bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting Conversion from Mild Cognitive Impairment to Alzheimer’s Disease Using K-Means Clustering on MRI Data
Authors: Bellezza Miranda , di Palma Azzurra , Frosini Andrea
Published: February 2024

Alzheimer’s disease (AD) is a neurodegenerative disorder that leads to the loss of cognitive functions due to the deterioration of brain tissue. Current diagnostic methods are often invasive or costly, limiting their widespread use. Developing non-invasive and cost-effective screening methods is crucial, especially for identifying patients with mild cognitive impairment (MCI) at the risk of developing Alzheimer’s disease. This study employs a Machine Learning (ML) approach, specifically K-means clustering, on a subset of pixels common to all magnetic resonance imaging (MRI) images to rapidly classify subjects with AD and those with normal Normal Cognitive (NC). In particular, we benefited from defining significant pixels, a narrow subset of points (in the range of 1.5% to 6% of the total) common to all MRI images and related to more intense degeneration of white or gray matter. We performed K-means clustering, with k = 2, on the significant pixels of AD and NC MRI images to separate subjects belonging to the two classes and detect the class centroids. Subsequently, we classified subjects with MCI using only the significant pixels. This approach enables quick classification of subjects with AD and NC, and more importantly, it predicts MCI-to-AD conversion with high accuracy and low computational cost, making it a rapid and effective diagnostic tool for real-time assessments.
Demography and Behaviour of Teinopodagrion oscillans (Odonata: Megapodagrionidae) in a Protected Area of the Colombian Andean Region
Authors: Palacino-Rodríguez Fredy , Palacino Diego Andres , Penagos Arevalo Andrea , Cordero-Rivera Adolfo
Published: February 2024

The demography and behaviour of Teinopodagrion oscillans was studied in a protected area in the Andean region of Colombia. Adult damselflies were individually marked, and using their recapture histories, we estimated survival, longevity, sex ratio, and population size using Cormack-Jolly-Seber models. Other aspects of their behaviour were recorded. Survival, recapture, and lifespan (14.1 ± 0.59 days) were similar for both sexes and all age groups. Mature males were larger, and the distance from the water was similar for all individuals. The most supported model was the time-dependent model for survival and recapture. This suggests that weather variations affect the demography of this population in a significant way. Individuals exhibited high fidelity to their site perch, perching with open wings near water on a variety of perches. Mature males make short flights from the perch to intercept conspecific and interspecific males and to hunt prey. The tandem position was formed on macrophytes, and then the pair flew away. Oviposition lasted for 11.23 min on average, with the females ovipositing by abdomen submersion. Our results offer insights into the demographic characteristics and behaviour of this species, providing crucial information for the short- and long-term, from the demography of one species to the conservation of ecosystems of the Andean region.
Defining Data Model Quality Metrics for Data Vault 2.0 Model Evaluation
Authors: Helskyaho Heli , Ruotsalainen Laura , Männistö Tomi
Published: February 2024

Designing a database is a crucial step in providing businesses with high-quality data for decision making. The quality of a data model is the key to the quality of its data. Evaluating the quality of a data model is a complex and time-consuming task. Having suitable metrics for evaluating the quality of a data model is an essential requirement for automating the design process of a data model. While there are metrics available for evaluating data warehouse data models to some degree, there is a distinct lack of metrics specifically designed to assess how well a data model conforms to the rules and best practices of Data Vault 2.0. The quality of a Data Vault 2.0 data model is considered suboptimal if it fails to adhere to these principles. In this paper, we introduce new metrics that can be used for evaluating the quality of a Data Vault 2.0 data model, either manually or automatically. This methodology involves defining a set of metrics based on the best practices of Data Vault 2.0, evaluating five representative data models using both metrics and manual assessments made by a human expert. Finally, a comparative analysis of both evaluations was conducted to validate the consistency of the metrics with the judgments made by a human expert.
Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic Aneurysm
Authors: Mulorz Joscha , Mazrekaj Agnesa , Sehl Justus , Arnautovic Amir , Garabet Waseem , Krott Kim-Jürgen , Schelzig Hubert , Elvers Margitta , Wagenhäuser Markus Udo
Published: February 2024

Background: An intraluminal, non-occlusive thrombus (ILT) is a common feature in an abdominal aortic aneurysm (AAA). This study investigated the relative progression of ILT vs. AAA volume using a novel parameter, the so-called thrombus burden ratio (TBR), in non-treated AAAs. Parameters potentially associated with TBR progression were analyzed and TBR progression in large vs. small and fast- vs. slow-growing AAAs was assessed. Methods: This retrospective, single-center study analyzed sequential contrast-enhanced computed tomography angiography (CTA) scans between 2009 and 2018 from patients with an AAA before surgical treatment. Patients’ medical data and CTA scans were analyzed at two given time points. The TBR was calculated as a ratio of ILT and AAA volume, and relative TBR progression was calculated by normalization for time between sequential CTA scans. Spearman’s correlation was applied to identify morphologic parameters correlating with TBR progression, and multivariate linear regression analysis was used to evaluate the association of clinical and morphological parameters with TBR progression. Results: A total of 35 patients were included. The mean time between CT scans was 16 ± 15.9 months. AAA volume progression was 12 ± 3% and ILT volume progression was 36 ± 13%, resulting in a TBR progression of 11 ± 4%, suggesting overproportioned ILT growth. TBR progression was 0.8 ± 0.8% per month. Spearman’s correlation verified ILT growth as the most relevant parameter contributing to TBR progression (R = 0.51). Relative TBR progression did not differ significantly in large vs. small and fast- vs. slow-growing AAAs. In the multivariate regression analysis, none of the studied factors were associated with TBR progression. Conclusion: TBR increases during AAA development, indicating an overproportioned ILT vs. AAA volume growth. The TBR may serve as a useful parameter, as it incorporates the ILT volume growth relative to the AAA volume, therefore combining two important parameters that are usually reported separately. Yet, the clinical relevance in helping to identify potential corresponding risk factors and the evaluation of patients at risk needs to be further validated in a larger study cohort.
Potential Application of Non-Invasive Optical Imaging Methods in Orthodontic Diagnosis
Authors: Baek Jae Ho
Published: February 2024

During orthodontic treatment, the early diagnosis of microscopic changes in soft and hard tissues, including periodontal tissue, is very important to prevent iatrogenic side effects like root resorption and periodontal diseases. Cervical periodontal tissue is the most critical area that reacts first to mal-habits or orthodontic forces, and it is also the place where bacteria deposits in the early stage of periodontal diseases. The early diagnosis of hard tissue changes, such as demineralization, is also very important in maintaining a patient’s health during orthodontic treatment. Many diagnostic devices, including radiographic equipment and intra-oral scanners, are helpful in diagnosing these problems, but have certain limitations in invasiveness and precision. The purpose of this study is to verify the possible utilities of non-invasive diagnostic devices in the orthodontic field that can compensate for these limitations. For this, non-invasive optical diagnostic devices, including optical coherence tomography and optical Doppler tomography, were used in vivo with animal and human examination for hard and soft tissues. These devices can provide real-time three-dimensional images at the histological scale. The results of this study verified these devices can be used in clinical practice during orthodontic treatment and introduced a new diagnostic paradigm differentiating microstructural changes in tissues in orthodontic diagnosis.
Short- to Mid-Term Clinical and Radiological Results of Selective Laser Melting Highly Porous Titanium Cup in Primary Total Hip Arthroplasty
Authors: Familiari Filippo , Barone Alessandro , De Gori Marco , Banci Lorenzo , Palco Michelangelo , Simonetta Roberto , Gasparini Giorgio , Mercurio Michele , Calafiore Giuseppe
Published: February 2024

(1) Background: The aim of this study was to evaluate short- to mid-term clinical and radiological results in patients undergoing primary total hip arthroplasty (THA) with the use of a Selective Laser Melting 3D-printed highly porous titanium acetabular cup (Jump System Traser®, Permedica Orthopaedics). (2) Methods: We conducted a retrospective study and collected prospective data on 125 consecutive patients who underwent primary THA with the use of highly porous titanium cup. Each patient was evaluated preoperatively and postoperatively with a clinical and radiological assessment. (3) Results: The final cohort consisted of 104 patients evaluated after a correct value of 52 (38–74) months. The median Harris Hip Score (HHS) significantly improved from 63.7 (16–95.8) preoperatively to 94.8 (38.2–95.8) postoperatively (p < 0.001), with higher improvement associated with higher age at surgery (β = 0.22, p = 0.025). On postoperative radiographs, the average acetabular cup inclination and anteversion were 46° (30°–57°) and 15° (1°–32°), respectively. All cups radiographically showed signs of osseointegration with no radiolucency observed, or component loosening. (4) Conclusions: The use of this highly porous acetabular cup in primary THA achieved excellent clinical, functional, and radiological results at mid-term follow-up. A better clinical recovery can be expected in older patients. The radiological evaluation showed excellent osseointegration of the cup with complete absence of periprosthetic radiolucent lines.
Improved Functioning and Activity According to the International Classification of Functioning and Disability after Multidisciplinary Telerehabilitation for Post-COVID-19 Condition—A Randomized Control Study
Authors: Bileviciute-Ljungar Indre , Norrefalk Jan-Rickard , Borg Kristian
Published: February 2024

This study investigates the outcomes and feasibility concerning the functioning and activity of multidisciplinary group telerehabilitation for a post-COVID-19 condition. Recruitment for the group rehabilitation was announced three times during 2021 and 2022 through the COVID-19 patient organization in Sweden. The key inclusion criteria were remaining symptoms and functional impairments beyond 12 weeks after SARS-CoV-2 infection; medical assessment and treatment regarding comorbidities or new postinfection symptoms; the ability to use the Internet. Participants were randomized into a rehabilitation group or onto a waiting list using an Internet program. Multiple outcomes included self-scored questionnaires and physical tests before and after eight weeks, and at six months follow-up. Here, we present the self-scored outcomes on the International Classification of Functioning and Disability questionnaire (ICF, 22 body functions and 16 activity/participation categories) and breathing scales. Of the 164 participants who registered for the study, 67 (mean age 43, 78% women) participated in an eight-week group rehabilitation compared to 42 who served as waiting list controls (mean age 47, 88% women). At six months follow-up, 60 participants from the rehabilitation group and 21 from the waiting list completed the data. The results indicate that a larger number of ICF body functions and activity/participation categories had improved in the rehabilitation group after eight weeks and six months. Overall credibility, as assessed by the Credibility Expectancy Questionnaire, was high, and the attrition rate in rehabilitation was low. The results indicate beneficial outcomes for multidisciplinary telerehabilitation in people suffering from a post-COVID-19 condition. Therefore, rehabilitation interventions should be further developed and implemented in clinical practice.
Challenges in Autologous Breast Reconstruction: A Review of Recommendations
Authors: Sinik Lauren M. , Collins Meredith S.
Published: February 2024

Breast reconstruction is an integral part of breast cancer treatment and offers significant psychosocial benefits for patients undergoing mastectomy as a part of their treatment plan. Autologous breast reconstruction (ABR) utilizes a patient’s own tissue to reconstruct the mastectomy defect, obviating the need for the implantation of a foreign object. As the field of plastic surgery progresses, ABR has become an excellent option for the recreation of a native breast mount. With that said, there are patient populations who present unique challenges when optimizing an aesthetic ABR result. We aim to discuss these challenging groups, including patients with both high and low body mass index (BMI), patients with a history of massive weight loss, patients who require post-mastectomy radiation therapy (PMRT), and patients electing for unilateral procedures where the surgeon attempts to match the reconstructed breast with the native breast. In our discussion, we review the literature recommendations for management as well as our experiences with our own patient cases. Ultimately, we believe this procedure can be performed in a wide variety of patient types and can be offered to those who may not be considered the “ideal” candidate.
Angle-Adjustable Dynamic Hip Screw Plate for Unstable Trochanteric Fractures in Middle-Aged Patients: Mid-Term Outcomes and Return to Sport
Authors: Andriollo Luca , Fravolini Giorgio , Sangaletti Rudy , Perticarini Loris , Benazzo Francesco , Rossi Stefano Marco Paolo
Published: February 2024

Background: There are conflicting results in the literature regarding the superiority of proximal femoral nails over dynamic hip screw (DHS) plates. The primary aim of this study is to evaluate mid-term post-injury patient-reported outcome measures (PROMs) and return to sport (RTS) in middle-aged patients treated with the DHS plate for unstable trochanteric fractures. Methods: Fifty-seven middle-aged patients (35–64 years) treated for proximal femoral fractures of type 31-A2 and 31-A3 according to the AO/OTA classification with the DMS Dynamic Martin Screw (KLS Martin Group, Jacksonville, FL, USA) between January 2017 and December 2019 were enrolled. Results: Forty-nine patients were included in this retrospective study, and the average age was 54.1 years (SD 8.4). The average follow-up duration at final follow-up was 60.5 months (SD 8.6). Post-operative complications included only one case of aseptic loosening of the implant, with a complication rate of 2%. There were no infections, peri-implant fractures, or other complications reported. Two out of the forty-nine patients (4.1%) required treatment with a total hip arthroplasty due to post-traumatic arthritis. The Harris Hip Score at final follow-up was 77.1 (SD 20.1), and the Western Ontario and McMaster Universities Osteoarthritis Index was 21.6 (SD 13.7). The overall rate of RTS was 57.7%. Conclusions: Treatment with DHS for unstable trochanteric fractures is a safe option in middle-aged patients, ensuring a good functional recovery.
The Role of Angiotensin-Converting Enzyme (ACE) Polymorphisms in the Risk of Development and Treatment of Diabetic Nephropathy
Authors: Król-Kulikowska Magdalena , Abramenko Nikita , Jakubek Milan , Banasik Mirosław , Kepinska Marta
Published: February 2024

Background: Angiotensin-converting enzyme (ACE) is responsible for the production of angiotensin II, and increased production of angiotensin II is observed in diabetes. What is more, ACE polymorphisms may play a role in the development of diabetic nephropathy. The aim of this study was to assess the role of selected ACE polymorphisms (rs4343 and rs4646994) in the risk of development of diabetic nephropathy and in the likelihood of renal replacement therapy. Methods: ACE polymorphisms were analyzed in a group of 225 patients who were divided into three subgroups. The rs4343 polymorphism was determined using the PCR-RFLP, and the rs4646994 polymorphism was determined using the PCR. Molecular docking between domains of ACE and its ligands was performed by using AutoDock Vina. Results: The G/G genotype of rs4343 polymorphism is associated with increased odds of developing diabetic nephropathy. The G allele is also associated with a higher risk of this disease. Similar results were obtained in patients who had already had a kidney transplant as a result of diabetic nephropathy. Conclusions: The presence of G/G and G/A genotypes, and the G allele increases the likelihood of developing diabetic nephropathy. This may also be a risk factor for renal replacement therapy.
Evaluating Image Quality and Radiation Dose in Low-Dose Thoraco-Abdominal CT Angiography with a Tin Filter for Patients with Aortic Disease
Authors: Oh Chang Hoon , Cho Soo Buem , Kwon Hyeyoung
Published: February 2024

Background: We aimed to compared radiation exposure and image quality between tin-filter-based and standard dose thoraco-abdominal computed tomography angiography (TACTA) protocols, aiming to address a gap in the existing literature. Methods: In this retrospective study, ninety consecutive patients undergoing TACTA were included. Of these, 45 followed a routine standard-dose protocol (ST100kV), and 45 underwent a low-dose protocol with a tin filter (TF100kV). Radiation metrics were compared. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) were calculated for the thoracic and abdominal aorta and right common iliac artery. Two independent readers assessed the image noise, image contrast, sharpness, and subjective image quality. Results: The mean dose for the TF100kV group was significantly lower (DLP 128.25 ± 18.18 mGy*cm vs. 662.75 ± 181.29, p < 0.001; CTDIvol 1.83 ± 0.25 mGy vs. 9.28 ± 2.17, p = 0.001), with an effective dose close to 2.3 mSv (2.31 ± 0.33 mSv; p < 0.001). The TF100kV group demonstrated greater dose efficiency (FOM, thoracic aorta: 36.70 ± 22.77 vs. 13.96 ± 13.18 mSv−1, p < 0.001) compared to the ST100kV group. Conclusions: Dedicated low-dose TACTA using a tin filter can significantly reduce the radiation dose while maintaining sufficient diagnostic image quality.
Reply to Su et al. Comment on “Matsumoto et al. Remimazolam’s Effects on Postoperative Nausea and Vomiting Are Similar to Those of Propofol after Laparoscopic Gynecological Surgery: A Randomized Controlled Trial. J. Clin. Med. 2023, 12, 5402”
Authors: Matsumoto Ayumu , Satomi Shiho , Kakuta Nami , Narasaki Soshi , Toyota Yukari , Miyoshi Hirotsugu , Horikawa Yousuke T. , Saeki Noboru , Tanaka Katsuya , Tsutsumi Yasuo M.
Published: February 2024

We thank the authors for their insightful and thoughtful commentary on our recent publication [...]
Are Surgeons Going to Be Left Holding the Bag? Incisional Hernia Repair and Intra-Peritoneal Non-Absorbable Mesh Implant Complications
Authors: Kirkpatrick Andrew W. , Coccolini Federico , Tolonen Matti , Minor Samual , Catena Fausto , Celotti Andrea , Gois Emanuel , Perrone Gennaro , Novelli Giuseppe , Garulli Gianluca , Ioannidis Orestis , Sugrue Michael , De Simone Belinda , Tartaglia Dario , Lampella Hanna , Ferreira Fernando , Ansaloni Luca , Parry Neil G. , Colak Elif , Podda Mauro , Noceroni Luigi , Vallicelli Carlo , Rezende-Netos Joao , Ball Chad G. , McKee Jessica , Moore Ernest E. , Mather Jack
Published: February 2024

Ventral incisional hernias are common indications for elective repair and frequently complicated by recurrence. Surgical meshes, which may be synthetic, bio-synthetic, or biological, decrease recurrence and, resultingly, their use has become standard. While most patients are greatly benefited, mesh represents a permanently implanted foreign body. Mesh may be implanted within the intra-peritoneal, preperitoneal, retrorectus, inlay, or onlay anatomic positions. Meshes may be associated with complications that may be early or late and range from minor to severe. Long-term complications with intra-peritoneal synthetic mesh (IPSM) in apposition to the viscera are particularly at risk for adhesions and potential enteric fistula formation. The overall rate of such complications is difficult to appreciate due to poor long-term follow-up data, although it behooves surgeons to understand these risks as they are the ones who implant these devices. All surgeons need to be aware that meshes are commercial devices that are delivered into their operating room without scientific evidence of efficacy or even safety due to the unique regulatory practices that distinguish medical devices from medications. Thus, surgeons must continue to advocate for more stringent oversight and improved scientific evaluation to serve our patients properly and protect the patient–surgeon relationship as the only rationale long-term strategy to avoid ongoing complications.
Electrocardiography versus Echocardiography in Severe Aortic Stenosis with the Consideration of Coexistent Coronary Artery Disease
Authors: Chyrchel Michał , Siłka Wojciech , Wylaź Mateusz , Wójcik Wiktor , Surdacki Andrzej
Published: February 2024

(1) Background: Coexistent coronary artery disease (CAD) might influence the ability of electrocardiogram (ECG) to identify echocardiographic left ventricular hypertrophy (ECHO-LVH) in patients with aortic stenosis (AS). We aimed to assess the relation between ECG–LVH (by the Sokolov–Lyon or Cornell criteria) and ECHO-LVH considering coexistent CAD. (2) Methods: We retrospectively analyzed the medical records of 74 patients (36 males) with severe AS who were hospitalized in the University Hospital in Cracow from 2021 to 2022. (3) Results: ECHO-LVH was present in 49 (66%) patients, whereas 35 (47.3%) patients had ECG-LVH. There was no difference between the rate of ECG-LVH in patients with vs. without ECHO-LVH. Single-vessel and multi-vessel CAD were diagnosed by invasive coronary angiography in 18% and 11% of patients, respectively. The sensitivity of the classical ECG-LVH criteria with regard to ECHO-LVH was low, reaching at best 41% for the Sokolov–Lyon and Cornell criteria. The results were similar and lacked a pattern when considering patients without significant stenosis, with single- and multi-vessel disease separately. Correlations between the left ventricular mass index and ECG-derived parameters were weak and present solely for the Lewis index (r = 0.31), R wave’s amplitude >1.1 mV in aVL (r = 0.36), as well as the Cornell (r = 0.32) and Sokolov–Lyon (r = 0.31) voltage criteria (p < 0.01). The presence, location of stenoses, and CAD extent were not associated with the presence of either ECHO-LVH or ECG-LVH, irrespective of individual ECG-LVH criteria. (4) Conclusions: The sensitivity of classical ECG criteria for echocardiographic LVH in severe AS is low, regardless of coexistent CAD or its angiographic extent.
Synergistic Enhancement of the Mechanical Properties of Epoxy-Based Coir Fiber Composites through Alkaline Treatment and Nanoclay Reinforcement
Authors: Puttaswamygowda Puneethraj Hebbalu , Sharma Sathyashankara , Ullal Achutha Kini , Shettar Manjunath
Published: February 2024

This study explores the synergistic effects of incorporating coir fibers and nanoclay into epoxy resin composites. Coir, a renewable and cost-effective natural fiber, undergoes an alkaline treatment to influence its ability to form strong interfacial bonding with the epoxy matrix. To further enhance the mechanical properties of the composite, montmorillonite nanoclay, surface-modified with aminopropyltriethoxysilane and octadecyl amine, is introduced. The research investigates different combinations of coir fiber content (20, 30, and 40 wt%) and nanoclay loading (0, 2, and 4 wt%) with epoxy resin. The composites are fabricated through an open molding process, and the mechanical properties are evaluated using tensile and flexural tests according to the ASTM D638 and D7264 standards, respectively. The tensile and flexural strengths of the 40 wt% coir fiber-reinforced epoxy composite are found to be 77.99 MPa and 136.13 MPa, which are 44% and 23% greater than pure epoxy, respectively. Furthermore, the strengths displayed a 23% improvement in tensile strength with 4 wt% and a 31.4% improvement in flexural strength with 2 wt% nanoclay as additional reinforcement. Scanning electron microscopy is employed for fractographic analysis of the fractured specimens from the tensile test. The study underscores the importance of understanding the interplay between natural fibers, nanoclay, and epoxy resin for optimizing the composite’s performance in real-world applications.
Polylactic Acid Polymer Matrix (Pla) Biocomposites with Plant Fibers for Manufacturing 3D Printing Filaments: A Review
Authors: Almeida Victor Hugo M. , Jesus Raildo M. , Santana Gregório M. , Pereira Thaís B.
Published: February 2024

The escalating global demand for polymer products and the consequent disposal challenge necessitate technological and sustainable solutions. Recent advances in the development of materials used in 3D printing equipment are described in this review, with a focus on new biocomposite materials. The investigation delves into biocomposites comprising PLA and its blends with other polymers, reinforced by plant fibers, with a particular focus on research conducted over the last five years. The information related to the raw materials’ physical, chemical, and processing properties necessary for creating biocomposite filament and printed parts were summarized. The best results in terms of tensile and flexural strength were presented and discussed, signposting future research avenues and desirable objectives. The findings elucidate that the inclusion of plant fibers led to a reduction in mechanical strength relative to pure PLA; however, when smaller particle sizes of plant fibers were added in volumes below 10%, it resulted in improved performance. Moreover, physical and/or chemical pretreatment of fibers, along with the isolation of cellulose fibrils, emerged as pivotal strategies for bolstering mechanical strengths. Noteworthy are the promising prospects presented by the incorporation of additives, while the refinement of printing parameters is key to improving the tensile and flexural strength of printed components.
Reconstructive Approach in Residual Periodontal Pockets with Biofunctionalized Heterografts—A Retrospective Comparison of 12-Month Data from Three Centers
Authors: Friedmann Anton , Liedloff Pheline , Eliezer Meizi , Brincat Arthur , Ostermann Thomas , Diehl Daniel
Published: February 2024

The regenerative capacity of well-preserved blood clots may be enhanced by biologics like enamel matrix derivative (EMD). This retrospective analysis compares outcomes reported by three centers using different heterografts. Center 1 (C1) treated intrabony defects combining cross-linked high-molecular-weight hyaluronic acid (xHyA) with a xenograft; center 2 (C2) used EMD with an allograft combination to graft a residual pocket. Center 3 (C3) combined xHyA with the placement of a resorbable polymer membrane for defect cover. Clinical parameters, BoP reduction, and radiographically observed defect fill at 12-month examination are reported. The 12-month evaluation yielded significant improvements in PPD and CAL at each center (p < 0.001, respectively). Analyses of Covariance revealed significant improvements in all parameters, and a significantly greater CAL gain was revealed for C2 vs. C1 (p = 0.006). Radiographic defect fill presented significantly higher scores for C2 and C3 vs. C1 (p = 0.003 and = 0.014; C2 vs. C3 p = 1.00). Gingival recession increased in C1 and C3 (p = 1.00), while C2 reported no GR after 12 months (C2:C1 p = 0.002; C2:C3 p = 0.005). BoP tendency and pocket closure rate shared similar rates. Within the limitations of the study, a data comparison indicated that xHyA showed a similar capacity to enhance the regenerative response, as known for EMD. Radiographic follow-up underlined xHyA’s unique role in new attachment formation.
StepTest4all: Improving the Prediction of Cardiovascular Capacity Assessment in Young Adults
Authors: Sampaio Tatiana , Morais Jorge E. , Bragada José A.
Published: February 2024

Cardiovascular capacity, expressed as maximal oxygen uptake (VO2max), is a strong predictor of health and fitness and is considered a key measure of physiological function in the healthy adult population. The aim of this study was to investigate the influence of the physical activity levels (PAlevel) of participants in the StepTest4all (validated protocol for the estimation of VO2max in adults). The sample consisted of 69 participants, including 27 women (age 21.7 ± 3.6 years; body mass = 63.5 ± 14.8 kg; height = 1.64 ± 0.06 m; body mass index = 23.7 ± 5.3 kg/m2) and 42 men (aged 21.7 ± 3.4 years; body mass = 72.0 ± 7.3 kg; height = 1.77 ± 0.07 m; body mass index = 23.1 ± 2.1 kg/m2). The participants were assigned to one of the two groups: (i) the VO2max prediction group and (ii) the prediction model validation group. In the multiple linear regression, the following predictors of VO2max remained significant: sex (p < 0.001), physical activity level (p = 0.014), and HRR60 (p = 0.020). The prediction equation (R2 = 74.0%, SEE = 4.78) showed a close and strong relationship between the measurements and can be expressed as follows: VO2max = 17.105 + 0.260·(HRR60) + 8.563·(sex) + 4.097·(PAlevel), in which HRR60 is the magnitude of the HR decrease (bpm) in one minute immediately after stopping the step, and sex: men = 1, women = 0, and PAlevel is level 1 (low), level 2 (moderate), and level 3 (high). The StepTest4all was shown to be a suitable method for estimating cardiovascular capacity, expressed as VO2max, in young adults. Retaining PAlevel as a significant predictor allows us to better individualize the participants’ VO2max.
Simulation Analysis and Experimental Study on Airfoil Optimization of Low-Velocity Turbine
Authors: Shen Chunyun , Zhang Jiahao , Ding Chenglin , Wang Shiming
Published: February 2024

By combining computational fluid dynamics (CFD) and surrogate model method (SMM), the relationship between turbine performance and airfoil shape and flow characteristics at low flow rate is revealed. In this paper, the flow velocity tidal energy airfoil model is designed based on the Kriging model, and the original airfoil with a relative thickness of 12% and a relative curvature of 2.5% is obtained. The parameter optimization is carried out by setting the 4th CST equations through the surrogate model; the maximum lift-drag ratio is the optimization goal, the optimization design variable is 10, the maximum number of iterations is 100, and the maximum number of sub-optimization iterations is 200. The results show that the hydrodynamic performance of the airfoil with thinner thickness and more curvature is better, the maximum thickness part is shifted forward by 4.58%, and the lift-drag ratio is improved by 4.03%. The flow field and the efficiency are more stable, which provides an engineering reference for the optimal design of hydraulic turbine airfoils under low flow velocity. It supplements the research on the performance of turbine blades in low velocity.
Elastoplastic Solution of Cylindrical Cavity Expansion in Unsaturated Offshore Island Soil Considering Anisotropy
Authors: Cui Jifei , Jin Yanhao , Jing Yingjie , Lu Yu
Published: February 2024

An elastoplastic analysis scheme for the cylindrical cavity expansion in offshore islands unsaturated soils considering anisotropy is established. The hydraulic properties and anisotropy caused by stress of unsaturated soils are coupled in an elastoplastic constitutive matrix for unsaturated soil to obtain the governing equations for the cylindrical cavity expansion problem, with an analytical solution that utilizes the original hydro-mechanical state of the soil as the initial conditions. Through a comparative analysis with other analytical solutions, the effectiveness of the new solution is verified. Moreover, the swelling response of the cylindrical cavity expansion in unsaturated soils is examined by systematically analyzing different parameters of the surrounding soil. The findings reveal that the development and rate of anisotropy in normal consolidated soil and over-consolidated soil exert a significant impact on the soil’s mechanical characteristics. Nevertheless, the alteration in the model constant h has little effect on the soil’s mechanical characteristics. The analytical solution introduces anisotropy and broadens the expansion theory of unsaturated soils to yield a more comprehensive theoretical framework for the comprehensive analysis of offshore islands’ unsaturated soils.
Transcriptome Analysis Reveals Mycelial and Fruiting Responses to Lithium Chloride in Coprinopsis cinerea
Authors: Chan Po-Lam , Kwan Hoi-Shan , Xie Yichun , Wong Ka-Hing , Chang Jinhui
Published: February 2024

Lithium chloride (LiCl) has been used in signalling and molecular studies of animals, plants, and yeast. However, information on its roles in basidiomycetous fungi is still limited. In this study, we used RNA-Seq to study the effects of LiCl on Coprinopsis cinerea. LiCl enhanced mycelial growth and inhibited fruiting body formation in C. cinerea. RNA-Seq of the LiCl-treated C. cinerea resulted in a total of 14,128 genes. There were 1199 differentially expressed genes (DEGs) between the LiCl-treated samples and control samples in the mycelium stage (the first time point), and 1391 DEGs were detected when the control samples were forming hyphal knots while the treated samples were still in the mycelium (the second time point). Pathway enrichment analysis of the DEGs revealed a significant association between enhanced mycelium growth in the LiCl-treated C. cinerea and metabolic pathways. In addition, the DEGs involved in cellular process pathways, including “cell cycle-yeast” and “meiosis-yeast”, were identified in suppressed C. cinerea fruiting body formation by LiCl under favourable environmental conditions. As LiCl can predominantly inhibit the activity of glycogen synthase kinase3 (GSK3), our findings suggest that LiCl affects the expression of genes involved in fruiting body initiation and cellular processes by inhibiting GSK3 activity which is essential for fruiting body formation.
Influence of Tumor Stroma on the Aggressiveness of Poorly Cohesive Gastric Carcinoma
Authors: Malpeli Giorgio , Filippini Federica , Tedone Fabrizio , Torroni Lorena , Alloggio Mariella , Castelli Claudia , Dal Cero Mariagiulia , Perris Roberto , Tomezzoli Anna , De Manzoni Giovanni , Bencivenga Maria
Published: February 2024

Tumor-stroma crosstalk promotes the adaptation of cancer cells to the local microenvironment and sustains their growth. We assessed the quantitative and qualitative impact of intralesional stroma on clinic-pathological features and the prognosis of poorly cohesive gastric cancer (PCGC) variants. Tissue microarrays including 75 PCGC specimens were immunostained for cytokeratin 8/18 and α-smooth muscle actin to assess the relative proportion of neoplastic cells versus stromal components and the cases were subsequently divided into stroma-rich (SR) and stroma-poor (SP) tumors. Stromal status is significantly associated with the depth of tumor invasion. Patient survival rate was found to be higher in the SP compared to the SR tumor group and, hence, abundant stroma was identified as a significant risk factor in univariable analysis but had no independent prognostic impact. We also investigated the mRNA levels of KRT8 and the associated transcriptional signatures using the molecular data of 82 PCGC cases divided into KRT8-high and KRT8-low groups. KRT8-high tumors were enriched in proteins localized in the extracellular compartment and their expression levels correlated with longer survival in the KRT8-high group and shorter overall survival in the KRT8-low group. Comprehensively, we find that relative intralesional stromal content is a marker of aggressiveness in PCGC tumors and that extracellular proteins characterize functionally and clinically different PCGC subgroups.
A Game-Theoretic Analysis of the Adoption of Patient-Generated Health Data
Authors: Akçura M. Tolga , Ozdemir Zafer D. , Tarakci Hakan
Published: February 2024

Patient-generated health data (PGHD) have great potential to improve clinical outcomes. As providers consider whether and how to incorporate PGHD into their clinical workflows, platforms by Apple and Amazon stand to fundamentally alter the landscape. With the aim to examine the conditions under which providers would adopt PGHD and possibly sign on with a platform, we analyzed the incentives and optimal strategies of two healthcare providers, a monopoly platform, and consumers using stylized game-theoretic models and solve for potential equilibria. We found that consumer surplus always increased with PGHD adoption, but social welfare may drop. The larger provider had more incentive to adopt PGHD than the smaller provider, but these incentives were reversed in the case of platform adoption. Accordingly, the platform enrolled the smaller provider first and possibly both providers. The emergence of the platform raised provider surplus, potentially at the expense of the consumers, despite offering its service to them for free. These results illustrate the importance of economic incentives regarding whether and how PGHD could be incorporated into our current healthcare system.
Identifying Ecological Security Patterns Considering the Stability of Ecological Sources in Ecologically Fragile Areas
Authors: Ma Jianfang , Li Lin , Jiao Limin , Zhu Haihong , Liu Chengcheng , Li Feng , Li Peng
Published: February 2024

Ecological security patterns (ESPs) provide an effective spatial approach for identifying critical conservation areas and ensuring regional ecological security. However, prior research has not paid much attention to the importance of the stability of ecological sources in time-series changes, which is especially critical for maintaining ecological functions in ecologically fragile areas. Focusing on the Ningxia Hui Autonomous Region (NHAR) of China, this study evaluated the spatiotemporal change patterns in ecosystem services importance (ESI) from 2000 to 2020, integrating the spatial principal component analysis (SPCA) and circuit theory to propose a novel ESP construction framework that aims to address the issue of insufficient consideration of source stability. A total of 93 stable ecological sources were identified, with the capacity to ensure the continuous provision of high-level ecosystem services and resistance to external disturbances. The extraction of 234 ecological corridors and 430 ecological nodes effectively enhanced the stable flow of ecological processes and connectivity. The stable ESP, constituted by the above ecological elements, can serve as core ecological space and basic skeleton to maintain the regional sustainable landscape. This study provides scientific references for identifying key priority conservation areas and formulating targeted ecological conservation and restoration strategies in ecologically fragile areas.
County-Level Land Use Carbon Budget in the Yangtze River Economic Belt, China: Spatiotemporal Differentiation and Coordination Zoning
Authors: Liu Chong , Wang Xiaoman , Li Haiyang
Published: February 2024

The local land use carbon budget (LUCB) balance is an important factor in achieving regional carbon neutrality. As the basic unit of China’s economic development and social governance, the county level is an important part of the realization of the “double carbon” goal. This paper focuses on 1069 county units within the Yangtze River Economic Belt (YREB). It utilizes data on land use, nighttime light, energy consumption, and social and economic factors to construct carbon emission models. The spatiotemporal characteristics of LUCB in these county units are analyzed using standard deviational ellipse (SDE) and spatial autocorrelation methods. Additionally, a zoning study is conducted by examining the economic contribution coefficient (ECC) of carbon emissions, the ecological support coefficient (ESC), and their coupling relationship. The results show that (1) the total land use carbon emissions (LUCE) increased significantly during the research period, and the total carbon sink was relatively stable. (2) The LUCB is spatially high in the east and low in the west, with the center of gravity moving to the southwest as a whole. (3) The LUCB shows positive spatial autocorrelation and has significant spatial agglomeration characteristics, which are mainly high–high and low–low regional agglomeration types. (4) The ECC is high in the east and low in the west, the ESC is high in the west and low in the east, and the coordination and coupling degrees of the two are low. (5) According to the ECC and ESC, the county unit is divided into a low-carbon conservation area, an economic development area, a carbon sink development area, and a comprehensive optimization area. This study is helpful in promoting the sustainable development of carbon neutrality and low carbon in the YREB.
Conceptualizing Forest Operations Planning and Management Using Principles of Functional Complex Systems Science to Increase the Forest’s Ability to Withstand Climate Change
Authors: Tampekis Stergios , Kantartzis Apostolos , Arabatzis Garyfallos , Sakellariou Stavros , Kolkos Georgios , Malesios Chrisovalantis
Published: February 2024

The sustainable management of forest resources is greatly influenced by forest operations (FO). Interactions between humans and nature describe how people engage with and are impacted by the natural world. As we enter the Anthropocene epoch, we are being compelled to reevaluate our past and present methods of managing and planning our forest operations in order to find new ones that are more adaptable and successful at addressing the growing unpredictability resulting from accelerating global change. We briefly discuss the goals and constraints of the prior and current management and planning principles for forest operations in this study, focusing on how these principles have evolved on a worldwide scale. We then propose a promising idea, such as managing forest operations as complex adaptive systems and approaches based on resilience and sustainable use of forest resources, in order to achieve the necessary economic, social, and ecological goals. An in-depth understanding of the ecological, economic, and social factors that influence forest resilience is necessary for planning and managing forest operations efficiently. The proposed strategy combines the effectiveness of forest operations with a functional, complex network approach in order to manage forests for the Anthropocene.
The Impact of Probiotic Bifidobacterium on Liver Diseases and the Microbiota
Authors: Hizo Gabriel Henrique , Rampelotto Pabulo Henrique
Published: February 2024

Recent studies have shown the promising potential of probiotics, especially the bacterial genus Bifidobacterium, in the treatment of liver diseases. In this work, a systematic review was conducted, with a focus on studies that employed advanced Next Generation Sequencing (NGS) technologies to explore the potential of Bifidobacterium as a probiotic for treating liver pathologies such as Non-Alcoholic Fatty Liver Disease (NAFLD), Non-Alcoholic Steatohepatitis (NASH), Alcoholic Liver Disease (ALD), Cirrhosis, and Hepatocelullar Carcinoma (HCC) and its impact on the microbiota. Our results indicate that Bifidobacterium is a safe and effective probiotic for treating liver lesions. It successfully restored balance to the intestinal microbiota and improved biochemical and clinical parameters in NAFLD, ALD, and Cirrhosis. No significant adverse effects were identified. While more research is needed to establish its efficacy in treating NASH and HCC, the evidence suggests that Bifidobacterium is a promising probiotic for managing liver lesions.
Role of IL-4 and IL-13 in Cutaneous T Cell Lymphoma
Authors: Mazzetto Roberto , Miceli Paola , Tartaglia Jacopo , Ciolfi Christian , Sernicola Alvise , Alaibac Mauro
Published: February 2024

The interleukins IL-4 and IL-13 are increasingly recognized contributors to the pathogenesis of cutaneous T cell lymphomas (CTCLs), and their role in disease-associated pruritus is accepted. The prevailing Th2 profile in advanced CTCL underscores the significance of understanding IL-4/IL-13 expression dynamics from the early stages of disease, as a shift from Th1 to Th2 may explain CTCL progression. Targeted agents blocking key cytokines of type 2 immunity are established therapeutics in atopic disorders and have a promising therapeutic potential in CTCL, given their involvement in cutaneous symptoms and their contribution to the pathogenesis of disease. IL-4, IL-13, and IL-31 are implicated in pruritus, offering therapeutic targets with dupilumab, tralokinumab, lebrikizumab, and nemolizumab. This review analyzes current knowledge on the IL-4/IL-13 axis in mycosis fungoides and Sezary syndrome, the most common types of CTCL, examining existing literature on the pathogenetic implications with a focus on investigational treatments. Clinical trials and case reports are required to shed light on novel uses of medications in various diseases, and ongoing research into the role of IL-4/IL-13 axis blockers in CTCL therapy might not only improve the management of disease-related pruritus but also provide in-depth insights on the pathophysiologic mechanisms of CTCL.
The Existence and Uniqueness Conditions for Solving Neutrosophic Differential Equations and Its Consequence on Optimal Order Quantity Strategy
Authors: Momena Alaa Fouad , Haque Rakibul , Rahaman Mostafijur , Salahshour Soheil , Mondal Sankar Prasad
Published: February 2024

Background: Neutrosophic logic explicitly quantifies indeterminacy while also maintaining the independence of truth, indeterminacy, and falsity membership functions. This characteristic assumes an imperative part in circumstances, where dealing with contradictory or insufficient data is a necessity. The exploration of differential equations within the context of uncertainty has emerged as an evolving area of research. Methods: the solvability conditions for the first-order linear neutrosophic differential equation are proposed in this study. This study also demonstrates both the existence and uniqueness of a solution to the neutrosophic differential equation, followed by a concise expression of the solution using generalized neutrosophic derivative. As an application of the first-order neutrosophic differential equation, we discussed an economic lot sizing model in a neutrosophic environment. Results: This study finds the conditions for the existing solution of a first-order neutrosophic differential equation. Through the numerical simulation, this study also finds that the neutrosophic differential equation approach is much better for handling uncertainty involved in inventory control problems. Conclusions: This article serves as an introductory exploration of differential equation principles and their application within a neutrosophic environment. This approach can be used in any operation research or decision-making scenarios to remove uncertainty and attain better outcomes.