 h−1. For the phycocyanin extraction under an ohmic heating process, a 3D-printed reactor was designed and built. To optimize phycocyanin extraction, a central composite rotatable design (CCDR) was evaluated, with three factors: time (min), temperature (°C), and pH. The highest phycocyanin content was 75.80 ± 0.98 mg/g in S. platensis biomass grown with rice husk extract. Ohmic heating is a promising method for rapid phycocyanin extraction, and rice husk as a culture medium is an alternative for the growth of S. platensis biomass in the integration of second- and third-generation biorefineries.
Volatility Analysis of Financial Time Series Using the Multifractal Conditional Diffusion Entropy Method
Authors: Mariani Maria C. , Kubin William , Asante Peter K. , Tweneboah Osei K.
Published: May 2024

In this article, we introduce the multifractal conditional diffusion entropy method for analyzing the volatility of financial time series. This method utilizes a q-order diffusion entropy based on a q-weighted time lag scale. The technique of conditional diffusion entropy proves valuable for examining bull and bear behaviors in stock markets across various time scales. Empirical findings from analyzing the Dow Jones Industrial Average (DJI) indicate that employing multi-time lag scales offers greater insight into the complex dynamics of highly fluctuating time series, often characterized by multifractal behavior. A smaller time scale like t=2 to t=256 coincides more with the state of the DJI index than larger time scales like t=256 to t=1024. We observe extreme fluctuations in the conditional diffusion entropy for DJI for a short time lag, while smoother or averaged fluctuations occur over larger time lags.
Outcome Measures of Clinical Trials in Pediatric Chronic Kidney Disease
Authors: Liang Ziyun , He Guohua , Tao Liyuan , Zhong Xuhui , Lin Tianxin , Jiang Xiaoyun , Ding Jie
Published: May 2024

Clinical trials of chronic kidney disease (CKD) in children have important implications for the early identification and management of CKD. The selection of clinical trial outcomes is critical for assessing the effectiveness of interventions in pediatric CKD clinical trials. This review systematically examines the spectrum of outcome measures deployed in pediatric CKD clinical trials, which includes clinical and alternative outcomes, patient-reported outcome measures (PROMs), and safety indicators. Alternative outcome measures were stratified into four levels of evidence strength: convincing, probable, suggestive, and inconclusive. Consequently, the selection of outcome measures for pediatric CKD clinical trials mandates careful consideration of both their methodological feasibility and the robustness of their evidence base. Moreover, the burgeoning field of PROMs warrants integration into the design of future pediatric clinical trials to enrich the relevance and impact of research findings.
Risk Factors for Eating Disorders in University Students: The RUNEAT Study
Authors: Eguren-García Imanol , Sumalla-Cano Sandra , Conde-González Sandra , Vila-Martí Anna , Briones-Urbano Mercedes , Martínez-Díaz Raquel , Elío Iñaki
Published: May 2024

The purpose of the study is to assess the risk of developing general eating disorders (ED), anorexia nervosa (AN), and bulimia nervosa (BN), as well as to examine the effects of gender, academic year, place of residence, faculty, and diet quality on that risk. Over two academic years, 129 first- and fourth-year Uneatlántico students were included in an observational descriptive study. The self-administered tests SCOFF, EAT-26, and BITE were used to determine the participants’ risk of developing ED. The degree of adherence to the Mediterranean diet (MD) was used to evaluate the quality of the diet. Data were collected at the beginning (T1) and at the end (T2) of the academic year. The main results were that at T1, 34.9% of participants were at risk of developing general ED, AN 3.9%, and BN 16.3%. At T2, these percentages were 37.2%, 14.7%, and 8.5%, respectively. At T2, the frequency of general ED in the female group was 2.5 times higher (OR: 2.55, 95% CI: 1.22–5.32, p = 0.012). The low-moderate adherence to the MD students’ group was 0.92 times less frequent than general ED at T2 (OR: 0.921, 95%CI: 0.385–2.20, p < 0.001). The most significant risk factor for developing ED is being a female in the first year of university. Moreover, it appears that the likelihood of developing ED generally increases during the academic year.
Identifying Features of a System of Practice to Inform a Contemporary Competency Framework for Paramedics in Canada
Authors: Batt Alan M. , Lysko Meghan , Bolster Jennifer L. , Poirier Pierre , Cassista Derek , Austin Michael , Cameron Cheryl , Donnelly Elizabeth A. , Donelon Becky , Dunn Noël , Johnston William , Lanos Chelsea , Lunn Tyne M. , Mason Paige , Teed Sean , Vacon Charlene , Tavares Walter
Published: May 2024

Introduction: Paramedic practice is highly variable, occurs in diverse contexts, and involves the assessment and management of a range of presentations of varying acuity across the lifespan. As a result, attempts to define paramedic practice have been challenging and incomplete. This has led to inaccurate or under-representations of practice that can ultimately affect education, assessment, and the delivery of care. In this study, we outline our efforts to better identify, explore, and represent professional practice when developing a national competency framework for paramedics in Canada. Methods: We used a systems-thinking approach to identify the settings, contexts, features, and influences on paramedic practice in Canada. This approach makes use of the role and influence of system features at the microsystem, mesosystem, exosystem, macrosystem, supra-macrosystem, and chronosystem levels in ways that can provide new insights. We used methods such as rich pictures, diagramming, and systems mapping to explore relationships between these contexts and features. Findings: When we examine the system of practice in paramedicine, multiple layers become evident and within them we start to see details of features that ought to be considered in any future competency development work. Our exploration of the system highlights that paramedic practice considers the person receiving care, caregivers, and paramedics. It involves collaboration within co-located and dispersed teams that are composed of other health and social care professionals, public safety personnel, and others. Practice is enacted across varying geographical, cultural, social, and technical contexts and is subject to multiple levels of policy, regulatory, and legislative influence. Conclusion: Using a systems-thinking approach, we developed a detailed systems map of paramedic practice in Canada. This map can be used to inform the initial stages of a more representative, comprehensive, and contemporary national competency framework for paramedics in Canada.
Trends in Shoulder Arthroplasty in Germany: A 10-Year Epidemiological Analysis of Patients with Primary Osteoarthritis of the Shoulder
Authors: Hochberger Felix , Herrmann Philipp , Rudert Maximilian , List Kilian , Stratos Ioannis
Published: May 2024

Shoulder arthroplasty has significantly gained popularity in orthopedic surgery, driven by progress in prosthesis design and surgical techniques. This study explored the epidemiology of shoulder arthroplasty, analyzing healthcare data from 2012 to 2022 for primary osteoarthritis of the shoulder. The data included patient demographics and types of surgical procedures. Data analysis indicates a higher utilization rate of reverse total shoulder arthroplasty (RTSA; n = 41,251) over total- (TSA; n = 18,679) and hemiarthroplasty (HSA; n = 12,827) for primary shoulder osteoarthritis. Overall, a significant increase in RTSA procedures from n = 2237 (2012) to n = 5415 (2022) was observed, representing more than a two-fold increase of 121.1%. The relative proportion of RTSA among all types of shoulder arthroplasty increased from 39% (2012) to 68.6% (2022), while HSA decreased and TSA essentially remained constant. Age analysis identified the following peaks: RTSA, 77 ± 7 y; HSA, 68 ± 12 y; and TSA, 67 ± 10 y. Among the over 60s, significantly more women were treated with any type of prosthesis, whereas in young patients (45 to 59 y), more men received HSA or TSA. Our study confirms that RTSA has become the preferred choice for elderly patients in Germany, reflecting the prevailing preference despite varying patient ages and conditions, with a noted difference in sex in treatment prevalence.
Potential Role of the Yeast Papiliotrema terrestris Strain PT22AV in the Management of the Root-Knot Nematode Meloidogyne incognita
Authors: D’Addabbo Trifone , Landi Silvia , Palmieri Davide , Piscitelli Lea , Caprio Elena , Esposito Vincenzo , d’Errico Giada
Published: May 2024

The nematicidal potential of the yeast Papiliotrema terrestris strain PT22AV (YSY) was investigated against the root nematode (RKN) Meloidogyne incognita in in vitro bioassays on infective juveniles (J2) and experiments on tomatoes in pot and greenhouse conditions. The J2 nematodes were exposed to YSY solutions for 19 days, using abamectin (ABA), fosthiazate (FOS) and distilled water as controls. In the experiments on potted and greenhouse tomatoes, 0.5 and 1 kg ha−1 doses of YSY were tested in comparison to ABA, biocontrol agents Purpureocillium lilacinus strain 251 (PUL) and Bacillus firmus strain 1-1582 (BAF), a plant biostimulant/fertilizer (ERG) and the nematicide Fluopyram (FLU). J2’s viability was affected by YSL after 7 days, decreasing to zero on the 15th exposure day, while ABA and FOS resulted in 83 and 100% J2 mortality within 24 h. Only the 1.0 kg ha−1 dose of YSY was able to significantly reduce the final nematode population in soil and gall formation on tomato roots, without significant differences from PUL and BAF. All treatments in comparison also resulted in a significant increase in tomato growth and crop yield, except for 0.5 kg ha−1 of YSY. Data indicated that YSY could represent an additional tool for organic and integrated RKN management.
Sustainability Indicators for the Environmental Impact Assessment of Plant Protection Products Use in Moroccan Vineyards
Authors: Aoujil Faiçal , Litskas Vassilis , Yahyaoui Hiba , El Allaoui Nadia , Benbouazza Abdellatif , Aziz Aziz , Hafidi Majida , Habbadi Khaoula
Published: May 2024

The Sebou River Basin is vital for Moroccan agriculture, particularly in terms of producing industrial crops, fruits, vegetables, and olive oil. It is especially significant in viticulture, accounting for 80% and 60% of the national production area for wine and table grapes, respectively. However, the prevalence of diseases and pests requires extensive pesticide application in vineyards. This study aims to assess the impact of pesticides used in vineyards on the environment, human health and their associated sustainability. Agro-environmental indicators were evaluated across 30 vineyards covering 1197 hectares. Results show an average treatment frequency of 24.05 applications per growing cycle, the highest among grape-producing countries, with 77.94% being fungicides. The Quantity of Active Substances Indicator (QASI) reveals a high pesticide application rate of 44.60 Kg a.i./ha. Over 50% of chemicals are classified as “hazardous” based on the Environmental Impact Quotient (EIQ). A Pesticide Environmental Risk Indicator model (PERI) identifies three active ingredients with a high Environmental Risk Score (>5). Life Cycle Assessment (LCA) reveals that copper sulfate has significant environmental impacts compared to Mancozeb and sulfur. These findings highlight the extensive use of pesticides in vineyards, posing challenges to long-term sustainable agriculture due to associated environmental and health risks.
Optimization of Fermentation Culture Medium for Sanghuangporus alpinus Using Response-Surface Methodology
Authors: Gao Yuhan , Li Xiaomin , Xu Hui , Sun Huijuan , Zhang Junli , Wu Xiaoping , Fu Junsheng
Published: May 2024

The newly identified Sanghuangporus alpinus species of the Sanghuang mushroom genus has been found to possess significant medical benefits. However, the current artificial cultivation technology has not reached the requisite maturity. The response-surface methodology (RSM) was used to optimize the Sanghuangporus alpinus culture medium formulation and evaluate the functional activity of S. alpinus exopolysaccharides. First, a single-factor experiment was conducted to screen for optimal carbon and nitrogen sources for S. alpinus. Then, using Box–Behnken’s central composite design, a response-surface experiment was conducted to determine optimal culture parameters. Finally, the rationality of those parameters was assessed in a shaking flask experiment. The optimal culture parameters, determined through regression analysis, were 20.20 ± 0.17 g/L fructose (carbon source), 7.29 ± 0.10 g/L yeast extract (nitrogen source), and 0.99 ± 0.01 g/L dandelion. With optimization, the S. alpinus yield increased to 12.79 ± 1.41 g/L, twice that obtained from the initial culture medium. The S. alpinus exopolysaccharide exhibited an excellent antioxidant capacity, with the strongest scavenging effect noted on ABTS free radicals (lowest half-inhibitory concentration: 0.039 mg/mL). Additionally, this exopolysaccharide effectively inhibited various cancer cells, exhibiting the strongest activity against human glioma cells U251 (half-inhibitory concentration: 0.91 mg/mL). The RSM used to optimize the fermentation culture parameters of S. alpinus significantly increased the mycelial biomass. The improvement of Sanghuangporus alpinus yield through liquid fermentation and optimizing the fermentation medium could fill the existing gap in the cultivation of Sanghuangporus alpinus, as well as provide valuable data for the large-scale production of S. alpinus.
Estimating Partnership Duration among MSM in Belgium—A Modeling Study
Authors: Tsoumanis Achilleas , Vanden Berghe Wim , Hens Niel , Van Dijck Christophe
Published: May 2024

Mathematical modeling is widely used for describing infection transmission and evaluating interventions. The lack of reliable social parameters in the literature has been mentioned by many modeling studies, leading to limitations in the validity and interpretation of the results. Using data from the European MSM Internet survey 2017, we developed a network model to describe sex acts among MSM in Belgium. The model simulates daily sex acts among steady, persistent casual and one-off partners in a population of 10,000 MSM, grouped as low- or high-activity by using three different definitions. Model calibration was used to estimate partnership duration and homophily rates to match the distribution of cumulative sex partners over 12 months. We estimated an average duration between 1065 and 1409 days for steady partnerships, 4–6 and 251–299 days for assortative high- and low-activity individuals and 8–13 days for disassortative persistent casual partnerships, respectively, varying across the three definitions. High-quality data on social network and behavioral parameters are scarce in the literature. Our study addresses this lack of information by providing a method to estimate crucial parameters for network specification.
Pulmonary Hypertension in Sickle Cell Disease: Novel Findings of Gene Polymorphisms Related to Pathophysiology
Authors: Chatzidavid Sevastianos , Flevari Pagona , Tombrou Ioanna , Anastasiadis Georgios , Dimopoulou Maria
Published: May 2024

Pulmonary hypertension (PH) is a progressive and potentially fatal complication of sickle cell disease (SCD), affecting 6–10% of adult SCD patients. Various mechanisms and theories have been evaluated to explain the pathophysiology of this disease. However, questions remain, particularly regarding the clinical heterogeneity of the disease in terms of symptoms, complications, and survival. Beyond the classical mechanisms that have been thoroughly investigated and include hemolysis, nitric oxide availability, endothelial disorders, thrombosis, and left heart failure, attention is currently focused on the potential role of genes involved in such processes. Potential candidate genes are investigated through next-generation sequencing, with the transforming growth factor-beta (TGF-β) pathway being the initial target. This field of research may also provide novel targets for pharmacologic agents in the future, as is already the case with idiopathic PH. The collection and processing of data and samples from multiple centers can yield reliable results that will allow a better understanding of SCD-related PH as a part of the disease’s clinical spectrum. This review attempts to capture the most recent findings of studies on gene polymorphisms that have been associated with PH in SCD patients.
Receptor Targeting Using Copolymer-Modified Gold Nanoparticles for pCMV-Luc Gene Delivery to Liver Cancer Cells In Vitro
Authors: Zenze Mkhuseli , Singh Moganavelli
Published: May 2024

The formulation of novel delivery protocols for the targeted delivery of genes into hepatocytes by receptor mediation is important for the treatment of liver-specific disorders, including cancer. Non-viral delivery methods have been extensively studied for gene therapy. Gold nanoparticles (AuNPs) have gained attention in nanomedicine due to their biocompatibility. In this study, AuNPs were synthesized and coated with polymers: chitosan (CS), and polyethylene glycol (PEG). The targeting moiety, lactobionic acid (LA), was added for hepatocyte-specific delivery. Physicochemical characterization revealed that all nano-formulations were spherical and monodispersed, with hydrodynamic sizes between 70 and 250 nm. Nanocomplexes with pCMV-Luc DNA (pDNA) confirmed that the NPs could bind, compact, and protect the pDNA from nuclease degradation. Cytotoxicity studies revealed that the AuNPs were well tolerated (cell viabilities > 70%) in human hepatocellular carcinoma (HepG2), embryonic kidney (HEK293), and colorectal adenocarcinoma (Caco-2) cells, with enhanced transgene activity in all cells. The inclusion of LA in the NP formulation was notable in the HepG2 cells, which overexpress the asialoglycoprotein receptor on their cell surface. A five-fold increase in luciferase gene expression was evident for the LA-targeted AuNPs compared to the non-targeted AuNPs. These AuNPs have shown potential as safe and suitable targeted delivery vehicles for liver-directed gene therapy.
Development of Personalized Strategies for Precisely Battling Malignant Melanoma
Authors: Isaak Armond J. , Clements GeGe R. , Buenaventura Rand Gabriel M. , Merlino Glenn , Yu Yanlin
Published: May 2024

Melanoma is the most severe and fatal form of skin cancer, resulting from multiple gene mutations with high intra-tumor and inter-tumor molecular heterogeneity. Treatment options for patients whose disease has progressed beyond the ability for surgical resection rely on currently accepted standard therapies, notably immune checkpoint inhibitors and targeted therapies. Acquired resistance to these therapies and treatment-associated toxicity necessitate exploring novel strategies, especially those that can be personalized for specific patients and/or populations. Here, we review the current landscape and progress of standard therapies and explore what personalized oncology techniques may entail in the scope of melanoma. Our purpose is to provide an up-to-date summary of the tools at our disposal that work to circumvent the common barriers faced when battling melanoma.
Measured and Estimated Glomerular Filtration Rate to Evaluate Rapid Progression and Changes over Time in Autosomal Polycystic Kidney Disease: Potential Impact on Therapeutic Decision-Making
Authors: Miquel-Rodríguez Rosa , González-Toledo Beatriz , Pérez-Gómez María-Vanessa , Cobo-Caso María Ángeles , Delgado-Mallén Patricia , Estupiñán Sara , Cruz-Perera Coriolano , Díaz-Martín Laura , González-Rinne Federico , González-Delgado Alejandra , Torres Armando , Gaspari Flavio , Hernández-Marrero Domingo , Ortiz Alberto , Porrini Esteban , Luis-Lima Sergio
Published: May 2024

Autosomal polycystic kidney disease (ADPKD) is the most common genetic form of kidney failure, reflecting unmet needs in management. Prescription of the only approved treatment (tolvaptan) is limited to persons with rapidly progressing ADPKD. Rapid progression may be diagnosed by assessing glomerular filtration rate (GFR) decline, usually estimated (eGFR) from equations based on serum creatinine (eGFRcr) or cystatin-C (eGFRcys). We have assessed the concordance between eGFR decline and identification of rapid progression (rapid eGFR loss), and measured GFR (mGFR) declines (rapid mGFR loss) using iohexol clearance in 140 adults with ADPKD with ≥3 mGFR and eGFRcr assessments, of which 97 also had eGFRcys assessments. The agreement between mGFR and eGFR decline was poor: mean concordance correlation coefficients (CCCs) between the method declines were low (0.661, range 0.628 to 0.713), and Bland and Altman limits of agreement between eGFR and mGFR declines were wide. CCC was lower for eGFRcys. From a practical point of view, creatinine-based formulas failed to detect rapid mGFR loss (−3 mL/min/y or faster) in around 37% of the cases. Moreover, formulas falsely indicated around 40% of the cases with moderate or stable decline as rapid progressors. The reliability of formulas in detecting real mGFR decline was lower in the non-rapid-progressors group with respect to that in rapid-progressor patients. The performance of eGFRcys and eGFRcr-cys equations was even worse. In conclusion, eGFR decline may misrepresent mGFR decline in ADPKD in a significant percentage of patients, potentially misclassifying them as progressors or non-progressors and impacting decisions of initiation of tolvaptan therapy.