bluuebunny/crossref_metadata_2025 huggingface dataset:
Glucose Homeostasis, Diabetes Mellitus, and Gender-Affirming Treatment
Authors: Milionis Charalampos , Ilias Ioannis , Venaki Evangelia , Koukkou Eftychia
Published: February 2023

The transgender (trans) population includes individuals with gender identities more fittingly aligned with the opposite sex or with an alternative that transcends the classical dipole of male/female. Hormonal treatment in transgender individuals aims to suppress the secretion of endogenous sex steroids and replace them with the steroids of the desired gender. The mainstay of gender-affirming treatment in transgender males is testosterone, whereas for transgender females it is estrogen, usually combined with an anti-androgen or a gonadotropin-releasing hormone agonist if testes are present. Testosterone and estrogen are involved in carbohydrate metabolism via direct effects on skeletal muscle, liver, adipose tissue, and immune cells and indirectly through changes in body fat mass and distribution. The effect of transgender treatment on glucose tolerance is not clear. The provided conflicting results demonstrate a positive, neutral, or even negative association between exogenous testosterone and insulin sensitivity in trans men. Studies show that feminizing hormonal therapy of trans women has mainly an aggravating effect on insulin sensitivity. The existing evidence is not robust and further research is needed to investigate the relationships between body fat distributions, muscle mass, and glycemia/insulin resistance in transgender people under hormonal therapy.
Localization Strategy Prior to Radiofrequency Ablation for Primary and Secondary Hyperparathyroidism
Authors: Lee Chih-Ying , Chang Yen-Hsiang , Chiang Pi-Ling , Wang Cheng-Kang , Lin An-Ni , Chen Chi-Cheng , Chen Yi-Fan , Chi Shun-Yu , Chou Fong-Fu , Lin Wei-Che
Published: February 2023

Objective: Preoperative localization in patients with primary or secondary hyperparathyroidism before radiofrequency ablation (RFA) is crucial. There is currently a lack of consensus regarding imaging protocol. Evaluating the diagnostic performance of ultrasound, four-dimensional computed tomography (4D-CT), and technetium 99m-sestamibi single-photon-emission-computed tomography/computed tomography (SPECT/CT) is necessary for RFA of hyperparathyroidism. Methods: This retrospective study recruited patients with primary or secondary hyperparathyroidism who underwent ultrasound, 4D-CT, and SPECT/CT before RFA at a single institution. The sensitivity, accuracy, and receiver operating characteristic curve analysis were used to evaluate the diagnostic performance of the imaging modalities. Results: A total of 33 patients underwent RFA for hyperparathyroidism (8 patients with primary hyperparathyroidism, 25 patients with secondary hyperparathyroidism). Ultrasound had the highest sensitivity (0.953) and accuracy (0.943), while 4D-CT had higher sensitivity and accuracy than SPECT/CT (sensitivity/accuracy, 4D-CT vs. SPECT/CT: 0.929/0.920 vs. 0.741/0.716). Combined ultrasound with 4D-CT and the three combined modalities achieved equivalent, and the highest, diagnostic performance (sensitivity 1.000, accuracy 0.989). The lesion length and volume were important predictors of the diagnostic performance of 4D-CT and SPECT/CT (area under curve of length in 4D-CT/volume in 4D-CT/length in SPECT/volume in SPECT: 0.895/0.834/0.767/0.761). Conclusion: Combined ultrasound with 4D-CT provides optimal preoperative localization prior to RFA in patients with primary or secondary hyperparathyroidism. The length and volume of parathyroid lesions are determinative of the diagnostic performance of 4D-CT and SPECT/CT.
With or without the Mask: Age Differences in Perceived Trustworthiness and Health during the COVID-19 Pandemic
Authors: Di Crosta Adolfo , Ceccato Irene , Bartolini Emanuela , La Malva Pasquale , Gatti Matteo , D’Intino Eleonora , Cannito Loreta , Marin Anna , Palumbo Riccardo , Mammarella Nicola , Di Domenico Alberto , Palumbo Rocco
Published: February 2023

The COVID-19 pandemic and the obligation to wear surgical face masks have affected social interactions. Wearing a mask can cause impairments in face identification, emotion recognition, and trait impressions. The present study investigated, during the COVID-19 period, age-related differences in perceived trustworthiness (Study 1) and health (Study 2) when viewing faces with or without masks. Younger (YAs, 18–35 years) and older (OAs, over 65 years) adults’ ratings were compared. Through a web-based platform, a series of neutral younger and older faces (YFs vs. OFs) were presented, on a computer screen, with or without a mask (Mask vs. No-Mask), and participants were asked to rate them on a 7-point scale. Furthermore, data collected during the pandemic (Mask and No-Mask conditions) were compared with ratings obtained before it (Pre-COVID condition). Perceived trustworthiness was lower in the No-Mask condition for both age groups compared to Mask and Pre-COVID conditions, which did not differ. For health ratings, no differences emerged for OAs between the conditions, whereas YAs’ ratings were lower in both the Mask and No-Mask conditions compared to the Pre-COVID condition. The fear of contracting COVID-19 affected both trustworthiness and health ratings. Wearing a surgical face mask affects trait impressions for YAs and OAs, partly due to the fear of COVID-19. Trait impressions are also influenced by the age of the face to be evaluated.
Possible Application of Computed Tomography for Numerical Simulation of the Damage Mechanism of Cementitious Materials—A Method Review
Authors: Kaczmarczyk Grzegorz Piotr , Cała Marek
Published: February 2023

Modeling the meso-scale behavior of a material allows one to answer many problems in an inductive reasoning approach. By simulating the behavior of the sample, researchers can correct the overall behavior of the material. The purpose of this article was to gather the main information linking the issue of tomographic imaging to the modeling of damage mechanisms. This paper addresses the topic of meso-scale modeling of cementitious materials. The authors have mapped the interconnectedness of the issues of cementitious materials and X-ray computed tomography (µCT) according to the Web of Science database. The main interconnecting threads are indicated. The authors focused on the use of µCT. The theoretical basis for conducting tomographic measurements is presented. Reference was made to the basics of physics and mathematics in X-ray projection and data reconstruction. Tools and analyses for data processing are indicated. The benefits of in situ µCT are indicated with reference to the practical application of the method. In addition, the main developments of recent years in the most widely used computational methods for meso-scale models are presented.
Asymmetric Cantilever Construction Control of a U-Shaped Box Concrete Continuous Bridge in Complex Environment
Authors: Zhou Haijun , Qi Xuan , Liu Zhidong , Xue Wuqiang , Sun Jiuchun , Liu Jian , Gui Songbai , Yang Xia
Published: February 2023

The bridge of Shanghai Metro Line 10 over Metro Line 6 is a U-shaped concrete single-box double-cell concrete box beam continuous bridge. A novel method is applied to construct the asymmetric cantilever prefabricated and assembled continuous bridge due to the limited construction space and the complex environment. Four mechanical state control methods are applied during the T-shape structure construction process: tensioning pre-stressed steel strand, jacking by the axial force servo system, adjusting the leg reaction force, and setting the auxiliary leg. Auxiliary measures such as the compressive column, side-span counterweight, and temporary pre-stressing are also taken into consideration. The finite element method simulations are performed to measure effects of the four control methods during the construction process. The front leg force of the bridge erection machine and the deflection of the bridge are then monitored. It was deduced that the simulated and measured values of the cantilever T-shape structure are controlled within the limit range during the construction process.
Body Adiposity Partially Mediates the Association between FTO rs9939609 and Lower Adiponectin Levels in Chilean Children
Authors: Ochoa-Rosales Carolina , Mardones Lorena , Villagrán Marcelo , Aguayo Claudio , Martorell Miquel , Celis-Morales Carlos , Ulloa Natalia
Published: February 2023

Children carrying the minor allele ‘A’ at the fat mass and obesity-associated protein (FTO) gene have higher obesity prevalence. We examined the link between FTO rs9939609 polymorphism and plasma adiponectin and the mediating role of body adiposity, in a cross-sectional study comprising 323 children aged 6–11 years. Adiponectin and FTO genotypes were assessed using a commercial kit and a real-time polymerase chain reaction with high-resolution melting analysis, respectively. Body adiposity included body mass index z-score, body fat percentage and waist-to-hip ratio. To investigate adiponectin (outcome) associations with FTO and adiposity, linear regressions were implemented in additive models and across genotype categories, adjusting for sex, age and Tanner’s stage. Using mediation analysis, we determined the proportion of the association adiponectin-FTO mediated by body adiposity. Lower adiponectin concentrations were associated with one additional risk allele (βadditive = −0.075 log-μg/mL [−0.124; −0.025]), a homozygous risk genotype (βAA/TT = −0.150 [−0.253; −0.048]) and a higher body mass index z-score (β = −0.130 [−0.176; −0.085]). Similar results were obtained for body fat percentage and waist-to-hip ratio. Body adiposity may mediate up to 29.8% of the FTO-adiponectin association. In conclusion, FTO rs9939609-related differences in body adiposity may partially explain lower adiponectin concentrations. Further studies need to disentangle the biological pathways independent from body adiposity.
Associations between Force-Time Related Single-Leg Counter Movement Jump Variables, Agility, and Linear Sprint in Competitive Youth Male Basketball Players
Authors: Pamuk Ömer , Makaracı Yücel , Ceylan Levent , Küçük Hamza , Kızılet Tuba , Ceylan Tülay , Kaya Erdi
Published: February 2023

Background: Previous research has reported a strong relationship between vertical jumping, sprinting, and agility, as a reflection of lower-limb power. Unilateral analysis of this relationship has not yet been explored. This study primarily investigated the associations between single-leg countermovement jump (CMJ), sprint, and agility performances in youth basketball players. Methods: Thirty-five male basketball players from the youth category (age 15.06 ± 2.62 years, n = 32 right-limb dominant; n = 3 left-limb dominant) performed single-leg CMJ, 20 m sprint, and T-drill agility tests over two sessions. Force–time-related performance variables were measured using a single-leg CMJ test on a Kistler force plate. Results: Significant moderate to large negative correlations were observed between single-leg CMJ variables, 20 m sprint, and T-drill agility, except for mean force for both dominant and non-dominant leg measures (r = −0.384 to −0.705). Mean power and mean force were correlated with the physical characteristics of the athletes for both legs (r = −0.389 to −0.843). Flight time and jump height were identified as the best predictor variables for both sprint and agility time in the stepwise model (R2 = 0.608 to 0.660). No statistical inter-limb differences were found during the single-leg CMJ test (p > 0.05). Conclusions: The study findings suggest that youth basketball players with greater single-leg jump output most likely have better sprint and agility performances. Thus, trainers and athletic performance coaches may include unilateral limb exercises in their training programs to enhance lower-limb explosive performance and reduce limb asymmetries.
Food Allergies and Quality of Life among School-Aged Children and Adolescents: A Systematic Review
Authors: Drakouli Artemis-Eirini , Kontele Ioanna , Poulimeneas Dimitrios , Saripanagiotou Stella , Grammatikopoulou Maria G. , Sergentanis Theodoros N. , Vassilakou Tonia
Published: February 2023

Recently, besides the focus on the medical diagnosis and therapeutic interventions for food allergy (FA), the psychosocial aspects of this frequent condition have also been investigated. The current systematic review aimed to explore and synthesize the scientific evidence published from January 2015 to April 2022 on Health-Related Quality of Life (HRQoL) among children and adolescents with FAs. Twenty-eight research studies were included in the review, which was conducted on three databases (PubMed, Scopus and Cochrane Library). In most studies, the scores indicate an average level of HRQoL for children and adolescents with FAs, with girls and older children being more negatively affected than boys and younger ones, respectively. Few studies compared HRQoL between children with FA and healthy children, with 3 of them showing worse HRQoL for children with FAs. Immunotherapy has been found to improve the QoL of children with FAs. Anaphylaxis history, number of FAs, additional allergies, number and severity of symptoms were identified as the main factors with a negative impact on QoL. More comparative studies on the HRQoL of children and adolescents with FAs and healthy populations or children with other chronic diseases are required in order to improve QoL of children with FAs.
Role of Maternal and Child Health Handbook on Improving Maternal, Newborn, and Child Health Outcomes: A Systematic Review and Meta-Analysis
Authors: Nishimura Etsuko , Rahman Md Obaidur , Ota Erika , Toyama Noriko , Nakamura Yasuhide
Published: February 2023

The objective of this review is to assess and synthesize the role of the maternal and child health (MCH) handbook on improving healthcare service utilization, behavior change, and health outcomes for women and children. A systematic search of all relevant existing reports was conducted on 14 January 2021, using the following online bibliographic databases: PubMed, EMBASE, MEDLINE, The Cochrane Library, Academic Search Premier, Emcare, APA PsycINFO, and Web of Science. Two reviewers independently performed study selection, data extraction, and quality assessment. We included 7 trials from 1430 articles, and a total of 2643 women. As overall risk of bias assessment, most domains of the Cochrane risk-of-bias assessment tool showed a high or unclear risk of bias. The risk of ≥6 antenatal care (ANC) visits was 19% higher (RR 1.19, 95% CI 1.09 to 1.30, I2 = 47%, 2 studies, 955 women, moderate certainty of evidence) and skilled birth attendants during delivery was 13% higher (RR 1.13, 95% CI 1.04 to 1.24, I2 = 0%, 2 studies, 1094 women, low certainty of the evidence) in the intervention group than in the control group. The MCH handbook can increase maternal health service utilization and early breastfeeding practice. It also leads to a sense of autonomy during ANC, better communication with healthcare providers, and support from family members.
A Survey of Saudi General Practitioners on the Use of Thromboprophylaxis Guidelines and Risk Assessment Tools in Atrial Fibrillation
Authors: Alnami Mohammed Ibrahim , Alsalim Ali Mansoor , Alhakeem Ruwaida Faisal , Al-Somali Bushra Abdulrahman , Bahkali Haitham Ali , Alhabshi Hanaa Ali , Alotaibi Hailah Talaq , Alqallaf Rahma Abdulrazzaq , Ali Sheraz
Published: February 2023

Clinical practice guidelines advise patients with atrial fibrillation who are at risk for stroke to undergo thromboprophylaxis with oral anticoagulants. However, it is noted that guidelines are not always followed. We sought to learn how Saudi Arabian general practitioners (GPs) self-reported using risk assessment tools and atrial fibrillation clinical practice guidelines created by cardiology associations, as well as how GPs felt about the resources that were available. Through the use of a self-administered questionnaire, we carried out a cross-sectional survey. A total of two-hundred GPs participated in the study. The guidelines were frequently used when a clinical decision regarding anticoagulation therapy appeared difficult (n = 57, 28.4%). The most predominant strengths of participants’ chosen clinical guidelines were clear recommendations (n = 56, 27.9%), easy-to-follow algorithms (n = 39, 16.9%), detailed recommendations supported by evidence (n = 34, 16.9%), and online availability (n = 27, 13.4%). Many respondents said they used a formal stroke risk assessment tool in addition to their clinical judgment as a GP for most decisions (60%). Most respondents preferred using the CHA2DS2-VASc (n = 106, 52.7%), CHA2DS2-VA (n = 45, 22.4%), CHADS2 (n = 35, 17.4%), and GARFIELD (n = 14, 7.0%). HAS-BLED (n = 100, 49.8%) and HEMORR2HAGES (n = 50, 24.9%) were the most frequently utilized formal tools for assessing the risk of bleeding among GPs. Over half of the participants referred to guidelines when deciding thromboprophylaxis in patients with atrial fibrillation. Additionally, many respondents used formal procedures for assessing the risks of bleeding and stroke in addition to their clinical judgement in their roles as GPs. The guideline was assessed as being extremely helpful overall by GPs who used it to make thromboprophylaxis decisions.
Consumer Behavior, Skin Phototype, Sunscreens, and Tools for Photoprotection: A Review
Authors: Reis-Mansur Maria Cristina Pinheiro Pereira , da Luz Beatriz Gonçalves , dos Santos Elisabete Pereira
Published: February 2023

Sunscreens and photoprotection tools along with consumer habits and behaviors, can mitigate the skin damage caused by excessive solar radiation. For example, protecting oneself in the shade, avoiding inadequate sun exposure at times of higher incidence of UVB radiation (between 10:00 a.m. and 4:00 p.m.), wearing clothes with sun protection factors, applying sunscreens at the correct amounts and intervals, and wearing glasses with anti-UVA and UVB lenses are effective measures for protecting an individual. Therefore, the objective of this review was to highlight the importance of photoprotection for all skin phototypes, as skin cancer is a worldwide public health problem. In this review of the scientific literature on the Scopus platform between 2015 and 2022, we addressed the most common behaviors among different individuals and their phototypes, the importance of clarifying population habits against solar radiation, and the use of sunscreens and photoprotection tools to provide advice on healthy and safe sun exposure.
Tumor-Infiltrating Immune Cell Landscapes in the Lymph Node Metastasis of Papillary Thyroid Cancer
Authors: Amanullah Md , Pan Meidie , Lu Kaining , Pan Xiaoqing , Lu Yan , Luo Dingcun , Liu Pengyuan
Published: February 2023

Regional lymph node metastasis (LNM) increases the risk of distant metastasis in papillary thyroid cancer (PTC) patients. However, it remains unclear how tumor cells in PTC patients with LNM evade immune system surveillance and proceed to colonize distant organs. Here, we comprehensively characterize the tumor-infiltrating immune cell landscape in PTC with LNM. LNM-related genes include multiple important soluble mediators such as CXCL6, IL37, MMP10, and COL11A1, along with genes involved in areas such as extracellular matrix organization and TLR regulation by endogenous ligands. In PTC without LNM, the tumor infiltration of activated dendritic cells and M0 macrophages showed increases from normal cells, but with yet greater increases and correspondingly worse prognosis in PTC with LNM. Conversely, the tumor infiltration of activated NK cells and eosinophils was decreased in PTC without LNM, as compared to normal cells, and yet further decreased in PTC with LNM, with such decreases associated with poor prognosis. We further demonstrate that mutations of driver genes in tumor cells influence the infiltration of surrounding immune cells in the tumor microenvironment (TME). Particularly, patients carrying TG mutations tend to show increased filtration of M2 macrophages and activated NK cells in the TME, whereas patients carrying HRAS mutations tend to show reduced filtration of M0 macrophages and show enhanced filtration of activated dendritic cells in the TME. These findings increase our understanding of the mechanisms of regional lymph node metastasis in PTC and its associated tumor microenvironment, potentially facilitating the development of personalized treatment regimens to combat immunotherapy failure.
Survival Benefit of Surgical Treatment for Elderly Patients with Intrahepatic Cholangiocarcinoma: A Retrospective Cohort Study in the SEER Database by Propensity Score Matching Analysis
Authors: Chen Kaiyu , Yu Haitao , Yang Jinhuan , Bo Zhiyuan , Jin Chen , Wu Lijun , Wang Yi , Chen Gang
Published: February 2023

Despite a rising trend in intrahepatic cholangiocarcinoma (ICC) incidence in the elderly population worldwide, the benefit of surgery for those patients is still controversial. Data from 811 elderly patients diagnosed with non-metastatic ICC were obtained from the US surveillance, epidemiology, and end results (SEER) program database. Propensity score matched (PSM) was conducted for the better balance of baseline. The associations between tumor characteristics and surgery with overall survival (OS) and cancer specific survival (CSS) were estimated using hazard ratios (HR) and 95% confidence intervals (CI). The results showed that ICC patients above 60 years old taking surgery had better OS (hazard ratio [HR], 0.258; 95% CI, 0.205–0.324) and CSS (hazard ratio [HR], 0.239; 95% CI, 0.188–0.303) than patients without surgery. Similar trends in patients above 65 years old, above 70 years old, above 75 years old, and above 80 years old were observed, separately. This benefit was also showed in lymph node-negative (N0) and lymph node-positive (N1) subgroups and N0 patients are more likely to take an advantage from surgery than N1 patients. The different outcomes between surgery and non-surgery suggest that surgical treatment may be recommended for elderly ICC if the tumor is resectable to ensure optimal treatment.
Prognostic Value of Sarcopenia and Metabolic Parameters of 18F-FDG-PET/CT in Patients with Advanced Gastroesophageal Cancer
Authors: Hinzpeter Ricarda , Mirshahvalad Seyed Ali , Kulanthaivelu Roshini , Murad Vanessa , Ortega Claudia , Metser Ur , Liu Zhihui Amy , Elimova Elena , Wong Rebecca K. S. , Yeung Jonathan , Jang Raymond W. , Veit-Haibach Patrick
Published: February 2023

We investigated the prognostic value of sarcopenia measurements and metabolic parameters of primary tumors derived from 18F-FDG-PET/CT among patients with primary, metastatic esophageal and gastroesophageal cancer. A total of 128 patients (26 females; 102 males; mean age 63.5 ± 11.7 years; age range: 29–91 years) with advanced metastatic gastroesophageal cancer who underwent 18F-FDG-PET/CT as part of their initial staging between November 2008 and December 2019 were included. Mean and maximum standardized uptake value (SUV) and SUV normalized by lean body mass (SUL) were measured. Skeletal muscle index (SMI) was measured at the level of L3 on the CT component of the 18F-FDG-PET/CT. Sarcopenia was defined as SMI < 34.4 cm2/m2 in women and <45.4 cm2/m2 in men. A total of 60/128 patients (47%) had sarcopenia on baseline 18F-FDG-PET/CT. Mean SMI in patients with sarcopenia was 29.7 cm2/m2 in females and 37.5 cm2/m2 in males. In a univariable analysis, ECOG (<0.001), bone metastases (p = 0.028), SMI (p = 0.0075) and dichotomized sarcopenia score (p = 0.033) were significant prognostic factors for overall survival (OS) and progression-free survival (PFS). Age was a poor prognostic factor for OS (p = 0.017). Standard metabolic parameters were not statistically significant in the univariable analysis and thus were not evaluated further. In a multivariable analysis, ECOG (p < 0.001) and bone metastases (p = 0.019) remained significant poor prognostic factors for OS and PFS. The final model demonstrated improved OS and PFS prognostication when combining clinical parameters with imaging-derived sarcopenia measurements but not metabolic tumor parameters. In summary, the combination of clinical parameters and sarcopenia status, but not standard metabolic values from 18F-FDG-PET/CT, may improve survival prognostication in patients with advanced, metastatic gastroesophageal cancer.
Current Perspectives on Periodontitis in Systemic Sclerosis: Associative Relationships, Pathogenic Links, and Best Practices
Authors: Ciurea Andreea , Rednic Nicolae Voicu , Soancă Andrada , Micu Iulia Cristina , Stanomir Alina , Oneț Diana , Șurlin Petra , Filipescu Ileana , Roman Alexandra , Stratul Ștefan Ioan , Pamfil Cristina
Published: February 2023

Systemic sclerosis is a chronic, autoimmune, multisystemic disease characterized by aberrant extracellular matrix protein deposition and extreme progressive microvasculopathy. These processes lead to damage within the skin, lungs, or gastrointestinal tract, but also to facial changes with physiognomic and functional alterations, and dental and periodontal lesions. Orofacial manifestations are common in SSc but are frequently overshadowed by systemic complications. In clinical practice, oral manifestations of SSc are suboptimally addressed, while their management is not included in the general treatment recommendations. Periodontitis is associated with autoimmune-mediated systemic diseases, including systemic sclerosis. In periodontitis, the microbial subgingival biofilm induces host-mediated inflammation with subsequent tissue damage, periodontal attachment, and bone loss. When these diseases coexist, patients experience additive damage, increasing malnutrition, and morbidity. The present review discusses the links between SSc and periodontitis, and provides a clinical guide for preventive and therapeutical approaches in the management of these patients.
XGBoost-Based Simple Three-Item Model Accurately Predicts Outcomes of Acute Ischemic Stroke
Authors: Chung Chen-Chih , Su Emily Chia-Yu , Chen Jia-Hung , Chen Yi-Tui , Kuo Chao-Yang
Published: February 2023

An all-inclusive and accurate prediction of outcomes for patients with acute ischemic stroke (AIS) is crucial for clinical decision-making. This study developed extreme gradient boosting (XGBoost)-based models using three simple factors—age, fasting glucose, and National Institutes of Health Stroke Scale (NIHSS) scores—to predict the three-month functional outcomes after AIS. We retrieved the medical records of 1848 patients diagnosed with AIS and managed at a single medical center between 2016 and 2020. We developed and validated the predictions and ranked the importance of each variable. The XGBoost model achieved notable performance, with an area under the curve of 0.8595. As predicted by the model, the patients with initial NIHSS score > 5, aged over 64 years, and fasting blood glucose > 86 mg/dL were associated with unfavorable prognoses. For patients receiving endovascular therapy, fasting glucose was the most important predictor. The NIHSS score at admission was the most significant predictor for those who received other treatments. Our proposed XGBoost model showed a reliable predictive power of AIS outcomes using readily available and simple predictors and also demonstrated the validity of the model for application in patients receiving different AIS treatments, providing clinical evidence for future optimization of AIS treatment strategies.
Association of Kinesiophobia with Catastrophism and Sensitization-Associated Symptoms in COVID-19 Survivors with Post-COVID Pain
Authors: Herrero-Montes Manuel , Fernández-de-las-Peñas César , Ferrer-Pargada Diego , Izquierdo-Cuervo Sheila , Abascal-Bolado Beatriz , Valera-Calero Juan Antonio , Paras-Bravo Paula
Published: February 2023

Pain symptoms after the acute phase of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are present in almost 50% of COVID-19 survivors. The presence of kinesiophobia is a risk factor which may promote and perpetuate pain. This study aimed to investigate variables associated with the presence of kinesiophobia in a sample of previously hospitalized COVID-19 survivors exhibiting post-COVID pain. An observational study was conducted in three urban hospitals in Spain, including one hundred and forty-six COVID-19 survivors with post-COVID pain. Demographic (age, weight, height), clinical (intensity and duration of pain), psychological (anxiety level, depressive level, sleep quality), cognitive (catastrophizing), sensitization-associated symptoms, and health-related quality of life variables were collected in 146 survivors with post-COVID pain, as well as whether they exhibited kinesiophobia. Stepwise multiple linear regression models were conducted to identify variables significantly associated with kinesiophobia. Patients were assessed a mean of 18.8 (SD 1.8) months after hospital discharge. Kinesiophobia levels were positively associated with anxiety levels (r: 0.356, p < 0.001), depression levels (r: 0.306, p < 0.001), sleep quality (r: 0.288, p < 0.001), catastrophism (r: 0.578, p < 0.001), and sensitization-associated symptoms (r: 0.450, p < 0.001). The stepwise regression analysis revealed that 38.1% of kinesiophobia variance was explained by catastrophism (r2 adj: 0.329, B = 0.416, t = 8.377, p < 0.001) and sensitization-associated symptoms (r2 adj: 0.381, B = 0.130, t = 3.585, p < 0.001). Kinesiophobia levels were associated with catastrophism and sensitization-associated symptoms in previously hospitalized COVID-19 survivors with post-COVID pain. Identification of patients at a higher risk of developing a higher level of kinesiophobia, associated with post-COVID pain symptoms, could lead to better therapeutic strategies.
Confocal Microscopy for Diagnosis and Management of Cutaneous Malignancies: Clinical Impacts and Innovation
Authors: Atak Mehmet Fatih , Farabi Banu , Navarrete-Dechent Cristian , Rubinstein Gennady , Rajadhyaksha Milind , Jain Manu
Published: February 2023

Cutaneous malignancies are common malignancies worldwide, with rising incidence. Most skin cancers, including melanoma, can be cured if diagnosed correctly at an early stage. Thus, millions of biopsies are performed annually, posing a major economic burden. Non-invasive skin imaging techniques can aid in early diagnosis and save unnecessary benign biopsies. In this review article, we will discuss in vivo and ex vivo confocal microscopy (CM) techniques that are currently being utilized in dermatology clinics for skin cancer diagnosis. We will discuss their current applications and clinical impact. Additionally, we will provide a comprehensive review of the advances in the field of CM, including multi-modal approaches, the integration of fluorescent targeted dyes, and the role of artificial intelligence for improved diagnosis and management.
Effective Coverage in Health Systems: Evolution of a Concept
Authors: Karim Aliya , de Savigny Don
Published: February 2023

The manner in which high-impact, life-saving health interventions reach populations in need is a critical dimension of health system performance. Intervention coverage has been a standard metric for such performance. To better understand and address the decay of intervention effectiveness in real-world health systems, the more complex measure of “effective coverage” is required, which includes the health gain the health system could potentially deliver. We have carried out a narrative review to trace the origins, timeline, and evolution of the concept of effective coverage metrics to illuminate potential improvements in coherence, terminology, application, and visualizations, based on which a combination of approaches appears to have the most influence on policy and practice. We found that the World Health Organization first proposed the concept over 45 years ago. It became increasingly popular with the further development of theoretical underpinnings, and after the introduction of quantification and visualization tools. The approach has been applied in low- and middle-income countries, mainly for HIV/AIDS, TB, malaria, child health interventions, and more recently for non-communicable diseases, particularly diabetes and hypertension. Nevertheless, despite decades of application of effective coverage concepts, there is considerable variability in the terminology used and the choices of effectiveness decay steps included in the measures. Results frequently illustrate a profound loss of service effectiveness due to health system factors. However, policy and practice rarely address these factors, and instead favour narrowly targeted technical interventions.
Bioactive Materials for Caries Management: A Literature Review
Authors: Zhang Olivia Lili , Niu John Yun , Yin Iris Xiaoxue , Yu Ollie Yiru , Mei May Lei , Chu Chun Hung
Published: February 2023

Researchers have developed novel bioactive materials for caries management. Many clinicians also favour these materials, which fit their contemporary practice philosophy of using the medical model of caries management and minimally invasive dentistry. Although there is no consensus on the definition of bioactive materials, bioactive materials in cariology are generally considered to be those that can form hydroxyapatite crystals on the tooth surface. Common bioactive materials include fluoride-based materials, calcium- and phosphate-based materials, graphene-based materials, metal and metal-oxide nanomaterials and peptide-based materials. Silver diamine fluoride (SDF) is a fluoride-based material containing silver; silver is antibacterial and fluoride promotes remineralisation. Casein phosphopeptide-amorphous calcium phosphate is a calcium- and phosphate-based material that can be added to toothpaste and chewing gum for caries prevention. Researchers use graphene-based materials and metal or metal-oxide nanomaterials as anticaries agents. Graphene-based materials, such as graphene oxide-silver, have antibacterial and mineralising properties. Metal and metal-oxide nanomaterials, such as silver and copper oxide, are antimicrobial. Incorporating mineralising materials could introduce remineralising properties to metallic nanoparticles. Researchers have also developed antimicrobial peptides with mineralising properties for caries prevention. The purpose of this literature review is to provide an overview of current bioactive materials for caries management.
Topology Optimization Method of a Cavity Receiver and Built-In Net-Based Flow Channels for a Solar Parabolic Dish Collector
Authors: Liu Jun , Li Renfu , Chen Yuxuan , Zheng Jianguo , Wang Kun
Published: February 2023

The design of a thermal cavity receiver and the arrangement of the fluid flow layout within it are critical in the construction of solar parabolic dish collectors, involving the prediction of the thermal–fluid physical field of the receiver and optimization design. However, the thermal–fluid analysis coupled with a heat loss model of the receiver is a non-linear and computationally intensive solving process that incurs high computational costs in the optimization procedure. To address this, we implement a net-based thermal–fluid model that incorporates heat loss analysis to describe the receiver’s flow and heat transfer processes, reducing computational costs. The physical field results of the net-based thermal–fluid model are compared with those of the numerical simulation, enabling us to verify the accuracy of the established thermal–fluid model. Additionally, based on the developed thermal–fluid model, a topology optimization method that employs a genetic algorithm (GA) is developed to design the cavity receiver and its built-in net-based flow channels. Using the established optimization method, single-objective and multi-objective optimization experiments are conducted under inhomogeneous heat flux conditions, with objectives including maximizing temperature uniformity and thermal efficiency, as well as minimizing the pressure drop. The results reveal varying topological characteristics for different optimization objectives. In comparison with the reference design (spiral channel) under the same conditions, the multi-objective optimization results exhibit superior comprehensive performance.
Cryptanalyzing and Improving an Image Encryption Algorithm Based on Chaotic Dual Scrambling of Pixel Position and Bit
Authors: Zhu Shuqin , Zhu Congxu , Yan Hanyu
Published: February 2023

An image encryption algorithm for the double scrambling of the pixel position and bit was cryptanalyzed. In the original image encryption algorithm, the positions of pixels were shuffled totally with the chaotic sequence. Then, the 0 and 1-bit positions of image pixels were scrambled through the use of another chaotic sequence generated by the input key. The authors claimed that the algorithm was able to resist the chosen-plaintext attack. However, through the analysis of the encryption algorithm, it was found that the equivalent key of the whole encryption algorithm was the scrambling sequence T in the global scrambling stage, the pixel bit level scrambling sequence WT and the diffusion sequence S. The generation of scrambling sequence T is related to the sum of all pixel values of the plaintext image, while the generation of WT and S is not associated with the image to be encrypted. By using a chosen-plaintext attack, these equivalent key streams can be cracked so as to realize the decoding of the original chaotic encryption algorithm. Both theoretical analysis and experimental results verify the feasibility of the chosen-plaintext attack strategy. Finally, an improved algorithm was proposed to overcome the defect, which can resist the chosen-plaintext attack and has the encryption effect of a “one time pad”.
Finite-Time H∞ Control for Time-Delay Markovian Jump Systems with Partially Unknown Transition Rate via General Controllers
Authors: Liu Xikui , Guo Xinye , Liu Wencheng , Li Yan
Published: February 2023

This paper deals with the problems of finite-time boundedness (FTB) and H∞ FTB for time-delay Markovian jump systems with a partially unknown transition rate. First of all, sufficient conditions are provided, ensuring the FTB and H∞ FTB of systems given by linear matrix inequalities (LMIs). A new type of partially delay-dependent controller (PDDC) is designed so that the resulting closed-loop systems are finite-time bounded and satisfy a given H∞ disturbance attenuation level. The PDDC contains both non-time-delay and time-delay states, though not happening at the same time, which is related to the probability distribution of the Bernoulli variable. Furthermore, the PDDC is extended to two other cases; one does not contain the Bernoulli variable, and the other experiences a disordering phenomenon. Finally, three numerical examples are used to show the effectiveness of the proposed approaches.
Usage of ICT among Social Educators—An Analysis of Current Practice in Spain
Authors: Martínez-Pérez Alejandro , Lezcano-Barbero Fernando , Zabaleta-González Rebeca , Casado-Muñoz Raquel
Published: February 2023

The objective of this study is to identify the usage of ICT tools among social educators within their professional activity. Technology among social educators is currently a very up-to-date topic. This is a professional group with its own characteristics that are different from those of teachers or other professionals in formal education. A mixed sequential two-phase method was proposed for the study: both quantitative and qualitative. In the first phase, the EdSocEval_V2 questionnaire was applied to a sample of 504 social educators from 17 autonomous communities. In the second phase, four focus groups were formed. The results presented reduced and basic usage of ICT: in management and administrative tasks and for communication with conventional tools. The COVID-19 pandemic has likewise increased the need for the use of ICT in socio-educational interventions, although their use for intervention among these groups is still very scarce. Training in and raising awareness of ICT among professionals for social interventions are priorities, as is the construction of a referential framework for professional training.
Taking the Challenge: An Exploratory Study of the Challenge-Based Learning Context in Higher Education Institutions across Three Different Continents
Authors: van den Beemt Antoine , Vázquez-Villegas Patricia , Gómez Puente Sonia , O’Riordan Fiona , Gormley Clare , Chiang Feng-Kuang , Leng Chuntao , Caratozzolo Patricia , Zavala Genaro , Membrillo-Hernández Jorge
Published: February 2023

Teaching by subjects and contents where students passively receive knowledge is increasingly obsolete. Universities are opting for teaching strategies supporting skills development to face the labor, social, environmental, and economic conditions afflicting us. Employers demand increasingly complex skills; universities have identified experiential learning as giving access to real situations and learning by doing. One of the most advanced strategies is Challenge-Based Learning (CBL). Through real problem situations, faculty and students collaborate to solve an established challenge, with or without external stakeholders. This educational advancement has been global and is developing graduates with international skills, which ensures a world-class standard. Here we report a global study carried out in universities from three different continents, and we analyze the implementations of CBL in educational programs through cases in Mexico, The Netherlands, Ireland, and China. Developing skills and competencies is evident, and CBL is a viable way to ensure the success of Higher Education graduates. Obstacles in the transformation of faculty towards CBL are a similar fence in all cases. For CBL, the path needs to be explored, as it is on the frontline of educational developments that can be most helpful for developing a new paradigm in education.
Applying Social Network Analysis to Model and Handle a Cross-Blockchain Ecosystem
Authors: Bonifazi Gianluca , Cauteruccio Francesco , Corradini Enrico , Marchetti Michele , Ursino Domenico , Virgili Luca
Published: February 2023

In recent years, the huge growth in the number and variety of blockchains has prompted researchers to investigate the cross-blockchain scenario. In this setting, multiple blockchains coexist, and wallets can exchange data and money from one blockchain to another. The effective and efficient management of a cross-blockchain ecosystem is an open problem. This paper aims to address it by exploiting the potential of Social Network Analysis. This general objective is declined into a set of activities. First, a social network-based model is proposed to represent such a scenario. Then, a multi-dimensional and multi-view framework is presented, which uses such a model to handle a cross-blockchain scenario. Such a framework allows all the results found in the past research on Social Network Analysis to be applied to the cross-blockchain ecosystem. Afterwards, this framework is used to extract insights and knowledge patterns concerning the behavior of several categories of wallets in a cross-blockchain scenario. To verify the goodness of the proposed framework, it is applied on a real dataset derived from Multichain, in order to identify various user categories and their “modus operandi”. Finally, a new centrality measure is proposed, which identifies the most significant wallets in the ecosytem. This measure considers several viewpoints, each of which addresses a specific aspect that may make a wallet more or less central in the cross-blockchain scenario.
Modeling on Monolithic Integration Structure of AlGaN/InGaN/GaN High Electron Mobility Transistors and LEDs: 2DEG Density and Radiative Recombination
Authors: An Yuan , Ren Kailin , Yin Luqiao , Zhang Jianhua
Published: February 2023

The monolithic integration structure of the AlGaN/InGaN/GaN−based high electron mobility transistor (HEMT) and light−emitting diode (LED) is attractive in LED lighting and visible light communication (VLC) systems owing to the reduction in parasitic elements by removing metal interconnections. Due to the band−offset and polarization effect, inserting a certain thickness in the InGaN layer into the traditional AlGaN/GaN single heterostructure increases the density of 2DEG to nearly twice the original. At the same time, inserting the InGaN quantum well layer can also improve the luminous efficiency of LED. In this paper, the physical models of two−dimensional electron gas (2DEG) densities and the threshold voltage of AlGaN/InGaN/GaN HEMTs are established and verified with experimental results from the literature. According to the calculation results, the two−dimensional electron gas (2DEG) density in the AlGaN/InGaN/GaN HEMT is 1.47 × 1013 cm−2, and the two−dimensional hole gas (2DHG) density is 0.55 × 1013 cm−2, when Al% = 0.2, In% = 0.1, dAlGaN = 20 nm. In addition, a physical model for the radiative recombination rate in the monolithic integration structure of HEMT−LED is proposed. This work provides a design guideline for AlGaN/InGaN/GaN HEMT and its application in visible light communication systems.
Robustness Assessment of Cyber–Physical System with Different Interdependent Mechanisms
Authors: Wang Peixiang , Wang Qianyi , Tu Haicheng , Xia Yongxiang
Published: February 2023

Cyber–physical systems (CPSs) are a new generation of intelligent system that integrate communication, control and computation functions and are widely used in traditional infrastructure networks, such as power network, transportation network and others. In order to ensure the stable operation and improve the robustness of CPSs, the studies of robustness assessment have attracted much attention from academia. However, previous models assume that the failure propagation conforms to a strongly interdependent relationship, and only consider the interaction between nodes, while ignoring the interaction between nodes and links. In this paper, we develop a novel simulation model with the consideration of both the coupling modes and the failure propagation objects. Based on the simulation model, we study how the interdependent mechanisms, failure propagation probability and protection strategies affect the robustness of CPSs. The simulations of our proposed model are demonstrated in a test CPS formed by coupling two classical complex networks. Compared with previous models, our proposed model shows different performances and comprehensively characterizes the interdependent relationship of CPSs. In detail, disassortative coupling shows the worst performance and the CPS becomes more sensitive to failure propagation when Node–Link is selected as the failure propagation object. In addition, compared to the communication network, the power network is more sensitive to failure propagation. Protecting electrical nodes is a more effective way to strengthen the robustness of CPSs when conservation resources are limited. Our work provides useful advice to operators on how to effectively design and protect a CPS.
New Perspectives in Nonintrusive Sleep Monitoring for Neurodegenerative Diseases—A Narrative Review
Authors: Masi Giulia , Amprimo Gianluca , Priano Lorenzo , Ferraris Claudia
Published: February 2023

Good sleep quality is of primary importance in ensuring people’s health and well-being. In fact, sleep disorders have well-known adverse effects on quality of life, as they influence attention, memory, mood, and various physiological regulatory body functions. Sleep alterations are often strictly related to age and comorbidities. For example, in neurodegenerative diseases, symptoms may be aggravated by alterations in sleep cycles or, vice versa, may be the cause of sleep disruption. Polysomnography is the primary instrumental method to investigate sleep diseases; however, its use is limited to clinical practice. This review aims to provide a comprehensive overview of the available innovative technologies and methodologies proposed for less invasive sleep-disorder analysis, with a focus on neurodegenerative disorders. The paper intends to summarize the main studies, selected between 2010 and 2022, from different perspectives covering three relevant contexts, the use of wearable and non-wearable technologies, and application to specific neurodegenerative diseases. In addition, the review provides a qualitative summary for each selected article concerning the objectives, instrumentation, metrics, and impact of the results obtained, in order to facilitate the comparison among methodological approaches and overall findings.