bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards Data-Driven Hydration Monitoring: Insights from Wearable Sensors and Advanced Machine Learning Techniques
Authors: Sreeharsha Apparaju , McHale Sarah , Nnamoko Nonso , Pereira Ella
Published: December 2024

Advancements in wearable sensors and digital technologies/computational tools (e.g., machine learning (ML), general data analytics, mobile and desktop applications) have been explored in existing studies. However, challenges related to sensor efficacy and the application of digital technology/computational approaches for hydration assessment remain under-explored. Key knowledge gaps include applicable devices and sensors for measuring hydration and/or dehydration, the performance of approaches (e.g., ML algorithms) on sensor-based hydration monitoring; the potential of multi-sensor fusion to enhance measurement accuracy and the limitations posed by experimental datasets. This review aims to address the gaps by examining existing research to provide recommendations for future improvements. A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Comprehensive searches across PubMed, Scopus, IEEE Xplore and MDPI databases for academic studies published between 2009 and 2024 were performed using predefined inclusion and exclusion criteria. Two reviewers independently screened and assessed studies, with disagreements resolved by a third reviewer. Data was synthesised narratively or through meta-analysis, where applicable. The database search yielded 1029 articles, with 999 unique studies remaining after duplicate removal. After title and abstract screening, 910 irrelevant studies were excluded. Full-text evaluation of 89 articles led to the inclusion of 20 studies for in-depth analysis. Findings highlight significant progress in hydration monitoring through multi-sensor fusion and advanced ML techniques, which improve accuracy and utility. However, challenges persist, including model complexity, sensor variability under different conditions, and a lack of diverse and representative datasets. This review underscores the need for further research to overcome these challenges and support the development of robust, data-driven hydration monitoring solutions.
Reinforcement Learning-Based Multi-Phase Seed Scheduling for Network Protocol Fuzzing
Authors: Cheng Mingjie , Zhu Kailong , Chen Yuanchao , Lu Yuliang , Chen Chiyu , Yu Jiayi
Published: December 2024

In network protocol fuzzing, effective seed scheduling plays a critical role in improving testing efficiency. Traditional state-driven seed scheduling methods in network protocol fuzzing are often limited by imbalanced seed selection, monolithic scheduling strategies, and ineffective power allocation. To overcome these limitations, we propose SCFuzz, specifically by employing a multi-armed bandit model to dynamically balance exploration and exploitation across multiple fuzzing phases. The fuzzing process is divided into initial, middle, and final phases with seed selection strategies adapted at each phase to optimize the discovery of new states, paths, and code coverage. Additionally, SCFuzz employs a power allocation method based on state weights, focusing power on high-potential messages to improve the overall fuzzing efficiency. Experimental evaluations on open-source protocol implementations show that SCFuzz significantly improves state and code coverage, achieving up to 17.10% more states, 22.92% higher state transitions, and 7.92% greater code branch coverage compared to AFLNet. Moreover, SCFuzz improves seed selection effectiveness by 389.37% and increases power utilization by 45.61%, effectively boosting the overall efficiency of fuzzing.
Unified Domain Adaptation for Specialized Indoor Scene Inpainting Using a Pre-Trained Model
Authors: Akter Asrafi , Lee Myungho
Published: December 2024

Image inpainting for indoor environments presents unique challenges due to complex spatial relationships, diverse lighting conditions, and domain-specific object configurations. This paper introduces a resource-efficient post-processing framework that enhances domain-specific image inpainting through an adaptation mechanism. Our architecture integrates a convolutional neural network with residual connections optimized via a multi-term objective function combining perceptual losses and adaptive loss weighting. Experiments on our curated dataset of 4000 indoor household scenes demonstrate improved performance, with training completed in 20 min on commodity GPU hardware with 0.14 s of inference latency per image. The framework exhibits enhanced results across standard metrics (FID, SSIM, LPIPS, MAE, and PSNR), showing improvements in structural coherence and perceptual quality while preserving cross-domain generalization abilities. Our methodology offers a novel approach for efficient domain adaptation in image inpainting, particularly suitable for real-world applications under computational constraints. This work advances the development of domain-aware image restoration systems and provides architectural insights for specialized image processing frameworks.
Characterization of Urease from Providencia sp. LBBE and Its Application in Degrading Urea and Ethyl Carbamate in Rice Wine
Authors: Wang Han , Li Dandan , Zhu Sibao , Guo Shuxian , Ding Jiahong , Wu Chuanchao , Liu Qingtao
Published: December 2024

Enzymatic degradation of the carcinogen ethyl carbamate (EC) and its precursor urea is a promising method for controlling EC levels in alcoholic beverages. However, limited enzymes with EC-hydrolyzing activity and low ethanol or acid tolerance hinder their practical application. Here, a new urease with urea- and EC-hydrolyzing activities from Providencia sp. LBBE was characterized. The enzyme displayed considerable ethanol tolerance, retaining 42.4% activity after 1 h of incubation with 30% (v/v) ethanol at 37 °C. It exhibited broad pH tolerance (pH 3.0–8.0), with optimal pH 7.0 for EC and 7.5 for urea. After treatment at pH 4.5 and 5.0, it retained 41.3% and 59.4% activity, respectively. The Km and Vmax for EC and urea at pH 4.5 were 515.6 mM, 33.9 µmol/(min⸱mg) and 32.0 mM, 263.6 µmol/(min⸱mg), respectively. Using 6000 U/L purified enzyme at 30 °C for 9 h, 49.8% and 81.6% of urea was removed from rice wine (pH 4.5 and 7.0), respectively. No appreciable reduction in EC was observed under identical conditions, which may be ascribed to the minimal EC affinity. This study contributes to the future realization of the effective control of EC content in alcoholic beverages.
Experimental Study on the Effect of Synergistic Extinguishing Method Based on Liquid Nitrogen on Lithium-Ion Battery Fire After Thermal Runaway
Authors: Xiao Xiukun , Chen Bin , Jin Xiang , Zeng Qian , Tian Yao , Li Qiang
Published: December 2024

Lithium-ion batteries (LIBs) catch fire easily due to thermal runaway (TR). Fires following TR in LIBs pose a serious threat to public safety. Effective extinguishing methods for LIB fires have not been developed. In this work, the effect of a synergistic fire extinguishing method based on liquid nitrogen (LN) is evaluated for the suppression effect of LIB fires. LiNixCoyMnzO2 (NCM) LIBs of 106 Ah were used in the experiments. The effects of LN, water and C6F12O (Perfluorohexanone) were compared separately, as well as the synergistic effects of LN with either water or C6F12O. The results show that all agents successfully extinguished the flame and prevented the battery from reignition. Spraying LN with water resulted in the highest efficiency, and achieved the lowest peak temperature rebound and rate of rebound. It also maintained low temperatures for twice as long as using LN alone. The results show that the synergistic extinguishing method based on LN offers significant advantages in fire control. This work provides a new perspective on suppressing LIB fires after thermal runaway.
Numerical Simulation Study on the Response of Ship Engine Room Structure Under Fire Based on Thermo-Mechanical Coupling Model
Authors: Zhao Yuechao , Miao Zeya , Wang Shouye , Ai Dihao
Published: December 2024

Ship structures may collapse or be severely deformed during a fire. To precisely assess the post-fire structural integrity of ships, in this study, a thermal–mechanical coupling data interface was created, employing a significant eddy simulation algorithm for fire dynamics and a technique to analyze the structural thermal–mechanical coupling reaction. PyroSim was utilized to build a fire scenario, exporting 3D data through the device’s own program, and then the ANSYS thermal–mechanical coupling model was employed to study the spatial temperature distribution under fire-induced conditions. Data from the three-dimensional spatial temperature field served as the boundary condition for the determination of the structural temperature burden. Building on this, an analysis was conducted on the structural response of the intricate two-story interior compartment under fire conditions. The results showed that the location of the fire source and the structural distribution of the mechanical equipment inside the cabin had a great influence on the temperature and combustion heat, followed by the ventilation conditions, while the temperature variations in the parallel dual fuel tanks were greatly influenced by the stack effect. By comparing the stress and strain of the two-layer cabin under normal and fire conditions, the damage and mechanisms associated with important positions in the cabin under fire conditions were revealed.
Numerical Study on Fire Suppression by Water Mist in Aircraft Cargo Compartments: Effects of Spray Pattern, Droplet Size, and Nozzle Layout
Authors: Zhu Pei , Xu Ziheng , Zhang Jiangao , Shao Quan , Chen Weiwang , Ai Hongzhou
Published: December 2024

Aircraft cargo compartment fires are one of the main threats to the safety of civil aircraft. In this study, a series of numerical simulations on the fire suppression performance of water mist in cargo compartments was carried out to examine the effects of the spray pattern, droplet size, and nozzle layout. The fire dynamics simulator (FDS) code was used to construct a fire suppression scenario in a full-scale aircraft cargo compartment. The results show that the extinguishment time of a corner fire was longer compared with center and sidewall fires due to the relatively larger distance from the nozzle and, therefore, a lower effective number of droplets reaching the flame area. Solid and hollow spray patterns showed significant differences in the spray coverage area. For a fixed flow rate, the hollow spray showed better fire suppression performance than solid spray. When the droplet size varied from 50 to 400 µm, the fire extinguishment time first increased and then decreased, corresponding to the dominant mechanism of the smothering effect of small droplets and the cooling effect of large droplets. In addition, the nozzle layout affected the water coverage on the ground of the cargo compartment. With an increase in nozzle number, the water mist flux was more evenly distributed and the fire extinguishment effect also increased.
RETRACTED: Choi et al. Distribution Pattern and Brood Parasitism Characteristics of an Endangered Fish, Pseudopungtungia nigra, in the Geum River Basin, South Korea. Fishes 2022, 7, 321
Authors: Choi Jong-Yun , Chang Hany , Kim Seong-Ki
Published: December 2024

The journal Fishes retracts the article titled “Distribution Pattern and Brood Parasitism Characteristics of an Endangered Fish, Pseudopungtungia nigra, in the Geum River Basin, South Korea” [...]
Reduced-Order Model of a Time-Trial Cyclist Helmet for Aerodynamic Optimization Through Mesh Morphing and Enhanced with Real-Time Interactive Visualization
Authors: Di Meo E. , Lopez A. , Groth C. , Biancolini M. E. , Valentini P. P.
Published: December 2024

Aerodynamics is a key factor in time-trial cycling. Over the years, various aspects have been investigated, including positioning, clothing, bicycle design, and helmet shape. The present study focuses on the development of a methodology for the aerodynamic optimization of a time-trial helmet through the implementation of a reduced-order model, alongside advanced simulation techniques, such as computational fluid dynamics, radial basis functions, mesh morphing, and response surface methodology. The implementation of a reduced-order model enhances the understanding of aerodynamic interactions compared to traditional optimization workflows reported in sports-related research, facilitating the identification of an optimal helmet shape during the design phase. The study offers practical insights for refining helmet design. Starting with a baseline teardrop profile, several morphing configurations are systematically tested, resulting in a 10% reduction in the drag force acting on the helmet. The reduced-order model also facilitates the analysis of turbulent flow patterns on the cyclist’s body, providing a detailed understanding of aerodynamic interactions. By leveraging reduced-order models and advanced simulation techniques, this study contributes to ongoing efforts to reduce the aerodynamic resistance of time-trial helmets, ultimately supporting the goal of improved athlete performance.
Study of Internal Flow in a Liquid Nitrogen Flow Decelerator Through Swirl Effect Consisting of a Jet-Type Cryogenic Injection System for Food Freezing
Authors: Arriaga Ian , Sayán Jasuo , Ronceros Julio , Klusmann Mirko , Albatrino Renzo , Raymundo Carlos , Zapata Gianpierre , Ronceros Gustavo
Published: December 2024

This article addresses the study of internal flow dynamics within a cryogenic chamber designed for freezing food using liquid nitrogen injection. The chamber features a circular section with strategically placed jet-type atomizers for this purpose. The primary objective is to extend the residence time of the cryogenic fluid within the chamber to ensure uniform and effective freezing of the passing food items. This is achieved by inducing a swirl effect through strategic deceleration of the flow using the atomizers. The meticulous placement of these atomizers at periodic intervals along the internal walls of the cylindrical chamber ensures prolonged recirculation of the internal flow. Internal temperature analysis is crucial to ensure the freezing process. The study is supported by numerical analysis in CFD ANSYS to assess the dynamics of the swirl effect and parameters associated with the nitrogen–air interface, from which we obtain a sophisticated analysis thanks to the design of a hexahedral mesh made in greater detail in ICEM CFD. This approach aims to understand internal flow behavior and its correlation with the complexity of cryogenic system design, utilizing variable nitrogen-injection pressures and strategic atomizer placement as fundamental parameters to optimize system design.
A Short Form of a Questionnaire on Attitudes Toward Patient Communication in Nurses and Nursing Students (ACO-R): Assessment of Psychometric Properties
Authors: Tamarit Alicia , Giménez-Espert María del Carmen , Lacomba-Trejo Laura , Prado-Gascó Vicente
Published: December 2024

Background: Attitudes toward the communication of nurses and nursing students with patients can influence the health outcomes of their patients. The present study aimed to develop and validate an abbreviated form of the Attitudes Toward Communication (ACO) scale for nurses and nursing students. Methods: Two types of participants were included in this study, 385 nurses and 1408 nursing students (67.30% of the nurses and 82.10% of the students were women). After obtaining their informed consent. Attitudes toward communication (ACO) of nurses and nursing students with patients were evaluated. Results: Internal consistency and construct validity analyses were conducted. A 12-item instrument (ACO-R) was obtained that maintained the factorial structure and ensured the homogeneous distribution of items in the different subscales. The same solution was found for both samples. Conclusions: The instrument showed adequate internal consistency and validity indices. The ACO-R instrument is an efficient, valid, and reliable measure to assess ACO among nursing students and nurses.
Prospection of the Red Biological Patinas Influencing the Urban Scenery Architecture in Portuguese Territory
Authors: Sitzia Fabio , Lisci Carla , Dias Luis , Arantes Silvia Macedo , Caldeira Ana Teresa
Published: December 2024

Portugal’s architecture reflects a rich history influenced by Roman, Moorish, Neoclassical and Romantic styles, with the 20th century marked by Art Deco and colonial influences. Regional styles vary, with white-painted buildings commonly experiencing color changes due to biofilm formation. Visually striking are the red-colored biological patinascommon in the coastal areas. A survey of 120 historical buildings affected by bio-colonization helps to understand the reasons for the patinas’ growing, which beyond natural factors, is often linked to construction defects. A characterization of four samples utilizes Next-Generation Sequencing (NGS) to identify the microorganisms composing the red biofilm, while the SEM-EDS, FTIR-ATR and XRD techniques provide further insights into the biofilm and substrate features. The comprehensive data of biochemical characterization indicate a wide variety of microorganisms, including bacteria and fungi, some of which exhibit potential as producers of a UV-tolerant red/yellow pigment (carotenoid) responsible for the macroscopic coloration of bio-colonization.
The Spatial and Temporal Characteristics of Ecosystem Service Trade-Offs and Synergistic Relationships in a Mountainous Region of Northern China
Authors: Hou Xianglong , Yang Hui , Cao Jiansheng
Published: December 2024

Understanding ecosystem service trade-offs and synergies is the foundation for achieving the efficient management of the ecosystem and improving human well-being. Therefore, in this paper, multi-scale trade-offs and synergies among eleven secondary ecosystem service (ES) types of four ecosystem service categories in the mountainous areas of North China in 2015 are assessed using statistical methods and spatial analysis, and their driving factors are analyzed, including natural factors and socioeconomic factors. The results show that for the study area, only the raw material production service and nutrient cycle maintenance service, water supply service and hydrological regulation service, environmental purification service and biodiversity maintenance service, environmental purification service and aesthetic landscape service, and biodiversity maintenance service and aesthetic landscape service show extremely strong synergistic correlations at four spatial scales. The spatial autocorrelation among services at different scales is basically consistent with the statistical correlation, but the degree of correlation varies. Unlike the grid, township, and county scales, all service pairs are spatially autocorrelated across the study area at the land use type scale, and the clustering characteristics are more obvious and similar. All service pairs are synergistic with low–low values at the mountain–plain junction in the Taihang Mountain (THM) and in the northern part of the Bashang region (BSR). The spatial trade-offs and synergies of the regulating and maintenance services in the study area are closely related to the spatial distribution of land use types. The main natural influence on the synergistic trade-offs of ecosystem services (ESs) at the township scale is elevation, while socioeconomics are mainly influenced by population and GDP. This study can contribute to strengthening decision makers’ understanding of the spatial scales of ES relationships in mountain areas and the extent to which different natural and socioeconomic factors influence them.
IL-18 and IL-18BP: A Unique Dyad in Health and Disease
Authors: Novick Daniela
Published: December 2024

Interleukin-18 (IL-18) serves a dual function in the immune system, acting as a “double-edged sword” cytokine. Depending on the microenvironment and timing, IL-18 can either drive harmful inflammation or restore immune homeostasis. Pathologies characterized by elevated IL-18, recently proposed to be termed IL-18opathies, highlight the therapeutic potential for IL-18 blockade. IL-18 Binding Protein (IL-18BP) is one of only four natural cytokine antagonists encoded by a separate gene, distinguishing it from canonical soluble receptors. IL-18BP’s exceptionally high affinity and slow dissociation rate make it an effective regulator of IL-18, essential for maintaining immune balance and influencing disease outcomes, and positions IL-18BP as a promising alternative to more aggressive treatments that carry risks of severe infections and other complications. Tadekinig alfa, the drug form of IL-18BP, represents a targeted therapy that modulates the IL-18/IL-18BP axis, offering a safe adverse-effect-free option. With orphan drug designation, Phase III clinical trial completion, and seven years of compassionate use, Tadekinig alfa holds promise in treating autoimmune and inflammatory diseases, cancer, and genetically linked disorders. Levels of IL-18, free IL-18 and IL-18BP, may serve as biomarkers for disease severity and therapeutic response. Given its pivotal role in immune balance, the IL-18/IL-18BP dyad has attracted interest from over ten pharmaceutical companies and startups, which are currently developing innovative strategies to either inhibit or enhance IL-18 activity depending on the therapeutic need. The review focuses on the features of the dyad members and screens the therapeutic approaches.
Evaluation of Neonatal Screening Programs for Tyrosinemia Type 1 Worldwide
Authors: Kuypers Allysa M. , Bouva Marelle J. , Loeber J. Gerard , Boelen Anita , Dekkers Eugenie , Petritis Konstantinos , Pickens C. Austin ,   The ISNS Representatives, van Spronsen Francjan J. , Heiner-Fokkema M. Rebecca
Published: December 2024

In The Netherlands, newborn screening (NBS) for tyrosinemia type 1 (TT1) uses dried blood spot (DBS) succinylacetone (SUAC) as a biomarker. However, high false-positive (FP) rates and a false-negative (FN) case show that the Dutch TT1 NBS protocol is suboptimal. In search of optimization options, we evaluated the protocols used by other NBS programs and their performance. We distributed an online survey to NBS program representatives worldwide (N = 41). Questions focused on the organization and performance of the programs and on changes since implementation. Thirty-three representatives completed the survey. TT1 incidence ranged from 1/13,636 to 1/750,000. Most NBS samples are taken between 36 and 72 h after birth. Most used biomarkers were DBS SUAC (78.9%), DBS Tyrosine (Tyr; 5.3%), or DBS Tyr with second tier SUAC (15.8%). The pooled median cut-off for SUAC was 1.50 µmol/L (range 0.3–7.0 µmol/L). The median cut-off from programs using laboratory-developed tests was significantly higher (2.63 µmol/L) than the medians from programs using commercial kits (range 1.0–1.7 µmol/L). The pooled median cut-off for Tyr was 216 µmol/L (range 120–600 µmol/L). Overall positive predictive values were 27.3% for SUAC, 1.2% for Tyr solely, and 90.1% for Tyr + SUAC. One FN result was reported for TT1 NBS using SUAC, while three FN results were reported for TT1 NBS using Tyr. The NBS programs for TT1 vary worldwide in terms of analytical methods, biochemical markers, and cut-off values. There is room for improvement through method standardization, cut-off adaptation, and integration of new biomarkers. Further enhancement is likely to be achieved by the application of post-analytical tools.
A Machine-Learning-Based and IoT-Enabled Robot Swarm System for Pipeline Crack Detection
Authors: Kandil Ayman , Khanafer Mounib , Darwiche Ali , Kassem Reem , Matook Fatima , Younis Ahmad , Badran Habib , Bin-Jassem Maryam , Ahmed Ossama , Behiry Ali , El-Abd Mohammed
Published: December 2024

In today’s expanding cities, pipeline networks are becoming an essential part of the industrial infrastructure. Monitoring these pipelines autonomously is becoming increasingly important. Inspecting pipelines for cracks is one specific task that poses a huge burden on humans. Undetected cracks may pose multi-dimensional risks. In this paper, we introduce the Pipeline Leak Identification Emergency Robot Swarm (PLIERS) system, an industrial system that deploys Internet-of-Things (IoT), robotics, and neural network technologies to detect cracks in emptied water and sewage pipelines. In PLIERS, a swarm of robots inspect emptied pipelines from the inside to detect cracks, collect images of them, and register their locations. When the images are taken, they are fed into a cloud-based module for analysis by a convolutional neural network (CNN). The CNN is used to detect cracks and identify their severity. Through extensive training and testing, the CNN model performance showed promising scores for accuracy (between 80% and 90%), recall (at least 95%), precision (at least 95%), and F1 (at least 96%). Additionally, through the careful design of a prototype for a water/sewage pipeline structure with several types of cracks, the robots used managed to exchange information among themselves and convey crack images to the cloud-based server for further analysis. PLIERS is a system that deploys modern technologies to detect and recognize cracks in pipeline grids. It adds to the efforts of improving instrumentation and measurement approaches by using robots, sensory, IoT principles, and the efficient analysis of CNNs.
Predictive Factors for Urinary Tract Infections in Patients with Type 2 Diabetes
Authors: Sorescu Teodora , Cosnita Andrei , Braha Adina , Timar Romulus , Timar Bogdan , Licker Monica , Lazar Sandra , Gaita Laura , Albai Oana , Popescu Simona
Published: December 2024

Background/Objectives: Patients with diabetes (DM) are at an increased risk of infection, with urinary tract infections (UTIs) being common among individuals with type 2 DM (T2D). The aim of this study was to determine the prevalence and risk factors for UTIs among hospitalized T2D patients from Timișoara, Romania. Methods: The hospital records of 1139 T2D adult inpatients who were ordered to provide urine cultures during hospitalization were reviewed. Results: The prevalence of UTIs among T2D patients was 19.7%, and was higher in women than in men (27.5% vs. 9.8%, p < 0.0001). Patients with UTIs presented a significantly older age, a longer duration of DM, a higher BMI, higher levels of HbA1c, higher renal function parameters, and more frequent DM-related complications and comorbidities than patients without UTIs. The following predictors were associated with increased UTI risk: age (OR = 1.05, p < 0.0001); duration of DM (OR = 1.04, p < 0.0001); BMI (OR = 1.05, p < 0.0002); HbA1c levels (OR = 1.58, p < 0.0001); female gender (OR = 3.47, p < 0.0001); and the presence of retinopathy (OR = 1.47, p = 0.0118), chronic kidney disease (OR = 3.98, p < 0.0001), distal symmetric polyneuropathy (OR = 7.65, p < 0.0001), and cerebrovascular disease (OR = 4.88, p < 0.0001). The use of sodium-glucose co-transporter 2 (SGLT2) inhibitors did not influence the risk of developing UTIs. Conclusions: T2D patients with prolonged disease duration, poor glycemic control, and DM-related complications are at an increased risk of developing UTIs. Therefore, a targeted therapeutic strategy addressing these risk factors is essential.
Use of Infrared Thermography in Podiatry: Systematic Review and Meta-Analysis
Authors: García-de-la-Peña Raquel , Juárez-Jiménez José María , Cuevas Sánchez José Manuel , Rayo Rosado Rafael , Rayo Pérez Ana María
Published: December 2024

Background/Objectives: Infrared thermography is an advanced technique that detects infrared light emitted by the body to map thermal changes related to blood flow. It is recognized for being noninvasive, fast, and reliable and is employed in the diagnosis and prevention of various medical conditions. In podiatry, it is utilized for managing diabetic foot ulcers, musculoskeletal injuries such as Achilles tendinopathy, and onychomycosis, among others. The primary objective is to analyze the application of thermography in podiatry as a diagnostic evaluation tool. Secondary objectives include evaluating the use of thermography in diagnosing musculoskeletal injuries, determining its role in preventing diabetic foot ulcers and onychomycosis, assessing its utility in sports performance evaluation with plantar orthoses, and reviewing its cost-effectiveness in detecting common foot conditions and deformities. Methods: A systematic review and meta-analysis of the existing literature on the use of thermography in podiatry were conducted. Studies addressing various applications of thermography were included, focusing on its effectiveness, sensitivity, and specificity. Both studies comparing plantar temperature before and after interventions with orthoses and those exploring thermography in diagnosing specific pathologies were analyzed. Results: Ten randomized clinical trials on the use of infrared thermography in podiatric conditions were included, with participant ages ranging from 18 to 80 years (n = 10–223). Treatments for Achilles tendinopathy, diabetic foot ulcers, and peripheral arterial disease were explored. Infrared thermography was utilized to measure thermal changes, evaluate plantar orthoses, and diagnose onychomycosis. The findings underscore the potential of infrared thermography in preventing and diagnosing various podiatric pathologies. Conclusions: Infrared thermography is a noninvasive technique in podiatry that provides real-time imaging without radiation. It is useful for detecting musculoskeletal injuries, diabetic skin ulcers, and onychomycosis and contributes to enhancing sports performance. In conclusion, it is a valuable tool in podiatric practice to optimize therapeutic approaches.
Demographics, Disease Characteristics, and Treatment Patterns of Patients with Plaque Psoriasis Treated with Biological Drugs: The Experience of a Single-Centre Study in Poland
Authors: Kimak-Pielas Agnieszka , Robak Ewa , Zajdel Radosław , Żebrowska Agnieszka
Published: December 2024

Objectives: This study is a retrospective analysis of patients with plaque psoriasis treated with biological drugs at a single center in Poland. We sought to evaluate patient demographics, disease characteristics, comorbidity burden, and treatment patterns in this cohort. Methods: Data were collected from the medical records of patients with plaque psoriasis who received biological treatments. In total, data from 1 January 2013 to 2 August 2024 were analyzed, encompassing 159 patients. The variables analyzed included age, disease duration, affected areas, prior treatments, and treatment outcomes. Results: The mean age at the start of biological treatment was 48 years (range: 10–73 years), with an average psoriasis duration of 18.2 years (range: 1–51 years). Obesity was noted in 39% of patients. Psoriasis lesions commonly affected the scalp (74.66%) and nails (64.38%). Methotrexate was the most commonly used systemic therapy prior to biologics (86.30%). Risankizumab and adalimumab were the most frequently prescribed biologics. Secondary treatment failure led to the highest discontinuation rates with tildrakizumab, whereas bimekizumab, guselkumab, risankizumab, and secukinumab showed the lowest rates. Conclusions: Biological drugs play a pivotal role in managing plaque psoriasis, particularly for patients with comorbidities and in treating challenging areas such as the scalp and nails. Risankizumab and adalimumab were prominent in prescription patterns. Future research involving larger cohorts and prospective designs is needed to deepen understanding and optimize treatment strategies for plaque psoriasis in Poland.
Neuromechanical Models of Mild Traumatic Brain Injury Conditioned on Reaction Time: A Systematic Review and Meta-Analysis
Authors: Baskaran Avinash , Hoehn Ross D. , Rose Chad G.
Published: December 2024

The accurate, repeatable, and cost-effective quantitative characterization of mild traumatic brain injuries (mTBIs) is crucial for safeguarding the long-term health and performance of high-risk groups, including athletes, emergency responders, and military personnel. However, gaps remain in optimizing mTBI assessment methods, especially regarding the integration of neuromechanical metrics such as reaction time (RT) in predictive models. Background/Objectives: This review synthesizes existing research on the use of neuromechanical probabilistic models as tools for assessing mTBI, with an emphasis on RT’s role in predictive diagnostics. Methods: We examined 57 published studies on recent sensing technologies such as advanced electromyographic (EMG) systems that contribute data for probabilistic neural imaging, and we also consider measurement models for real-time RT tracking as a diagnostic measure. Results: The analysis identifies three primary contributions: (1) a comprehensive survey of probabilistic approaches for mTBI characterization based on RT, (2) a technical examination of these probabilistic algorithms in terms of reliability and clinical utility, and (3) a detailed outline of experimental requirements for using RT-based metrics in psychomotor tasks to advance mTBI diagnostics. Conclusions: This review provides insights into implementing RT-based neuromechanical metrics within experimental frameworks for mTBI diagnosis, suggesting that such metrics may enhance the sensitivity and utility of assessment and rehabilitation protocols. Further validation studies are recommended to refine RT-based probabilistic models for mTBI applications.
Radiological Perspectives in Congenital Sensorineural Hearing Loss: Insights from Cochlear Implant Candidates
Authors: Şirolu Sabri , Hamid Rauf , Karagöz Seyfullah Halit , Kargın Osman Aykan , Salt Vefa , Yener Sevda , Kara Halide Çetin , Gözen Emine Deniz , Arslan Serdar , Korkmazer Bora , Tutar Onur , Kızılkılıç Osman
Published: December 2024

Objectives: Congenital hearing loss is a significant health concern, with diverse etiologies encompassing cochlear and cochleovestibular pathologies. Preoperative radiological evaluation in cochlear implant candidates is pivotal for treatment planning. We aim to elucidate the spectrum of radiological findings in patients with congenital hearing loss undergoing cochlear implant assessment. Methods: An analysis included 389 sensorineural hearing loss (SNHL) patients who underwent cochlear implantation at a tertiary university hospital, of which 177 were congenital SNHL. Computed tomography (CT) and magnetic resonance imaging (MRI) data were meticulously assessed for diverse congenital pathologies, focusing on congenital malformations. Results: In the congenital SNHL group, comprising 177 patients (80 females and 97 males), congenital cochleovestibular malformations were evident in 56 ears of 29 cases. Different congenital cochleovestibular malformations, ranging from labyrinthine aplasia to isolated large vestibular aqueducts, were detected. Among the various anomalies, incomplete partitions and cochlear hypoplasia emerged as more frequent patterns. Conclusions: This study offers a comprehensive radiological analysis of congenital SNHL patients undergoing cochlear implantation, revealing a spectrum of anomalies. It demonstrates the diverse nature of anomalies affecting the external auditory canal, middle ear structures, and cochleovestibular system. These insights provide a deeper understanding of congenital SNHL and contribute to developing informed treatment strategies.
On-Target Low-Density Lipoprotein Cholesterol in Adults with Diabetes Not at High Cardiovascular Disease Risk Predicts Greater Mortality, Independent of Early Deaths or Frailty
Authors: Chwal Bruna C. , Reis Rodrigo C. P. dos , Schmidt Maria I. , Ribeiro Antonio L. P. , Barreto Sandhi M. , Griep Rosane H. , Lotufo Paulo A. , Duncan Bruce B.
Published: December 2024

Background/Objectives: Lowering low-density lipoprotein cholesterol (LDL-C) to <70 mg/dL is recommended for most patients with diabetes. However, clinical trials investigating subjects with diabetes who are not at high cardiovascular risk are inconclusive regarding the all-cause mortality benefit of the current target, and real-world studies suggest greater mortality. We aimed to assess the all-cause mortality at different LDL-C levels among subjects with diabetes not at high risk and to examine the potential roles of early deaths and frailty for this greater mortality. Methods: We followed 2098 such participants of the ELSA-Brasil cohort between 2008 and 2019. Results: Over 10.3 (1.4) years of follow-up, 204 (9.7%) individuals died. In the proportional hazards models, participants with LDL-C values < 100 mg/dL and <70 mg/dL had greater adjusted mortality compared to those with LDL-C 100–129 mg/dL (HR = 1.67; 95%CI 1.21–2.30 and HR = 2.27; 95%CI 1.51–3.41, respectively). Increased risk when LDL-C was <100 mg/dL was higher in those >60 years (HR = 2.12; 95%CI 1.35–3.34) and greatest for deaths due to cancer (HR = 2.55; 95%CI 1.10–5.91). Further analyses for those with LDL-C < 100 mg/dL that excluded early deaths and adjusted for the frailty phenotype (HR = 2.01; 1.19–3.41) or frailty index (HR = 1.92; 1.17–3.16) did not materially alter the results. The risk of death across the spectrum of LDL-C was U-shaped, with a nadir at 112.2 mg/dL. Conclusions: The higher risk of all-cause mortality in these subjects with LDL-C within currently recommended levels was not explained by early deaths or frailty. Given the recent decline in cardiovascular mortality and the increased risk of cancer and infections in persons with diabetes, the clinical significance of low LDL-C in diabetes requires reconsideration and the definition of LDL-C treatment targets in diabetes warrants further trial evaluation.
Potential Causal Association Between Atrial Fibrillation/Flutter and Primary Open-Angle Glaucoma: A Two-Sample Mendelian Randomisation Study
Authors: Lee Young , Seo Je Hyun
Published: December 2024

Background: A few studies have reported controversial relationships between atrial fibrillation/flutter (AF/L) and primary open-angle glaucoma (POAG). This study aimed to investigate the potential causal relationship between AF/L and POAG. Methods: Single-nucleotide polymorphisms associated with exposure to AF/L were selected as instrumental variables with significance (p < 5.0 × 10−8) from a genome-wide association study (GWAS) by FinnGen. The GWAS summary of POAG from the UK Biobank was used as the outcome dataset. A two-sample Mendelian randomisation (MR) study was performed to assess the causal effects of AF/L on POAG. In addition, potential confounders, including hypertension, autoimmune hyperthyroidism, sleep apnoea, and alcohol use disorder, were assessed using multivariable MR analysis. Results: There was a significant causal association of AF/L with POAG (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.07–1.48, p = 0.005 using inverse-variance weighting [IVW]). Multivariable MR analysis confirmed a causal association of AF/L with POAG (OR = 1.24, 95% CI = 1.02–1.51, p = 0.034 using IVW), but hypertension, hyperthyroidism, sleep apnoea and alcohol use disorder did not show significant causal associations with POAG (all p > 0.05). Conclusions: This established causal relationship between AF/L and POAG supports the need for further investigation into the role of AF/L as a possible risk factor for POAG. Further research is required to confirm these findings.
The Etiology of Total Knee Arthroplasty Failure Influences on Improvement in Knee Function: A Follow-Up Study
Authors: Weis Sandy , Seifert Lisa , Oltmanns Moritz , Khury Farouk , Bieger Ralf , Faschingbauer Martin
Published: December 2024

Background: Outcomes following total knee arthroplasty (TKA) revisions are variable, and it is hypothesized that the underlying cause of primary TKA failure impacts postoperative outcomes. This study analyzes the results of TKA revisions seven years after surgery, in relation to the etiology of primary failure and other influencing factors. A previous study conducted in 2013 examined the same cohort of patients three months after revision surgery. Methods: From the original study, 97 patients were followed up, and 49 patients were eligible for inclusion. Patients were classified into four groups: “periprosthetic infection” (PPI), “aseptic loosening,” “instability,” and “arthrofibrosis.” Outcomes were analyzed using established scores (the Knee Society Score (KSS), New Knee Society Score (nKSS), and the Western Ontario and McMaster Universities (WOMAC) index) and considering factors such as age, gender, BMI, and ASA classification. The outcomes were analyzed using three time intervals: “Outcome Short” (preoperative to 3 months postoperative); “Outcome Long” (preoperative to 7 years postoperative); and “Delta PostOP” (3 months postoperative to 7 years postoperative). Results: Significant improvements were observed in all time intervals, especially in the “Outcome Short” (p < 0.001) and “Delta PostOP” (p < 0.001) periods. The “instability” and “aseptic loosening” groups showed better outcomes in terms of range of motion and knee scores than the “arthrofibrosis” and “infection” groups (p < 0.05). A lower BMI and an ASA status of II were associated with better outcomes (p < 0.05). Women also showed superior results in the nKSS (p < 0.05). Discussion: Patients with “aseptic loosening” and “instability” had the best long-term outcomes. Lower BMI and better ASA status also correlated with improved results. These findings can inform patients of the potential outcomes of revision surgery, thereby facilitating informed decision-making.
Are Healthcare Resource Utilization Patterns for Pain Management Specific to Post-Acute COVID-19 Syndrome? A Study of Survivors from the First French Pandemic Wave
Authors: Dziadzko Mikhail , Belhassen Manon , Van Ganse Eric , Marant-Micallef Claire , Martinez Valeria , Aubrun Frederic
Published: December 2024

Objectives: Chronic pain is a common symptom in Post-Acute COVID-19 Syndrome (PACS), affecting 11–60% of patients, but the link between COVID-19 and chronic pain remains unclear. This study assesses healthcare resource utilization (HRU) for pain management among French COVID-19 survivors, using the National French Claims Database (SNDS). We analyzed medical consultations, rehabilitation services, diagnostic procedures, and medication dispensing to identify PACS-related pain patterns and their impact on the healthcare system. Methods: The cohort included 68,822 patients hospitalized during the first COVID-19 wave (March–June 2020), with 13,939 ICU survivors. HRU was assessed for six months pre- and post-hospitalization in four areas: (1) medical consultations and rehabilitation; (2) pain-related medication dispensing; (3) neuropathic diagnostic procedures; (4) hospital admissions for chronic pain. A post–pre ratio (PP-Ratio) compared post-COVID to pre-COVID HRU. Results: Significant changes in HRU were observed, particularly for ICU survivors. Neurology consultations (PP-Ratio 1.41) and outpatient physical therapy (PP-Ratio 1.69) increased. Dispensing of strong opioids, antiepileptics, anxiolytics, and hypnotics rose, while NSAID use decreased. Hospitalizations for chronic pain also increased (PP-Ratio 1.52). Similar trends were seen among ICU survivors, with notable increases in opioid and antiepileptic use. No distinct PACS-related pain patterns emerged. Conclusions: Non-specific increases in HRU for pain management were found following COVID-19 hospitalization, likely due to disease severity and ICU care rather than PACS-related chronic pain. Further research is needed to explore long-term pain outcomes in this population.
Effect of Exposure to Blue Light from Electronic Devices and the Mediterranean Diet on Macular Pigment
Authors: García-Romera Marta-C. , Ponce-García Víctor , Torres-Parejo Úrsula , López-Muñoz Alfredo
Published: December 2024

Objective: To explore the effect of time exposure to flat screen electronic devices with LED lighting and the Mediterranean diet on macular pigment optical density (MPOD). Methods: In this cross-sectional observational study, the MPOD was measured by heterochromatic flicker photometry in 164 eyes (47 of younger women aged 20–31 and 35 of older women aged 42–70). Exclusion criteria: evidence of macular degeneration and eyes with cataracts. Data on the use of electronic devices and Mediterranean diet adherence were collected through a survey. Nonparametric analysis of variance and independent sample t-tests were used to compare subjects. Results: Significant differences (p < 0.01) were found in total time of exposure to LEDs (hours per day) between both groups (9.31 ± 3.74 younger women vs. 6.33 ± 3.64 older women). The MPOD values for the younger and adult populations were significantly different: 0.38 ± 0.16 and 0.47 ± 0.15 (p < 0.01), respectively. When comparing both groups for the same time of exposure to LEDs, differences were obtained between MPOD values of both populations: For total exposures greater than 6 h per day, the MPOD values were lower in younger women than in adult ones (0.37 ± 0.14 vs. 0.50 ± 0.14, p < 0.01). On the other hand, a significantly higher adherence was found in the older women in comparison with the younger women (OW 9.23 ± 2.50 vs. YW 7.70 ± 2.08, p < 0.01), with higher MPOD values (OW (0.52 ± 0.14) vs. (YW (0.34 ± 0.18). Conclusions: Higher MPOD values are observed with decreasing exposure time to electronic devices with LED lighting screens and higher adherence to the Mediterranean diet.
Endurance Sports and Atrial Fibrillation: A Puzzling Conundrum
Authors: Ostojic Marina , Ostojic Mladen , Petrovic Olga , Nedeljkovic-Arsenovic Olga , Perone Francesco , Banovic Marko , Stojmenovic Tamara , Stojmenovic Dragutin , Giga Vojislav , Beleslin Branko , Nedeljkovic Ivana
Published: December 2024

The confirmed benefits of regular moderate exercise on cardiovascular health have positioned athletes as an illustration of well-being. However, concerns have arisen regarding the potential predisposition to arrhythmias in individuals engaged in prolonged strenuous exercise. Atrial fibrillation (AF), the most common heart arrhythmia, is typically associated with age-related risks but has been documented in otherwise healthy young and middle-aged endurance athletes. The mechanism responsible for AF involves atrial remodeling, fibrosis, inflammation, and alterations in autonomic tone, all of which intersect with the demands of endurance sports, cumulative training hours, and competitive participation. This unique lifestyle requires a tailored therapeutic approach, often favoring radiofrequency ablation as the preferred treatment. As the number of professional and non-professional athletes engaging in high-level daily sports activities rises, awareness of AF within this demographic becomes imperative. This review delivers the etiology, pathophysiology, and therapeutic considerations surrounding AF in endurance sports.