bluuebunny/crossref_metadata_2025 huggingface dataset:
Automatic Aortic Valve Extraction Using Deep Learning with Contrast-Enhanced Cardiac CT Images
Authors: Inomata Soichiro , Yoshimura Takaaki , Tang Minghui , Ichikawa Shota , Sugimori Hiroyuki
Published: December 2024

Purpose: This study evaluates the use of deep learning techniques to automatically extract and delineate the aortic valve annulus region from contrast-enhanced cardiac CT images. Two approaches, namely, segmentation and object detection, were compared to determine their accuracy. Materials and Methods: A dataset of 32 contrast-enhanced cardiac CT scans was analyzed. The segmentation approach utilized the DeepLabv3+ model, while the object detection approach employed YOLOv2. The dataset was augmented through rotation and scaling, and five-fold cross-validation was applied. The accuracy of both methods was evaluated using the Dice similarity coefficient (DSC), and their performance in estimating the aortic valve annulus area was compared. Results: The object detection approach achieved a mean DSC of 0.809, significantly outperforming the segmentation approach, which had a mean DSC of 0.711. Object detection also demonstrated higher precision and recall, with fewer false positives and negatives. The aortic valve annulus area estimation had a mean error of 2.55 mm. Conclusions: Object detection showed superior performance in identifying the aortic valve annulus region, suggesting its potential for clinical application in cardiac imaging. The results highlight the promise of deep learning in improving the accuracy and efficiency of preoperative planning for cardiovascular interventions.
Safety and Efficacy in Mitral Regurgitation Management with the MitraClip® G4 System: Insights from a Single-Center Study
Authors: Papadopoulos Georgios E. , Ninios Ilias , Evangelou Sotirios , Ioannidis Andreas , Ninios Vlasis
Published: December 2024

Background: Mitral regurgitation (MR) is a common valvular disorder linked to high morbidity and mortality. For patients unsuitable for surgery, transcatheter mitral edge-to-edge repair (TEER) with the MitraClip® G4 system offers an alternative. This study aims to evaluate procedural, echocardiographic, functional, and quality of life (QoL) outcomes in patients who underwent TEER with the MitraClip® G4 system, along with possible predictors of New York Heart Association (NYHA) class I at 30 days and at 1 year. Methods: Patients with moderate-to-severe (3+) or severe (4+) degenerative MR (DMR) or functional MR (FMR), classified as NYHA class III or IV, and who underwent TEER with the MitraClip® G4 system at our center between January 2021 and December 2023 were included. Results: A total of 83 patients [71% FMR, 66% male, median (IQR) age 70 (11) years] underwent TEER, with 100% procedural success. MR ≤ 2+ was achieved in 100% and 98% of patients at 30 days and 1 year, respectively. NYHA class I or II was achieved in 100% and 96.8% of patients at 30 days and 1 year, respectively. The Kansas City Cardiomyopathy Questionnaire (KCCQ) score improved from 51 ± 20 at baseline to 69 ± 15 at 30 days (p < 0.001) and 70.5 ± 15 at 1 year (p < 0.001). Lower baseline N-terminal pro-brain natriuretic peptide (NT-proBNP) predicted achieving NYHA class I at 30 days (HR: 0.63, 95% CI: 0.41–0.95, p = 0.030), while lower European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and NT-proBNP predicted it at 1 year [(HR: 0.50, 95% CI: 0.28–0.89, p = 0.019), (HR: 0.67, 95% CI: 0.44–0.99, p = 0.049), respectively]. Conclusions: The MitraClip® G4 system provides significant improvements in MR severity, functional class, and QoL. Lower NT-proBNP and EuroSCORE II were strong predictors of achieving optimal functional status (NYHA class I).
Cerebral Embolic Protection in Patients Undergoing Left Atrial Appendage Closure
Authors: Seeger Julia , Seppelt Philipp , Iturbe-Orbe Mario , Leistner David , Wöhrle Jochen , Joner Michael
Published: December 2024

(1) Background: Cerebral magnetic resonance imaging has reported new cerebral ischemic lesions after left atrial appendage (LAA) closure in about one- third of patients. Stroke occurs predominantly periprocedurally. This study evaluated the characteristics of embolized debris captured by the SENTINELTM cerebral embolic protection system in patients undergoing LAA closure; (2) Methods: Sixty filters of 30 consecutive patients undergoing LAA closure with the WATCHMAN FLXTM device were collected and captured debris was analyzed by histopathology and histomorphometry. Clinical outcome measures were disabling and non-disabling stroke within 72 h; (3) Results: In most filters, no material was captured. The predominant captured debris was acute or organized thrombi. The most common pattern was acute fibrin-rich thrombus, which was detected in 11/30 (33.3%) patients. Particles of heart tissue were seen in 6/30 (20%) patients, and foreign material was seen in one (3.3%) patient. The number of particles ranged from 0 to 52 per patient with a maximum of 31 in the distal and 21 in the proximal filter. Particle diameter ranged from 131 to 2614 µm. By logistic regression analysis, only protected time remained a multivariable predictor for larger particles (p = 0.039). There was no disabling or non-disabling stroke. Compared to transfemoral aortic valve replacement, the number of particles is only about 1.5%. (4) Conclusion: LAA occlusion with the WATCHMAN FLXTM was associated with a very low number of embolized particles captured with the double-filter SENTINELTM embolic protection system and no periprocedural stroke.
Preclinical Identification of Poorly Controlled COPD: Patients with a Single Moderate Exacerbation Matter Too
Authors: Maya Viejo José David , Navarro Ros Fernando M.
Published: December 2024

Background and Objectives: Chronic obstructive pulmonary disease (COPD) remains a critical global health challenge, characterized by high morbidity, mortality, and healthcare costs. Current guidelines may overlook patients who present with only one moderate exacerbation or with frequent short-acting beta-agonist (SABA) use. Building on findings from the Seleida study, this research refines the criteria for poor COPD control to include these patients, aiming to improve early identification of high-risk cases in primary care. Methods: A retrospectiveand multicenter study is conducted using data from 110 COPD patients in Spain. Poor control is redefined as having at least one moderate exacerbation or as using three or more SABA inhalers annually. Key predictors, such as SABA/short-acting muscarinic antagonist (SAMA) inhalers and antibiotic prescriptions, are identified using logistic regression and LASSO regularization to enhance predictive accuracy. Results: The model achieves a good predictive performance, with an AUC-ROC of 0.978, sensitivity of 92.86%, and specificity of 87.50%. Key predictors reliably identify high-risk patients, enabling timely interventions. This study demonstrates a statistically significant association between once-daily inhaler therapies and better COPD control compared to multiple daily doses, supported by chi-square analysis (p = 0.008) and binary logistic regression (p = 0.018). Nevertheless, the variable ‘daily inhalation frequency’ (1 vs. >1 inhalation/day) was excluded from the final model to prevent overfitting. Conclusions: By refining the criteria for COPD control to include patients with at least one moderate exacerbation or frequent SABA use, this model provides a practical tool for early risk stratification in primary care, particularly in resource-limited settings. Early identification of high-risk patients can reduce hospitalizations and healthcare costs, supporting a proactive approach to COPD management. Further validation in larger cohorts is essential to confirm its broader applicability.
Polycystic Ovary Syndrome and Eating Disorders—A Literature Review
Authors: Góral Agata , Żywot Klaudia , Zalewski Wojciech , Jagodziński Adam , Murawski Marek
Published: December 2024

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects women of reproductive age and is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology. PCOS is often associated with hormonal imbalances, metabolic dysfunction and comorbid psychiatric disorders, including eating disorders (EDs). The review identifies key hormonal factors—serotonin, leptin, insulin, ghrelin, kisspeptin and cortisol—and their roles in the pathophysiology of PCOS and associated psychiatric symptoms. Serotonin deficiency, commonly seen in PCOS patients, is associated with mood and eating disorders. Fluctuations in leptin, the satiety hormone, affect hypothalamic–pituitary–ovarian axis function and ovarian follicle maturation, increasing the risk of infertility. Elevated levels of kisspeptin in PCOS patients contribute not only to hormonal dysregulation but also to increased susceptibility to eating disorders such as bulimia and binge eating, likely due to its influence on the limbic system and glucose metabolism. Hyperinsulinemia and insulin resistance further impair reproductive and metabolic health, while promoting eating disorders such as binge eating and bulimia. Ghrelin and cortisol also emerge as significant factors. The review emphasizes the bidirectional relationship between PCOS and eating disorders, in which hormonal imbalances perpetuate psychiatric conditions, creating a vicious cycle. A multidisciplinary approach including gynecologists, endocrinologists, psychiatrists and nutritionists is recommended to ensure complex treatment. Early identification of those at risk through targeted screening and personalized interventions is key. Future research should focus on discovering the underlying hormonal mechanisms to improve treatment strategies and quality of life for women with PCOS.
An Approach to and Treatment of Indeterminate Biliary Strictures: A Comprehensive Review of the Literature
Authors: Impellizzeri Giovanna , Grassini Maria Vittoria , Donato Giulio , De Angelis Claudio Giovanni , Pagano Nico
Published: December 2024

This review aims to focus on what we know about the management of biliary strictures of unknown etiology, especially exploring our diagnostic armamentarium in the setting of indeterminate biliary strictures. Presently, this is a current issue that has a relevant impact both on patient prognosis, often delaying diagnosis, and on overall costs associated with repeating diagnostic procedures, sometimes performed with very expensive devices. We also focus on current biliary drainage approaches, providing an overview of therapeutic options, endoscopic or not.
The Impact of Genetic Polymorphism on Complication Development in Heart Failure Patients
Authors: Zhalbinova Madina R. , Rakhimova Saule E. , Kozhamkulov Ulan A. , Akilzhanov Kenes R. , Shaimardanov Nurlan K. , Akilzhanova Gulbanu A. , Lee Joseph H. , Pya Yuriy V. , Bekbossynova Makhabbat S. , Akilzhanova Ainur R.
Published: December 2024

Background: Despite the high progress that has been made in the field of cardiology, the left ventricular assist device (LVAD) can still cause complications (thrombosis/bleeding) in heart failure (HF) patients after implantation. Complications develop due to the incorrect dose of antithrombotic therapy, due to the influence of the non-physiological shear stress of the device, and also due to inherited genetic polymorphisms. Therefore, the aim of our study is to identify the influence of the genetic polymorphisms on complication development in HF patients with implanted LVADs with prescribed antiplatelet therapy. Methods: Our study investigated 98 HF patients with/without complications who were genotyped for 21 single-nucleotide polymorphisms (SNPs) associated with cardiovascular events, the coagulation system, and the metabolism of warfarin and aspirin drugs. This study performed a more detailed analysis on genetic polymorphism in the UGT1A6 gene and its influence on aspirin dose. Results: SNP rs2070959 in the UGT1A6 gene showed a significant association with the group of HF patients with complications [(OR (95% CI): 4.40 (1.06–18.20), p = 0.044]. The genetic polymorphism of rs2070959 in the UGT1A6 gene showed a significant association in HF patients who received aspirin treatment on the 12th month after LVAD implantation [OR (95% CI): 5.10 (1.31–19.87), p = 0.018]. Moreover, our genotype distribution analysis showed that the GG genotype of rs2070959 in the UGT1A6 gene was significantly higher in the group with aspirin treatment than without treatment after the 12th month of treatment (50.0% vs. 0%, p = 0.008), especially in the group of patients with complications. A higher frequency of the GG genotype with long-lasting aspirin therapy up to the 12th month showed that 100 mg of aspirin was not an effective dose in the group of patients with complications. Conclusions: Our study identified that genotyping for genetic polymorphism rs2070959 in the UGT1A6 gene could predict the recommended dose of aspirin in HF patients, which could help to prevent and predict complication development after LVAD implantation.
Impact of Demographics and Psychological Factors on Three-Day Postoperative Pain Perception Following Hand Surgery
Authors: Borna Sahar , Ho Olivia A. , Gomez-Cabello Cesar A. , Haider Syed Ali , Genovese Ariana , Prabha Srinivasagam , Haider Clifton R. , Felton Christopher L. , McLeod Christopher J. , Bruce Charles J. , Carter Rickey E. , Forte Antonio Jorge
Published: December 2024

Background: Effective pain management is crucial for both comfort and outcomes, yet predicting and managing this pain is difficult. This study aimed to analyze postoperative pain in patients undergoing hand surgery at the Mayo Clinic Florida, examining how patient characteristics and anxiety affect pain outcomes. Methods: We conducted a single-arm clinical trial at Mayo Clinic Florida, recruiting patients undergoing hand surgery. Preoperative pain and anxiety were assessed using the Pain Catastrophizing Scale (PCS) and State-Trait Anxiety Inventory (STAI). Postoperatively, patients used an iPhone app to record pain levels and medication use every four hours. Devices were collected three days after surgery. We analyzed the relationship between demographics, PCS, STAI scores, and pain levels using linear and logistic regression models. All statistical tests were two-sided with significance set at p < 0.05, analyzed with R4.2.2. Results: Data were collected from 62 patients (62.9% women, 37.1% men) undergoing hand surgery. Participants were mainly White (90.3%), with 50% being in the middle-aged adult group. Most had low anxiety levels (80.6% STAI-S, 82.3% STAI-T) and low catastrophizing (61.3% PCS). Postoperative pain was low, with median scores between 1.0 and 2.0 over three days. Demographics, anxiety, and catastrophizing were not significant predictors of pain levels. Logistic regression showed time as a significant factor, with pain levels peaking on Day 3. Conclusions: Postoperative pain after hand surgery was generally low, with time being a significant predictor of increased pain. Demographic factors, anxiety, and catastrophizing did not significantly affect pain levels. Pain management should emphasize time-sensitive interventions and ongoing monitoring.
Recent Advances in Perioperative Analgesia in Thoracic Surgery: A Narrative Review
Authors: Mitchell John , Couvreur Céline , Forget Patrice
Published: December 2024

Thoracic surgery is associated with significant postoperative pain, which can hinder recovery and elevate morbidity risks. Traditionally, epidural anesthesia has been the cornerstone for pain management, but its drawbacks including technical challenges, side effects, and complications necessitate exploring alternative methods. This narrative review examined recent advances in perioperative analgesic strategies in thoracic surgery, focusing on regional anesthetic techniques like paravertebral blocks (PVBs), erector spinae plane blocks (ESPBs), intercostal blocks, and serratus anterior blocks. Each approach was evaluated for efficacy, safety, and impact on patient outcomes. PVB can provide effective unilateral analgesia with fewer systemic complications compared to epidurals. ESPB provides analgesia through a superficial, ultrasound-guided approach, minimizing risks and offering an alternative for various thoracic procedures. Intercostal blocks are effective but are limited by the need for multiple injections, increasing the complication risks. Serratus anterior blocks, targeting intercostal and thoracic nerves, show promise in managing lateral thoracic wall pain with a low complication rate. Advancements in surgical techniques including minimally invasive approaches further optimize pain control and recovery. A multimodal analgesic approach combining regional anesthesia and systemic therapies enhances outcomes by addressing somatic and visceral pain components. Despite the efficacy of epidural analgesia, alternative regional techniques offer comparable pain relief with fewer complications, suggesting their growing role in thoracic surgery. Collaborative efforts between surgical, anesthetic, and emergency teams are crucial for tailoring pain management strategies to individual patients, improving recovery and reducing long-term morbidity. Future research should continue exploring these methods to refine their application and broaden their accessibility.
Postoperative Vision-Related Quality of Life After Sphenoid Wing Meningioma Surgery: Impact of Radiomic Shape Features and Age
Authors: Basaran Alim Emre , Vychopen Martin , Seidel Clemens , Barrantes-Freer Alonso , Arlt Felix , Güresir Erdem , Wach Johannes
Published: December 2024

Background: Sphenoid wing meningiomas (SWM) frequently compress structures of the optic pathway, resulting in significant visual dysfunction characterized by vision loss and visual field deficits, which profoundly impact patients’ quality of life (QoL), daily activities, and independence. The objective of this study was to assess the impact of SWM surgery on patient-reported outcome measures (PROMs) regarding postoperative visual function. Methods: The Visual Function Score Questionnaire (VFQ-25) is a validated tool designed to assess the impact of visual impairment on quality of life. The questionnaire was distributed to a previously published study population in which shape radiomics were correlated with new cranial nerve deficits after SWM surgery. Results: A total of 42 patients (42/74; 56.8%) responded to the questionnaire. Of the 42 patients, 30 were female (71%) and 12 were male (29%). The multivariable analysis demonstrated that lower sphericity reflecting irregular SWM shape was associated with poorer VFQ-25 (OR: 6.8, 95% CI: 1.141.8, p = 0.039), while age was associated with lower VFQ-25 (OR: 27, 95% CI: 2.7−272.93, p = 0.005), too. Analysis of the subcategories of the VFQ-25 revealed significantly reduced general vision (p = 0.045), social functioning (p = 0.045), and peripheral vision (p = 0.017) in those with SWM with low sphericity. Conclusions: The study highlights that SWM surgery impacts postoperative visual function, with age and irregular SWM shape being associated with poorer postoperative VFQ-25 scores. VFQ-25 is a feasible tool to assess vision outcome in SWM surgery and has clinical potential for longitudinal follow-up evaluations. Irregular SWM shape should be considered during preoperative treatment planning and patient consultation regarding functional outcome.
Effects of Automated Versus Conventional Ventilation on Quality of Oxygenation—A Substudy of a Randomized Crossover Clinical Trial
Authors: Botta Michela , van Meenen David M. P. , van Leijsen Tobias D. , Rogmans Jitske R. , List Stephanie S. , van der Heiden Pim L. J. , Horn Janneke , Paulus Frederique , Schultz Marcus J. , Buiteman-Kruizinga Laura A.
Published: December 2024

Background/Objectives: Attaining adequate oxygenation in critically ill patients undergoing invasive ventilation necessitates intense monitoring through pulse oximetry (SpO2) and frequent manual adjustments of ventilator settings like the fraction of inspired oxygen (FiO2) and the level of positive end-expiratory pressure (PEEP). Our aim was to compare the quality of oxygenation with the use of automated ventilation provided by INTELLiVENT–Adaptive Support Ventilation (ASV) vs. ventilation that is not automated, i.e., conventional pressure-controlled or pressure support ventilation. Methods: A substudy within a randomized crossover clinical trial in critically ill patients under invasive ventilation. The primary endpoint was the percentage of breaths in an optimal oxygenation zone, defined by predetermined levels of SpO2, FiO2, and PEEP. Secondary endpoints were the percentage of breaths in acceptable or critical oxygenation zones, the percentage of time spent in optimal, acceptable, and critical oxygenation zones, the number of manual interventions at the ventilator, and the number and duration of ventilator alarms related to oxygenation. Results: Of the 96 patients included in the parent study, 53 were eligible for this current subanalysis. Among them, 31 patients were randomized to start with automated ventilation, while 22 patients began with conventional ventilation. No significant differences were found in the percentage of breaths within the optimal zone between the two ventilation modes (median percentage of breaths during automated ventilation 19.4 [0.1–99.9]% vs. 25.3 [0.0–100.0]%; p = 0.963). Similarly, there were no differences in the percentage of breaths within the acceptable and critical zones, nor in the time spent in the three predefined oxygenation zones. Although the number of manual interventions was lower with automated ventilation, the number and duration of ventilator alarms were fewer with conventional ventilation. Conclusions: The quality of oxygenation with automated ventilation is not different from that with conventional ventilation. However, while automated ventilation comes with fewer manual interventions at the ventilator, it also comes with more ventilator alarms.
The Severity of Prostaglandin-Associated Periorbitopathy Did Not Affect the Surgical Effectiveness of the Ahmed Glaucoma Valve
Authors: Harano Akiko , Ichioka Sho , Murakami Kana , Iida Mizuki , Tanito Masaki
Published: December 2024

Introduction: To report the role of prostaglandin-associated periorbitopathy (PAP) severity on the surgical efficacy of Ahmed Glaucoma Valve (AGV) implantation. Subjects and Methods: Retrospective observational case series. Participants were the consecutive 102 eyes from 102 Japanese subjects (55 males, 47 females; mean age ± standard deviation, 74.9 ± 7.8 years) who underwent AGV implantation for primary open-angle glaucoma (POAG), completed full postoperative visits for 12 months, and had information on PAP severity graded by the Shimane University PAP Grading System (SU-PAP). Data were collected via medical chart review. Comparison of surgical success rates among groups stratified by SU-PAP grades (grades 0–3) using survival curve analysis. Failure was defined based on additional glaucoma surgery, IOP reduction in less than 20%, postoperative IOP exceeding 18 mmHg (definition A) or 15 mmHg (definition B), or postoperative visual acuity reduced to no light perception. Results: At 12 months postoperatively, the success rates for grades 0, 1, 2, and 3 were 47%, 43%, 42%, and 73%, respectively, for definition A (p = 0.35) and 35%, 26%, 19%, and 27%, respectively, for definition B (p = 0.64, log-rank test). For definition A, younger age was associated with surgical failure (Hazard ratio = 0.97/year, p = 0.049, Wald test), while no other factors, including gender, preoperative IOP, medications, refractive error, history of conjunctival manipulation procedures, or SU-PAP grade, were associated with surgical failure. For definition B, no factors were found to influence surgical outcomes. Conclusions: The preoperative severity of PAP might not affect the postoperative outcomes of AGV. Given that the success rate of trabeculectomy is influenced by PAP severity, in cases with severe PAP, physicians are advised to consider long-tube shunt surgery as an initial filtration procedure or as a rescue procedure when filtration surgery is unsuccessful.
Malignant Salivary Gland Tumors in a Tertiary University Hospital in Northern Spain
Authors: Chiesa-Estomba Carlos M. , Rodriguez-Urzay Alfonso , Landa-Garmendia Maria , Larruscain-Sarasola Ekhiñe , González-García Jose A. , Sistiaga-Suarez Jon A. , González-Vallejo Leyre , Blanco-García Carlos
Published: December 2024

(1) Background: Salivary gland tumors (SGTs) are a rare and diverse group of neoplasms arising in the parotid, submandibular, sublingual, and minor salivary glands distributed throughout the upper aerodigestive tract. Given the rarity and complexity of MSGTs, understanding their epidemiology across diverse populations is crucial for improving diagnostic and therapeutic strategies. (2) Methods: A retrospective analysis involving 45 patients diagnosed with malignant salivary gland tumors and treated with curative intention between 1 July 2016 and 1 July 2021 in a tertiary academic hospital was performed. (3) Results: Histologically, the most common subtype was adenoid cystic carcinoma in 12 (26.7%) cases, followed by carcinoma ex-pleomorphic adenoma in 7 (15.6%) cases, mucoepidermoid carcinoma in 6 (13.3%) cases, and adenocarcinoma in 6 (13.3%) cases. The majority of tumors were located in the parotid gland in 28 cases (62.2%). The three-year overall survival rate was 80% and the three-year specific survival rate was 86.7%. Tumor grade was significantly associated with local recurrence and the appearance of distant metastasis during the follow-up period (p = 0.04). We also evidenced a worse survival in patients with advanced T-Stage (p = 0.038) and positive nodes in the neck (p = 0.015). (4) Conclusions: Overall, our study reinforces the prognostic significance of tumor grade, T-Stage and N-Stage while challenging the conventional understanding of factors such as PNI, LNM, and margin status.
Glycated Hemoglobin and Cardiovascular Disease in Patients Without Diabetes
Authors: Jakubiak Grzegorz K. , Chwalba Artur , Basek Aleksandra , Cieślar Grzegorz , Pawlas Natalia
Published: December 2024

Cardiovascular diseases (CVDs) are one of the most critical public health problems in the contemporary world because they are the leading cause of morbidity and mortality. Diabetes mellitus (DM) is one of the most substantial risk factors for developing CVDs. Glycated hemoglobin is a product of the non-enzymatic glycation of hemoglobin present in erythrocytes. The determination of the percentage of glycated hemoglobin (HbA1c) is commonly used in clinical practice to assess glycemic control in patients diagnosed with DM. This method is much more informative than repeated blood glucose tests, because the HbA1c value reflects the degree of glycemic control over the last three months. It is, therefore, not surprising that the HbA1c value correlates with the presence and severity of diabetes complications, including CVDs, in the population of diabetic patients. The purpose of this publication was to present the results of a literature review on the relationship between the HbA1c value in people without DM, the presence and severity of subclinical cardiovascular dysfunction, and the presence of clinically overt CVDs. The most important tools used to assess subclinical cardiovascular dysfunction included the measurement of intima-media thickness (IMT), especially carotid IMT (cIMT), arterial stiffness assessment by the measurement of pulse wave velocity (PWV), and ankle–brachial index (ABI). According to the results of the studies cited in this literature review, it can be concluded that there are certain relationships between HbA1c, the presence and severity of subclinical cardiovascular dysfunction, and the presence of clinically overt CVDs such as coronary heart disease, cerebrovascular disease, and chronic lower extremity ischemia in non-diabetic patients. It is worth noting, however, that the results of studies conducted so far in this area are not fully unambiguous. Further studies are needed to better understand the influence of additional factors on the relationship between HbA1c and cardiovascular dysfunction in non-diabetic patients.
Sedimentary Signatures of Super Typhoon Haiyan: Insight from Core Record in South China Sea
Authors: Chen Yu-Huang , Su Chih-Chieh , Yu Pai-Sen , Hsu Ta-Wei , Hsu Sheng-Ting , Juan Hsing-Chien , Chang Yuan-Pin , Ma Yu-Fang , Chiu Shye-Donq
Published: December 2024

Sedimentary records of event deposits are crucial for regional natural disaster risk assessments and hazard history reconstructions. After Super Typhoon Haiyan passed through the South China Sea in 2013, five gravity cores were collected along the typhoon path in the southern South China Sea basin (>3800 mbsl). The results showed that Super Typhoon Haiyan deposits with clear graded bedding are preserved at the top of all cores. The thickness of the typhoon layers ranges from 20 to 240 cm and is related to changes in typhoon intensity. The lack of river-connected submarine canyon systems limited the transportation of terrestrial sediments from land to sea. Super Typhoon Haiyan-induced large surface waves played an important role in carrying suspended sediment from the Philippines. The Mn-rich layers at the bottom of the typhoon layers may be related to the soil and rock composition of the Palawan region, which experienced tsunami-like storm surges caused by Super Typhoon Haiyan. These Mn-rich layers may serve as a proxy for sediment export from large-scale extreme terrigenous events. This study provides the first sedimentary record of extreme typhoon events in the deep ocean, which may shed light on reconstructing regional hazard history.
Risk Contextualization for Nuclear Systems
Authors: Petkov Gueorgui
Published: December 2024

Risk management strives to reach the standards of theoretical systematicity and empirical precision achieved in natural science models. To this end, a set of risk-informed and performance-based standards was developed in the form of statistically validated measures. The set enables the systematic extraction by deterministic and probabilistic analysis of potentially objective risk assessments and well-defined decisions. However, much of the data and models are subjectively influenced by the uncertainty of the context in which they are related and derived. Current risk analysis contains a large amount of risk-related information, but without the context of the models, its results lack sufficient predictive and explanatory power to be a solid basis for decisions. Therefore, to model the entire site of a multi-unit nuclear power plant as an integrated system connecting facility and activity, it is necessary to consider not only the technological conditions, but also the entire site context, including human, organizational, and environmental factors. An interface tool for dynamic deterministic-probabilistic safety analysis should be used to contextualize and complement existing risk indicators, but not to replace them. This article presents the possibilities of risk contextualization for nuclear systems through the symptom-based context quantification procedure of the Performance Evaluation Teamwork method.
Utility of Cand PCR in the Diagnosis of Vulvovaginal Candidiasis in Pregnant Women
Authors: García-Salazar Eduardo , Betancourt-Cisneros Paola , Ramírez-Magaña Xóchitl , Díaz-Huerta Hugo , Martínez-Herrera Erick , Frías-De-León María Guadalupe
Published: December 2024

Vulvovaginal candidiasis (VVC) can lead to multiple complications when it occurs during pregnancy, so it is necessary to diagnose it promptly for effective treatment. Traditional methods for identifying Candida spp. are often too time-consuming and have limited specificity and sensitivity. In this work, we evaluated the diagnostic utility of an endpoint PCR assay (Cand PCR) in vaginal swab specimens. Using a cotton swab, 108 vaginal swab samples were taken from pregnant women who consented to participate in the study. The samples were inoculated in Sabouraud agar plates (the gold standard) and subsequently used to extract DNA directly from the exudate. The yeasts isolated from the Sabouraud agar were identified in CHROMagar™ Candida. DNA extracted from vaginal swabs was amplified by Cand PCR. Based on the results of the Cand PCR and the gold standard, sensitivity (S), specificity (E), positive predictive values (PPVs), and negative predictive values (NPVs) were determined. Cand PCR presented an S = 65%, E = 100%, PPV = 100% and NPV = 91%. Cand PCR showed low sensitivity for detecting Candida spp. directly from vaginal swabs, but it was useful for identifying the etiologic agent and reducing the time to obtain the result, which is usually at least 48 h.
The Representational Challenge of Integration and Interoperability in Transformed Health Ecosystems
Authors: Blobel Bernd , Oemig Frank , Ruotsalainen Pekka , Brochhausen Mathias , Sexton Kevin W. , Giacomini Mauro
Published: December 2024

Background/Objectives: Health and social care systems around the globe are currently undergoing a transformation towards personalized, preventive, predictive, participative precision medicine (5PM), considering the individual health status, conditions, genetic and genomic dispositions, etc., in personal, social, occupational, environmental, and behavioral contexts. This transformation is strongly supported by technologies such as micro- and nanotechnologies, advanced computing, artificial intelligence, edge computing, etc. Methods: To enable communication and cooperation between actors from different domains using different methodologies, languages, and ontologies based on different education, experiences, etc., we have to understand the transformed health ecosystem and all its components in terms of structure, function and relationships in the necessary detail, ranging from elementary particles up to the universe. In this way, we advance design and management of the complex and highly dynamic ecosystem from data to knowledge level. The challenge is the consistent, correct, and formalized representation of the transformed health ecosystem from the perspectives of all domains involved, representing and managing them based on related ontologies. The resulting business viewpoint of the real-world ecosystem must be interrelated using the ISO/IEC 21838 Top Level Ontologies standard. Thereafter, the outcome can be transformed into implementable solutions using the ISO/IEC 10746 Open Distributed Processing Reference Model. Results: The model and framework for this system-oriented, architecture-centric, ontology-based, policy-driven approach have been developed by the first author and meanwhile standardized as ISO 23903 Interoperability and Integration Reference Architecture. The formal representation of any ecosystem and its development process including examples of practical deployment of the approach, are presented in detail. This includes correct systems and standards integration and interoperability solutions. A special issue newly addressed in the paper is the correct and consistent formal representation Conclusions: of all components in the development process, enabling interoperability between and integration of any existing representational artifacts such as models, work products, as well as used terminologies and ontologies. The provided solution is meanwhile mandatory at ISOTC215, CEN/TC251 and many other standards developing organization in health informatics for all projects covering more than just one domain.
The Impact of Sentiment on Realized Higher-Order Moments in the S&P 500: Evidence from the Fear and Greed Index
Authors: Ahadzie Richard Mawulawoe , Owusu Junior Peterson , Woode John Kingsley
Published: December 2024

This study empirically investigates the relationship between realized higher-order moments and the Fear and Greed Index as a measure of sentiments. We estimate daily realized moments using 5 min return data of the S&P 500 index from 3 January 2011 to 18 September 2020. We find that the Fear and Greed Index significantly impacts realized volatility during periods of extreme fear. Additionally, various sentiment indicators influence realized skewness and realized kurtosis. The VIX index significantly reduces realized skewness across all sentiment levels. Bearish and bullish sentiments have a significant negative relationship with negative realized skewness during periods of extreme fear and extreme greed. However, the Fear and Greed Index and bearish and bullish sentiments have a significant positive relationship with positive realized skewness. During extreme fear, the Fear and Greed Index and bearish and bullish sentiments have a significant negative relationship with realized kurtosis. These results remain consistent when considering the non-linear characteristics of the Fear and Greed Index during periods of extreme fear and extreme greed. These findings highlight the relevance of understanding sentiment in financial risk management and its significant relationship with the asymmetric and extremity characteristics of asset returns.
Bioremediation of Soil Contamination with Polycyclic Aromatic Hydrocarbons—A Review
Authors: Rusănescu Carmen Otilia , Istrate Irina Aura , Rusănescu Andrei Marian , Constantin Gabriel Alexandru
Published: December 2024

Polycyclic aromatic hydrocarbons (PAHs) are considered hazardous pollutants due to their negative impact on the environment and human health. PAHs can accumulate and be retained in the soil, so PAH pollution is a worldwide problem. This review paper highlights the sources of PAH soil pollution, factors affecting the bioavailability of PAHs in soil, and soil bioremediation methods, as well as the advantages and limitations of the application of these methods. Aspects regarding the impact of the application of surfactants are presented in order to obtain good bioavailability during PAH bioremediation. Bioremediation techniques of soil polluted by these hydrocarbons are addressed: phytoremediation, rhizoremediation, composting, vermiremediation, micoremediation, and electrokinetic bioremediation of PAH-polluted soils. A comprehensive overview of bioremediation technologies for PAH-polluted soils is needed so that the right soil remediation technology is chosen. It has been observed the bioremediation of contaminated soils through rhizoremediation proved to be an effective process, the future of organic pollutants in interaction with plants and microbes must be researched. Vermiremediation, electrokinetic bioremediation, and microcomposting are effective processes for treating soils in situ. Phytoremediation is a sustainable and ecological method of PAH depollution. It improves soil fertility by releasing different organic matter in the soil, and it can be applied on a large scale.
The Prevalence of Accommodative and Binocular Dysfunctions in Children with Reading Difficulties
Authors: Ceple Ilze , Svede Aiga , Serpa Evita , Kassaliete Evita , Volberga Liva , Mikelsone Rita , Berzina Asnate , Ganebnaya Angelina , Krauze Linda , Krumina Gunta
Published: December 2024

Uncorrected refractive error and unsatisfactory performance on several clinical accommodation and binocular vision tests are more common in children who struggle with reading. The aim of the current study is to explore the prevalence of accommodative and binocular dysfunctions in children with and without reading difficulties. Reading performance was assessed with the Acadience Reading (formerly DIBELS Next) test adjusted and validated for the Latvian language. Children with (N = 39) and without (N = 43) reading difficulties underwent thorough assessment of their subjective refraction, as well as binocular and accommodation functions. The results demonstrate no difference in the prevalence of complaints between children with and without reading difficulties (26% and 23%, respectively). However, children with reading difficulties more frequently present with significant uncorrected refractive errors and/or accommodative and binocular dysfunctions than children without reading difficulties (69% and 47%, respectively). According to the findings, even in cases where a child does not exhibit any ocular or visual complaints, a comprehensive visual function evaluation should be required for any child who struggles with reading.
Investigations on Beekeeping and Breeding of Apis cerana in China
Authors: Qu Xinying , Zhang Xinru , Zhang Guiqian , Qin Hanrong , Zhang Huixia , Tian Huiyu , Chen Xiao
Published: December 2024

The worldwide value of the honey bee as an agricultural animal is increasingly being recognized. Not only does the honey bee directly produce useful agricultural products, but also large portions of crops are dependent on the pollination activities of honey bees. Apis cerana (A. cerana), the native honey bee of China, is widely distributed in the country. Studying the biological environment and colony management of A. cerana is important for its conservation and breeding. This study investigated the apiculture of A. cerana among a total of 201 beekeepers in the eastern, southern, northwestern and central regions of China and conducted data analysis on the surveyed data. The results showed that the most favorite traits for beekeepers are colony size, colony health and honey production. Compared with Apis mellifera ligustica, A. cerana is more adaptable to low temperature and scattered nectar sources. The results help to optimize the breeding programs of A. cerana and further contribute to substantive breeding accomplishments with honey bees which have enhanced their role in modern agriculture.
Forging-Submerged Arc Additive Hybrid Manufacturing of the Mn-Mo-Ni Component: In Situ Reheat Cycles Inducing the Homogenization of the HAZ Microstructure
Authors: Chi Qiang , Hu Meijuan , Wang Jun , Yan Shuai , Xue Manye , Wu Shaojie , Cheng Fangjie
Published: December 2024

Forging additive hybrid manufacturing integrated the high efficiency of forging and the great flexibility of additive manufacturing, which has significant potential in the construction of reactor pressure vessels (RPVs). In the components, the heat-affected zone (HAZ, also called as bonding zone) between the forged substrate zone and the arc deposition zone was key to the final performance of the components. In this study, the Mn-Mo-Ni welding wire was deposited on the 16MnD5 substrate with a submerged arc heat source. The in situ reheat cycle effect of the submerged arc heat source on the microstructure and mechanical properties of the HAZ were studied. The results showed that the HAZ underwent four heat treatment processes, including two full austenitizing stages, one high-temperature stage, and continuous low-temperature tempering, which formed a homogenized microstructure in the HAZ and was mainly composed of tempered sorbite (Tempered-S). The HAZ microhardness is around 278.7 HV, which is about 150 HV lower than the microhardness only conducted by one thermal cycle. Furthermore, the effects of preheating the substrate and adjusting the heat inputs on the HAZ were studied. The results indicated that the clustered cementite was precipitated, which destroys the low-temperature impact toughness of the HAZ after preheating. A suitable heat input not only homogenized the microstructure within the HAZ but also promoted the transformation of grains into equiaxed grains. The −60 °C impact toughness of the HAZ was significantly increased from 96.7 J to 113 J.
Corona Poling Enabling Gravure Printing of Electroactive Flexible PVDF-TrFE Devices
Authors: Sico Giuliano , Montanino Maria , Loffredo Fausta , Borriello Carmela , Miscioscia Riccardo
Published: December 2024

Polyvinylidene fluoride (PVDF)-based materials are the most researched polymers in the field of energy harvesting. Their production in thin-film form through printing technologies can potentially offer several manufacturing and performance advantages, such as low-cost, low-temperature processing, use of flexible substrates, custom design, low thermal inertia and surface-scaling performance. However, solution-based processes, like printing, miss fine control of the microstructure during film-forming, making it difficult to achieve a high level of polarization, necessary for PVDF to exhibit electroactive characteristics. Here, corona treatment is investigated for the poling of gravure-printed polyvinylidene fluoride–trifluoroethylene (PVDF-TrFE) films, as a particularly suitable poling method for printing since it is rapid, contactless and scalable, and no metal electrodes are required. Effects of corona conditioning on the functional properties of the printed films were examined and discussed. Electroactive properties of corona-poled printed films improved manyfold when they were treated at 9 kV, near room temperature (30 °C) and using very short treatment time (30 s). In particular, piezoelectric and pyroelectric coefficients improved tenfold and by two orders of magnitude, respectively. Considering the upscaling potential of roll-to-roll gravure printing and corona poling, combined with the area-scaling performance of thin-film-based generators, our results can enable the corona-printing process for mass production of future electroactive flexible PVDF-based devices.
Experimental Determination of the Equivalent Moment of Inertia and Stresses of Aluminium Profiles with Thermal Breaks
Authors: Rusin Dawid , Juraszek Janusz , Woźniczka Piotr
Published: December 2024

This paper presents the results of experimental tests and computer simulations on the stiffness of composite aluminium mullions used in unitised façades. The elements analysed were subjected to bending in order to simulate the actual operating conditions of aluminium façades subjected to significant wind pressure or suction loads. The basic mechanical and physical properties of the materials from which the analysed type of aluminium façade is made (Aluminium EN AW-6060 in the T66 temper and polyamide PA66 25GF), the test method, and the results obtained are described. As a result of the tests, equivalent moments of inertia of the composite profile (aluminium profile with the thermal break) were determined, which are strongly dependent on the strength of the connection between the individual elements, the asymmetry of the cross-section, and the properties of the thermal break. Strain measurements carried out using FBG (Fiber Bragg Grating) strain sensors installed in the profiles under tests allowed for determining the actual stress values of the aluminium profiles under consideration. The results obtained were compared to theoretical (numerical) values, indicating discrepancies at higher load values. The methodology presented in this article is to be used to monitor the deformation of the aluminium façade mullions of HRB (High-Rise Buildings).
The Effects of Nitrogen Alloying on the Microstructure and Properties of Cu-Bearing Antimicrobial Stainless Steel
Authors: Tu Yuguo , Peng Wei , Chen Liujie , Xiao Xueshan
Published: December 2024

In this study, a novel Cu-bearing 304 stainless steel doped with 4.0 wt.% Cu (304-Cu SS) was developed, and the effects of nitrogen microalloying (304N-Cu SS) and heat treatment on mechanical, antibacterial, and corrosion properties were investigated. It was found that when aging at 700 °C, the Vickers hardness and strength of the 304N-Cu SS first significantly increased with increasing aging time up to 4 h and then slowly decreased with further increase in aging time. The best combination of strength and ductility, namely, a yield strength of 319 MPa, ultimate tensile strength of 657 MPa, and elongation to fracture of 47.0%, was achieved in the 304N-Cu SS after aging at 700 °C for 6 h. Moreover, the antibacterial and corrosion rates of the newly developed 304N-Cu SS reached 99.67% and 0.0032 g·m−2h−1, surpassing those of 304-Cu SS by 0.38% and 9.4%, respectively. These enhancements in the mechanical, antibacterial, and corrosion properties were attributed to the precipitation of high-density nanoscale Cu-rich precipitates during aging. Our results demonstrate that nitrogen microalloying is an effective metallurgical method for the future development of new antibacterial austenitic stainless steels with simultaneously enhanced mechanical, antibacterial, and corrosion properties for direct drinking water distribution systems.