bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of the Global Pandemic on Veterans with Serious Mental Illness (SMI): Healthcare Utilization and Mortality
Authors: Soreca Isabella , Boudreaux-Kelly Monique , Seo Yeon-Jung , Haas Gretchen
Published: April 2024

Background: Individuals with serious mental illness (SMI) experience barriers to accessing and engaging with healthcare, which may have been exacerbated during the emergence of the global pandemic and the rapid shift to telemedicine platforms, substantially decreasing healthcare utilization for non-COVID-19 disorders. Important repercussions on morbidity and mortality may be seen in the months and years to come, which may disproportionately affect high-risk populations, such as patients with SMI, with reduced access to technology platforms. In this study, we explored the impact of the pandemic on healthcare utilization and all-cause mortality rate in SMI compared to non-SMI individuals for the months of March–September 2020 and the same two quarters in 2019. Methods: Data were obtained from the VA Corporate Data Warehouse (CDW), a data repository from clinical and administrative VA systems. The sample included veterans with ≥1 outpatient clinical encounter nationally between 1 January 2019 and 31 December 2020. Results: The cohort for this study included 1,018,047 veterans receiving care through the Veterans Health Administration between 2019 and 2020. Of those, 339,349 had a diagnosis of SMI. Patients with SMI had a significantly larger pre–post-pandemic decrease in outpatient (49.7%, p < 0.001), inpatient (14.4%, p < 0.001), and ED (14.5%, p < 0.001) visits compared to non-SMI patients. Overall, 3752 (1.59%) veterans without SMI and 4562 (1.93%) veterans with SMI died during our observation period. Veterans without SMI who died during the observation period were more likely to have had a positive COVID-19 test compared to veterans with SMI. Unadjusted analyses showed that veterans with SMI were approximately 2.5 times more likely to die than veterans without SMI during the first 6 months of the pandemic, compared to the same two quarters of the previous year. However, after adjustment by pertinent covariates, the predictors associated with an increased risk of death from SMI were older age, being male, a higher CAN score, more inpatient stays in the pre period compared to post, and a positive COVID-19 test. Discussion: Consistent with our initial hypothesis, all the indices of healthcare utilization, namely the number of outpatient, inpatient, and ED visits, significantly decreased between pre- and post-pandemic and did more so for veterans with SMI, despite having more chronic medical illnesses and being prescribed more medications than veterans without SMI. On the other hand, while mortality was greater post-pandemic, factors such as age, morbidity, and having a positive COVID-19 test predicted mortality above and beyond having an SMI diagnosis.
Development of Seismic Fragility Function for Underground Railway Station Structures in Korea
Authors: Kwon Sun Yong , Kim Jongkwan , Kwak Dongyoup , Yang Seunghoon , Yoo Mintaek
Published: April 2024

This study describes the methodology employed to construct a seismic fragility function based on a pre-existing numerical model tailored for underground stations. Employing a dynamic numerical model, a comprehensive analysis encompassing 110 distinct cases was conducted, each varying in soil depth and classification. Seismic waves, conforming to the standard design spectrum, were utilized within these numerical analyses. The formulation of the fragility function within the constructed model follows a structured approach, segmented by damage indices and severity levels. This systematic breakdown serves to outline the fundamental framework for establishing the fragility function, providing insights into its development process. Subsequently, the derived fragility function underwent a rigorous comparative analysis against established seismic fragility functions from prior studies. This comparative assessment serves as a critical evaluation tool, allowing for an appraisal of the suitability and robustness of the newly developed fragility function in relation to existing benchmarks.
Mechanical Performance Optimization and Microstructural Mechanism Study of Alkali-Activated Steel Slag–Slag Cementitious Materials
Authors: Wang Mengqi , Xu Jian , Zhang Xuejing , Tan Longzhen , Mei Yuan
Published: April 2024

The optimal proportion of alkali-activated steel slag–slag cementitious materials is investigated by considering the combined effects of steel slag content, alkali content, water glass modulus, and water–binder ratio using the Box–Behnken design in response surface methodology. Qualitative and semi-quantitative analyses of X-ray diffraction (XRD) patterns and scanning electron microscopy with energy-dispersive spectroscopy (SEM-EDS) images are conducted. The microstructural mechanism is elucidated based on the chemical composition, surface morphology, and microscale pore (crack) structures of the samples. A microreaction model for the alkali-activated steel slag and slag is proposed. The optimal composition for alkali-activated steel slag–slag cementitious materials is as follows: steel slag content, 38.60%; alkali content, 6.35%; water glass modulus, 1.23; and water–binder ratio, 0.48. The strength values predicted by the response surface model are p1d = 32.66 MPa, p7d = 50.46 MPa, and p28d = 56.87 MPa. XRD analysis confirms that the compressive strength of the sample is not only influenced by the amount of gel formed, but also, to a certain extent, by the CaCO3 crystals present in the steel slag, which act as nucleation sites. The SEM-EDS results confirm that the gel phase within the system comprises a hydrated calcium silicate gel formed through the reaction of volcanic ash and geopolymer gel formed through geo-polymerization. Analysis of the pore (crack) structure reveals that the compressive strength of the specimens is primarily influenced by porosity, with a secondary influence of the pore fractal dimension.
A BIM-Based Bar Bending Schedule Generation Algorithm with Enhanced Accuracy
Authors: Khant Lwun Poe , Widjaja Daniel Darma , Kwon Keehoon , Kim Sunkuk
Published: April 2024

Rebar quantity estimation is pivotal for determining the cost of construction projects and is essential for bidding purposes. A bar bending schedule plays a crucial role by providing rebar information and bending instructions, facilitating efficient procurement. Traditional methods, which rely on manually extracting data from 2D (two-dimensional) drawings, are error-prone and hinder construction productivity. This study utilized a special length approach to yield optimal rebar consumption, resulting in a total rebar order of 19,582.427 t and minimizing rebar waste to 0.77%. Additionally, this method saved 3000.22 t of rebar compared to traditional methods, using only stock lengths. To enhance the accuracy and efficiency, a 3D (three-dimensional) model was developed in a Building Information Modeling (BIM) environment to prepare a Bar Bending Schedule (BBS) automatically, integrated with an Application Programming Interface (API) for data entry to eliminate manual errors. The efficacy of the proposed algorithm was confirmed by comparing the rebar quantities it generated with those obtained from optimization calculations. The results demonstrated a mean absolute error of 0.017 and a mean absolute percentage error of 1.13%, validating the algorithm’s precision. Furthermore, this method reduced the manpower required for BBS preparation by 33.33%, highlighting its potential to revolutionize construction workflow efficiency and accuracy.
Optimizing the Incorporation Modes of TiO2 in TiO2-Al2O3 Composites for Enhancing Hydrodesulfurization Performance of Corresponding NiMoP-Supported Catalysts
Authors: Hou Ranran , Yang Qinghe , Zeng Shuangqin , Bao Jun , Nie Hong , Yang Chuangchuang , Jia Yanzi , Hu Anpeng , Dai Qiaoling
Published: April 2024

TiO2-Al2O3 supports with different incorporation methods of titania were synthesized via three methods: impregnation (TA-I), co-precipitation (TA-CP), and co-precipitation–hydrothermal treatment (TA-HT). And the NiMoP catalysts prepared on the corresponding supports were evaluated for hydrodesulfurization (HDS) reactions. The results demonstrated that the Ti atoms in TA-I are attached to alumina through hydroxyl groups, while the Ti atoms in TA-CP and TA-HT can be dispersed in the alumina skeleton. Variations in the incorporation modes of TiO2 affect the support properties, consequently influencing the nature of the active metal on the supports. The Ti atoms dispersed in the Al2O3 skeleton allow an increase in the basic hydroxyl groups. Meanwhile, TiO2 in TA-CP and TA-HT can absorb hydrogen molecules and be partially reduced. Furthermore, metal species supported on the TA-CP and TA-HT are more easily reduced and better dispersed. For the NiMoP catalysts prepared with TA-CP and TA-HT, the Ti element promotes the sulfidation degree of Mo, besides shortening the average (Ni)MoS2 slab. The catalysts prepared with TA-CP exhibited superior activity for 4,6-DMDBT hydrodesulfurization. This can be ascribed not only to the relatively high sulfidation degree of Mo and proportion of the NiMoS active phase but also to the well-dispersed (Ni)MoS2 slabs. Moreover, the Ti4+ ions dispersed in the Al2O3 skeleton can be partially reduced to act as electron donors, enhancing the metallic character of the S layers in MoS2, which facilitates the improvement of the hydrogenation desulfurization activity.
Crosstalk between DNA Damage Repair and Metabolic Regulation in Hematopoietic Stem Cells
Authors: Xu Jian , Fei Peiwen , Simon Dennis W. , Morowitz Michael J. , Mehta Parinda A. , Du Wei
Published: April 2024

Self-renewal and differentiation are two characteristics of hematopoietic stem cells (HSCs). Under steady physiological conditions, most primitive HSCs remain quiescent in the bone marrow (BM). They respond to different stimuli to refresh the blood system. The transition from quiescence to activation is accompanied by major changes in metabolism, a fundamental cellular process in living organisms that produces or consumes energy. Cellular metabolism is now considered to be a key regulator of HSC maintenance. Interestingly, HSCs possess a distinct metabolic profile with a preference for glycolysis rather than oxidative phosphorylation (OXPHOS) for energy production. Byproducts from the cellular metabolism can also damage DNA. To counteract such insults, mammalian cells have evolved a complex and efficient DNA damage repair (DDR) system to eliminate various DNA lesions and guard genomic stability. Given the enormous regenerative potential coupled with the lifetime persistence of HSCs, tight control of HSC genome stability is essential. The intersection of DDR and the HSC metabolism has recently emerged as an area of intense research interest, unraveling the profound connections between genomic stability and cellular energetics. In this brief review, we delve into the interplay between DDR deficiency and the metabolic reprogramming of HSCs, shedding light on the dynamic relationship that governs the fate and functionality of these remarkable stem cells. Understanding the crosstalk between DDR and the cellular metabolism will open a new avenue of research designed to target these interacting pathways for improving HSC function and treating hematologic disorders.
Divergent and Compensatory Effects of BMP2 and BMP4 on the VSMC Phenotype and BMP4’s Role in Thoracic Aortic Aneurysm Development
Authors: Klessinger Daniel , Mamazhakypov Argen , Glaeser Sophie , Emig Ramona , Peyronnet Remi , Meier Lena , Proelss Kora , Marenne Katia , Smolka Christian , Grundmann Sebastian , Pankratz Franziska , Esser Philipp R. , Moser Martin , Zhou Qian , Esser Jennifer S.
Published: April 2024

Vascular smooth muscle cells (VSMCs) play a key role in aortic aneurysm formation. Bone morphogenetic proteins (BMPs) have been implicated as important regulators of VSMC phenotype, and dysregulation of the BMP pathway has been shown to be associated with vascular diseases. The aim of this study was to investigate for the first time the effects of BMP-4 on the VSMC phenotype and to understand its role in the development of thoracic aortic aneurysms (TAAs). Using the angiotensin II (AngII) osmotic pump model in mice, aortas from mice with VSMC-specific BMP-4 deficiency showed changes similar to AngII-infused aortas, characterised by a loss of contractile markers, increased fibrosis, and activation of matrix metalloproteinase 9. When BMP-4 deficiency was combined with AngII infusion, there was a significantly higher rate of apoptosis and aortic dilatation. In vitro, VSMCs with mRNA silencing of BMP-4 displayed a dedifferentiated phenotype with activated canonical BMP signalling. In contrast, BMP-2-deficient VSMCs exhibited the opposite phenotype. The compensatory regulation between BMP-2 and BMP-4, with BMP-4 promoting the contractile phenotype, appeared to be independent of the canonical signalling pathway. Taken together, these results demonstrate the impact of VSMC-specific BMP-4 deficiency on TAA development.
Immunomonitoring via ELISPOT Assay Reveals Attenuated T-Cell Immunity to CMV in Immunocompromised Liver-Transplant Patients
Authors: Traska Ann-Kristin , Nowacki Tobias Max , Vollenberg Richard , Rennebaum Florian , Meier Jörn Arne , Schomacher Tina , Reinartz Groba Sara Noemi , Fischer Julia , Trebicka Jonel , Tepasse Phil-Robin
Published: April 2024

Assessing immune responses to cytomegalovirus (CMV) after liver transplant in patients on immunosuppressive therapy remains challenging. In this study, employing ELISPOT assays, 52 liver-transplant recipients were evaluated for antiviral T-cell activity in peripheral blood mononuclear cells (PBMCs), measuring interferon-γ (IFN-γ) secretion upon stimulation with CMV-specific peptides (CMV peptide pool, CMV IE-1, and pp65 antigens). Parameters such as stimulation index, mean spot size, and mean spot count were measured. The study found that heightened immunosuppression, especially with prednisolone in triple therapy, significantly dampened CMV-specific immune responses. This was demonstrated by decreased IFN-γ production by CMV-specific T-cells (CMV peptide pool: p = 0.036; OR = 0.065 [95% CI: 0.005–0.840], pp65 antigen: p = 0.026; OR = 0.048 [95% CI: 0.003–0.699]). Increased immunosuppression correlated with reduced IFN-γ secretion per cell, reflected in smaller mean spot sizes for the CMV peptide pool (p = 0.019). Notably, shorter post-transplant intervals correlated with diminished antiviral T-cell IFN-γ release at two years (CMV peptide pool: p = 0.019; IE antigen: p = 0.010) and five years (CMV peptide pool: p = 0.0001; IE antigen: p = 0.002; pp65 antigen: p = 0.047), as did advancing age (pp65 antigen: p = 0.016, OR = 0.932, 95% CI: 0.881–0.987). Patients with undetectable CMV antigens had a notably higher risk of CMV reactivation within six months from blood collection, closely linked with triple immunosuppression and prednisolone use. These findings highlight the intricate interplay between immunosuppression, immune response dynamics, and CMV reactivation risk, emphasizing the necessity for tailored immunosuppressive strategies to mitigate CMV reactivation in liver-transplant recipients. It can be concluded that, particularly in the early months post-transplantation, the use of prednisolone as a third immunosuppressant should be critically reconsidered. Additionally, the use of prophylactic antiviral therapy effective against CMV in this context holds significant importance.
Neonatal Enterovirus-Associated Myocarditis in Dizygotic Twins: Myocardial Longitudinal Strain Pattern Analysis
Authors: Giampetruzzi Stefania , Sirico Domenico , Mainini Nicoletta , Meneghelli Marta , Valerio Enrico , Salvadori Sabrina , Di Salvo Giovanni
Published: April 2024

Enteroviruses (EVs) are the most common causes of viral myocarditis in neonates. Neonatal enterovirus myocarditis manifestations range from nonspecific febrile illness to congestive heart failure and cardiogenic shock with high risk of in-hospital mortality and long-term cardiac sequelae. Early recognition is essential to undertake appropriate therapy and predict outcomes. Echocardiography and echo-derived left ventricular strain measures seem promising for these purposes. We herein report two cases of neonatal enterovirus-associated myocarditis in dichorionic diamniotic twins, with different presentation, clinical course, and intensity of treatments.
Adapting to Climate Change in Vulnerable Areas: Farmers’ Perceptions in the Punjab, Pakistan
Authors: Nadeem Faisal , Jacobs Brent , Cordell Dana
Published: April 2024

Climate variability and change pose a substantial threat to agricultural practices and livelihoods in the Punjab province of Pakistan, a region of agricultural significance in South Asia. In particular, farmers residing in vulnerable parts of Punjab will be affected by a combination of high exposure to the impacts of climate events, the innate sensitivity of agricultural systems, and constraints on farmers’ adaptive capacity. The situation requires closer engagement with vulnerable farming communities of Punjab to assess their vulnerability and build their capacity for adaptation actions. Through qualitative analysis of semi-structured interviews with farmers from four highly vulnerable districts of Punjab (Rajanpur, Muzaffargarh, Chakwal, Dera Ghazi Khan), we explored farmers’ perceptions of climate change, their adaptation strategies, and enablers and limitations on adaptation options imposed by the enabling environment. We found issues around water governance, knowledge exchange, and market arrangements for crops as key limitations to farmers’ local adaptation action in highly resource-constrained settings. Moreover, the results indicated the need to address equity issues for small-scale compared to large-scale farmers. Farmers valued their experience-based local knowledge and peer-to-peer sharing networks as pivotal resources in pursuit of their practice-based learning. The research findings highlighted the necessity of directed institutional assistance to empower adaptation by vulnerable small-scale farmers. This study emphasizes the critical significance of the enabling environment that facilitates vulnerable farmers to implement adaptation strategies, thereby promoting the adoption of Vulnerable-Smart Agriculture.
The Effectiveness of Climate Adaptation Finance and Readiness on Vulnerability in African Economies
Authors: Maina Purity , Parádi-Dolgos Anett
Published: April 2024

Addressing climate vulnerability remains a priority for economies globally. This study used the panel-corrected standard error (PCSE) methodology to investigate the impact of adaptation financing on climate vulnerability. This analysis examined 52 African countries from 2012 to 2021 while considering their climate adaptation readiness. The impact was also assessed based on the Human Development Index (HDI) categories to reflect different levels of development. The findings showed that adaptation finance considerably influenced climate vulnerability reduction in Africa, particularly in nations with a moderate HDI. However, most countries still need higher levels of adaptation financing, resulting in a small impact on vulnerability reduction. Furthermore, the impact of readiness measures differed by HDI category. Economic and social climate readiness strongly impacted climate vulnerability in high-HDI nations, but governance preparedness was more critical in low-HDI countries. Based on the empirical facts, two policy proposals emerge. First, it is critical to reconsider the distribution of adaptation financing to reduce disparities and effectively alleviate climate vulnerability. Moreover, African economies should consider implementing innovative localized financing mechanisms to mobilize extra adaptation finance. Second, African governments should customize climate readiness interventions based on their HDI levels to improve the achievement of a positive impact on climate vulnerability.
Study of High-Temperature Rheological Properties of Emulsified Asphalt Residues
Authors: Wang Houzhi , Li Chunxi , Xu Gang , Zhou Yixin , Wang Rui
Published: April 2024

The residue of emulsified asphalt is its final state when it becomes part of an asphalt mixture. Therefore, the mechanical properties of the residue have a significant impact on the performance of emulsified asphalt mixtures. Dynamic shear rheological tests and fluorescence microscopy were conducted to explore the effects of emulsification and aging on the rheological properties and micro-morphology of emulsified asphalt residue. The results of both the temperature sweep and multiple stress creep recovery tests indicated that the emulsification of the asphalt had different effects on the rheological properties of the base asphalt and the styrene-butadiene-styrene (SBS)-modified asphalt. For the base asphalt, emulsification increases the complex shear modulus by about 5% and reduces irrecoverable creep flexibility by 30%. However, the physical grinding effect of the colloid mill during the emulsification process could destroy the internal spatial network structure of SBS, leading to a reduction in the complex shear modulus by about 5% and a 10% increase in irrecoverable creep flexibility. This phenomenon is similar to the aging of SBS-modified asphalt, which, in turn, leads to a decline in the performance of emulsified SBS-modified asphalt residues.
Optical Coherence Tomography in Inherited Macular Dystrophies: A Review
Authors: Gómez-Benlloch Alba , Garrell-Salat Xavier , Cobos Estefanía , López Elena , Esteve-Garcia Anna , Ruiz Sergi , Vázquez Meritxell , Sararols Laura , Biarnés Marc
Published: April 2024

Macular dystrophies (MDs) constitute a collection of hereditary retina disorders leading to notable visual impairment, primarily due to progressive macular atrophy. These conditions are distinguished by bilateral and relatively symmetrical abnormalities in the macula that significantly impair central visual function. Recent strides in fundus imaging, especially optical coherence tomography (OCT), have enhanced our comprehension and diagnostic capabilities for MD. OCT enables the identification of neurosensory retinal disorganization patterns and the extent of damage to retinal pigment epithelium (RPE) and photoreceptor cells in the dystrophies before visible macular pathology appears on fundus examinations. It not only helps us in diagnostic retinal and choroidal pathologies but also guides us in monitoring the progression of, staging of, and response to treatment. In this review, we summarize the key findings on OCT in some of the most common MD.
Spontaneous Intracranial Hypotension: Case Report and Update on Diagnosis and Treatment
Authors: Jurcau Maria Carolina , Jurcau Anamaria , Hogea Vlad Octavian , Diaconu Razvan Gabriel
Published: April 2024

Spontaneous intracranial hypotension (SIH) is an important cause of daily headaches that occur in young and middle-aged, active persons and is often misdiagnosed, leading to prolonged inactivity and rather high healthcare expenditures. Its diagnosis requires a high degree of clinical suspicion and careful interpretation of imaging studies. We present a case of SIH, which was successfully treated but which posed serious diagnostic challenges, ranging from cerebro-vascular disease and meningitis to granulomatous diseases, and for whom every therapeutic attempt just worsened the patient’s condition until we finally reached the correct diagnosis. To raise awareness of this condition, we also present an updated overview of the clinical picture, evaluation, and treatment options for SIH.
Differential Diagnosis of Solid Pancreatic Lesions Using Detective Flow Imaging Endoscopic Ultrasonography
Authors: Miwa Haruo , Sugimori Kazuya , Yonei Shoichiro , Yoshimura Hayato , Endo Kazuki , Oishi Ritsuko , Funaoka Akihiro , Tsuchiya Hiromi , Kaneko Takashi , Numata Kazushi , Maeda Shin
Published: April 2024

The differential diagnosis of solid pancreatic lesions (SPLs) using B-mode endoscopic ultrasonography (EUS) is challenging. Detective flow imaging (DFI) offers the potential for detecting low-flow vessels in the pancreas, thus enhancing diagnostic accuracy. This retrospective study aimed to investigate DFI-EUS findings of SPLs and analyze their differential diagnostic accuracy for pancreatic cancer. We included 104 patients with pathologically confirmed SPLs who underwent EUS between April 2021 and June 2023. Expert endosonographers, blinded to the patients’ clinical data, evaluated images obtained through B-mode, eFLOW, and DFI-EUS. The frame rate and vessel detection sensitivity were compared between eFLOW and DFI, and the diagnostic criteria for pancreatic cancer were established. The visualization rate for vessels in SPLs was significantly higher with DFI-EUS (96%) compared to eFLOW (27%). Additionally, DFI showed a superior frame rate, sensitivity (99%), and accuracy (88%) for detecting pancreatic cancer, although with a modest specificity (43%). On DFI-EUS, characteristics such as hypovascularity, peritumoral vessel distribution, or spotty vessel form were suggestive of pancreatic cancer. DFI-EUS significantly improved the visualization of vascular structures within the SPLs, highlighting its efficacy as a diagnostic modality for pancreatic cancer.
Videoautopsy—A Minimally Invasive Autopsy Method Using Endoscopic Techniques in Forensic Medicine: Clinical Features
Authors: Świderski Paweł , Rzepczyk Szymon , Bożek Beata , Żaba Czesław
Published: April 2024

In light of falling global autopsy rates, one of the causes of which is the resulting body disfigurement, it has become crucial to search for new, minimally invasive post-mortem diagnostic tools. One of these methods is videoautopsy, a minimally invasive autopsy technique using endoscopic methods. In the years 2020–2023, 15 videoautopsies were conducted at the Department of Forensic Medicine of the Poznan University of Medical Sciences in order to determine the usefulness of the method in forensic approaches. Each post-mortem examination included laparoscopy and thoracoscopy, followed by a classic autopsy to assess the effectiveness of the method. In total, the endoscopic examination allowed for determining the cause of death in 53.3% of cases, and when the cause of death was located in the abdominal cavity or chest, the percentage increased to 80%. Traumatic lesions had good recognition efficiency. In addition, it was also possible to collect material for histopathological and toxicological tests. Retroperitoneal organs were difficult to assess. The main limitation of the method is the inability to assess the inside of the skull and the structures of the central nervous system. Videoautopsy may become an important tool in post-mortem diagnostics and in forensic cases, especially when the alternative is to not perform an autopsy. Further research is necessary to standardise the examination protocol, optimise the instrumentation, and assess the potential synergistic effect with other methods of minimally and non-invasive post-mortem examination.
Functional Exercise Capacity and Perceived Exertion in Patients with Empty Nose Syndrome
Authors: Hung Wei-Te , Lee Ta-Jen , Wu Pei-Wen , Huang Chi-Che , Chang Po-Hung , Huang Chien-Chia
Published: April 2024

Empty nose syndrome (ENS) is a complex condition characterized by symptoms such as dyspnea, nasal discomfort, and emotional challenges. This study aimed to evaluate functional exercise capacity and perceived exertion in patients with ENS. Patients with ENS who presented with a range of severe symptoms were prospectively enrolled. Pulmonary function was evaluated using spirometry, and functional exercise capacity was measured via the 6 min walk test (6-MWT). Perceived exertion was quantified using the Borg scale, and cardiopulmonary function was evaluated by monitoring peripheral oxygen saturation (SpO2). These parameters were assessed before and after nasal reconstruction surgery. A total of 44 patients with ENS were enrolled and classified into mild-to-moderate (n = 20) and severe (n = 24) symptom groups. Spirometry results showed no significant differences before and after surgery in the entire cohort. Perceived exertion showed significant postoperative improvement (p = 0.006). The severe ENS symptom group experienced significant improvement in SpO2 (p = 0.013) and perceived exertion (p = 0.002) at the end of the 6-MWT after surgery. Surgical intervention significantly enhanced functional exercise capacity (p = 0.038) in patients with mild-to-moderate ENS symptoms. Surgical reconstruction positively affected perceived exertion and SpO2 at the end of the 6-MWT in patients with ENS. The severity of ENS symptoms, as assessed by SNOT-25 scores, influenced these outcomes. These findings underscore the potential benefits of surgical intervention for enhancing exercise tolerance and respiratory efficiency.
Plasma Rich in Growth Factors in Bone Regeneration: The Proximity to the Clot as a Differential Factor in Osteoblast Cell Behaviour
Authors: Anitua Eduardo , Zalduendo Mar , Tierno Roberto , Alkhraisat Mohammad Hamdan
Published: April 2024

The osteogenic differentiation process, by which bone marrow mesenchymal stem cells and osteoprogenitors transform into osteoblasts, is regulated by several growth factors, cytokines, and hormones. Plasma Rich in Growth Factors (PRGF) is a blood-derived preparation consisting of a plethora of bioactive molecules, also susceptible to containing epigenetic factors such as ncRNAs and EVs, that stimulates tissue regeneration. The aim of this study was to investigate the effect of the PRGF clot formulation on osteogenic differentiation. Firstly, osteoblast cells were isolated and characterised. The proliferation of bone cells cultured onto PRGF clots or treated with PRGF supernatant was determined. Moreover, the gene expression of Runx2 (ID: 860), SP7 (ID: 121340), and ALPL (ID: 249) was analysed by one-step real-time quantitative polymerase chain reaction (RT-qPCR). Additionally, alkaline phosphatase (ALPL) activity determination was performed. The highest proliferative effect was achieved by the PRGF supernatant in all the study periods analysed. Concerning gene expression, the logRGE of Runx2 increased significantly in osteoblasts cultured with PRGF formulations compared with the control group, while that of SP7 increased significantly in osteoblasts grown on the PRGF clots. On the other hand, despite the fact that the PRGF supernatant induced ALPL up-regulation, significantly higher enzyme activity was detected for the PRGF clots in comparison with the supernatant formulation. According to our results, contact with the PRGF clot could promote a more advanced phase in the osteogenic process, associated to higher levels of ALPL activity. Furthermore, the PRGF clot releasate stimulated a higher proliferation rate in addition to reduced SP7 expression in the cells located at a distant ubication, leading to a less mature osteoblast stage. Thus, the spatial relationship between the PRGF clot and the osteoprogenitors cells could be a factor that influences regenerative outcomes.
The Unique Professional Journey of Female High School Principals in Utah
Authors: Leavy Deon , Baum Donald , Calvert Isaac , Bowles Bryan , Erickson Heidi , Owens Michael , Ashcraft Jessica
Published: April 2024

The purpose of this study was to increase awareness of the unique professional journey of female high school principals in Utah and to potentially adjust the male-gendered lens through which such leadership positions have traditionally been viewed. A narrative, phenomenological qualitative research approach was used to gather and analyze the career journeys of six female high school principals in Utah. Our findings indicated that female high school principals in Utah have experienced barriers similar to those identified in the relevant literature. Mentored support and examples of inclusive leadership practices assisted these women in moving through and beyond these barriers. Themes included expectations for female high school principals to act more like moms, failure to be recognized as the principal, perceptions of female leadership as unnatural, a woman’s voice not being heard, coaching as an effective career move for men, men freely talking down to women, not considering women for advancement, career-limiting stereotypes, women having to work harder, and the impact of mentors. We suggest that the simple sharing of rich narratives like those in this paper can invite administrators and policy makers to develop an awareness of the unique experiences of female high school principals and facilitate a reconceptualization of the high school principalship both in terms of theory as well as policy.
Didactical Materials Customizable to Suit Classroom Needs: A Valuable Resource for Teachers
Authors: Sbaragli Silvia , Panero Monica
Published: April 2024

Can free, adaptable, and didactically validated materials have an impact on teachers’ practices and competences? This issue has been focused on by the researchers working on the MaMa—Matematica per la scuola elementare (MaMa—Mathematics for the primary school) project, commissioned by the Dipartimento dell’educazione, della cultura e dello sport (Department of education, culture and sport) of the Canton of Ticino (Switzerland). Since 2019, this project has been aiming to create materials for teaching and learning mathematics in primary school, in line with the curriculum. The innovative MaMa materials, which can be freely downloaded via the mama.edu.ti.ch platform, are addressed to both teachers and learners. In many cases, they are editable, so that they can be customized by each user to suit the different teaching contexts and pupils’ learning needs and be grouped into collections. Via the administration and analysis of a questionnaire, this article investigates how teachers use the materials, and whether they influence teachers’ practices and competences. The results of this pilot study show that MaMa materials are perceived from teacher–users as “materials for teacher education and development”, especially at the disciplinary level, supporting both the instructional design process and the appropriation/transformation of didactical resources to deal with the challenges of differentiation in the classrooms.
HR-YOLOv8: A Crop Growth Status Object Detection Method Based on YOLOv8
Authors: Zhang Jin , Yang Wenzhong , Lu Zhifeng , Chen Danny
Published: April 2024

Crop growth status detection is significant in agriculture and is vital in planting planning, crop yield, and reducing the consumption of fertilizers and workforce. However, little attention has been paid to detecting the growth status of each crop. Accuracy remains a challenging problem due to the small size of individual targets in the image. This paper proposes an object detection model, HR-YOLOv8, where HR means High-Resolution, based on a self-attention mechanism to alleviate the above problem. First, we add a new dual self-attention mechanism to the backbone network of YOLOv8 to improve the model’s attention to small targets. Second, we use InnerShape(IS)-IoU as the bounding box regression loss, computed by focusing on the shape and size of the bounding box itself. Finally, we modify the feature fusion part by connecting the convolution streams from high resolution to low resolution in parallel instead of in series. As a result, our method can maintain a high resolution in the feature fusion part rather than recovering high resolution from low resolution, and the learned representation is more spatially accurate. Repeated multiresolution fusion improves the high-resolution representation with the help of the low-resolution representation. Our proposed HR-YOLOv8 model improves the detection performance on crop growth states. The experimental results show that on the oilpalmuav dataset and strawberry ripeness dataset, our model has fewer parameters compared to the baseline model, and the average detection accuracy is 5.2% and 0.6% higher than the baseline model, respectively. Our model’s overall performance is much better than other mainstream models. The proposed method effectively improves the ability to detect small objects.
Correction: Srinivasan et al. Detection and Grade Classification of Diabetic Retinopathy and Adult Vitelliform Macular Dystrophy Based on Ophthalmoscopy Images. Electronics 2023, 12, 862
Authors: Srinivasan Saravanan , Nagarnaidu Rajaperumal Rajalakshmi , Kumar Mathivanan Sandeep , Jayagopal Prabhu , Krishnamoorthy Sujatha , Kardy Seifedine
Published: April 2024

There was an error in the original publication [...]
Exploring Skin Interactions with 5G Millimeter-Wave through Fluorescence Lifetime Imaging Microscopy
Authors: Foroughimehr Negin , Clayton Andrew H. A. , Yavari Ali
Published: April 2024

The ongoing expansion of fifth-generation (5G) and future sixth-generation (6G) mobile communications is expected to result in widespread human exposure to millimeter-wave (mmWave) radiation globally. Given the short penetration depth of mmWaves and their high absorption by the skin, it is imperative to investigate the potential effects of 5G radiation not only in terms of temperature increase but also at the cellular level. To understand the biological mechanisms of mmWave effects, accurate methods for assessing mmWave absorption in the skin are crucial. In this study, we use fluorescence lifetime imaging microscopy (FLIM) to explore these effects. Employing a mmWave exposure system operating at 26 gigahertz (GHz), porcine skin is irradiated for varying durations (5, 10, 20, and 30 min). We investigate changes in tissue temperature and the autofluorescence of flavin adenine dinucleotide (FAD). Our findings suggest that operating our mmWave exposure systems at the configured power level of 26 GHz is unlikely to cause damage to FADs, even after a 30 min exposure duration.
Realization of Empathy Capability for the Evolution of Artificial Intelligence Using an MXene(Ti3C2)-Based Memristor
Authors: Wang Yu , Zhang Yanzhong , Wang Yanji , Zhang Hao , Wang Xinpeng , Xu Rongqing , Tong Yi
Published: April 2024

Empathy is the emotional capacity to feel and understand the emotions experienced by other human beings from within their frame of reference. As a unique psychological faculty, empathy is an important source of motivation to behave altruistically and cooperatively. Although human-like emotion should be a critical component in the construction of artificial intelligence (AI), the discovery of emotional elements such as empathy is subject to complexity and uncertainty. In this work, we demonstrated an interesting electrical device (i.e., an MXene (Ti3C2) memristor) and successfully exploited the device to emulate a psychological model of “empathic blame”. To emulate this affective reaction, MXene was introduced into memristive devices because of its interesting structure and ionic capacity. Additionally, depending on several rehearsal repetitions, self-adaptive characteristic of the memristive weights corresponded to different levels of empathy. Moreover, an artificial neural system was designed to analogously realize a moral judgment with empathy. This work may indicate a breakthrough in making cool machines manifest real voltage-motivated feelings at the level of the hardware rather than the algorithm.
Tests of Fire Circuit Breakers (FCBs) to Assess Their Suitability for Use in Construction Objects
Authors: Popielarczyk Tomasz , Stępień Paweł , Chmiel Michał , Iwańska Marta
Published: April 2024

A fire circuit breaker (FCB) is dedicated to emergency services that can cut off the flow of electricity to all circuits, except for circuits supplying installations and equipment, the functioning of which is necessary during a fire. Theoretical research shows that there are no comprehensive studies on the FCB systems. Therefore, the aim of this study is to assess the impact of the components used (activating, signalling and executive devices) on the functionality of the entire FCB system (signal transmission time, actuation time, signalling, operational safety and resistance to various environmental conditions). This study proposes a new test scheme to evaluate the functionality of the entire FCB system, not just their individual components, which are widely known and used by electricians. However, it is only by combining them into a system, taking into account the requirements for firefighting equipment used by firefighters, that a completely new product is created. The new test scheme was properly validated by conducting a series of tests on several systems, consisting of multiple components (activating, signalling and executive devices). The tests carried out confirmed the validity of the assumptions made for the test methods and demonstrated the strong influence of the components (actuators, signalling and execution devices) on the functionality of the entire FCB system.
Improvement of Practical Byzantine Fault Tolerance Consensus Algorithm Based on DIANA in Intellectual Property Environment Transactions
Authors: Wang Jing , Feng Wenlong , Huang Mengxing , Feng Siling , Du Dan
Published: April 2024

In response to the shortcomings of the consensus algorithm for intellectual property transactions, such as high communication overhead, random primary node selection, and prolonged consensus time, a Practical Byzantine Fault Tolerance (PBFT) improvement algorithm based on Divisive Analysis (DIANA) D-PBFT algorithm is proposed. Firstly, the algorithm adopts the hierarchical clustering mechanism of DIANA to cluster nodes based on similarity, enhancing node partition accuracy and reducing the number of participating consensus nodes. Secondly, it designs a reward and punishment system based on node ranking, to achieve consistency between node status and permissions, timely evaluation, and feedback on node behaviours, thereby enhancing node enthusiasm. Then, the election method of the primary node is improved by constructing proxy and alternate nodes and adopting a majority voting strategy to achieve the selection and reliability of the primary node. Finally, the consistency protocol is optimised to perform consensus once within the cluster and once between all primary nodes, to ensure the accuracy of the consensus results. Experimental results demonstrate that the D-PBFT algorithm shows a better performance, in terms of communication complexity, throughput, and latency.
A New Non-Extensive Equation of State for the Fluid Phases of Argon, Including the Metastable States, from the Melting Line to 2300 K and 50 GPa
Authors: Aitken Frédéric , Denat André , Volino Ferdinand
Published: April 2024

A new equation of state for argon was developed with the view of extending the range of validity of the equation of state previously proposed by Tegeler et al. and obtaining a better physical description of the experimental thermodynamic data for the whole fluid region (single-phase, metastable, and saturation states). As proposed by Tegeler et al., this equation is also based on a functional form of the residual part of the reduced Helmholtz free energy. However, in this work, the fundamental equation for Helmholtz free energy was derived from the measured quantities CV(ρ, T) and P(ρ, T). The empirical description of the isochoric heat capacity CV(ρ, T) was based on an original empirical description explicitly containing the metastable states. The thermodynamic properties (internal energy, entropy, and free energy) were then obtained by combining the integration of CV(ρ, T). The arbitrary functions introduced by the integration process were deduced from a comparison between calculated and experimental pressure P(ρ, T) data. The new formulation is valid for the whole fluid region from the melting line to 2300 K and for pressures up to 50 GPa. It also predicts the existence of a maximum of the isochoric heat capacity CV along isochors, as experimentally observed in several other fluids. For many applications, an approximate form of the equation of state for the liquid phase may be sufficient. A Tait–Tammann equation is therefore proposed between the triple-point temperature and 148 K.
Human Milk—The Biofluid That Nourishes Infants from the First Day of Life
Authors: Lugonja Nikoleta , Marinković Vesna , Pucarević Mira , Miletić Srdjan , Stojić Nataša , Crnković Dragan , Vrvić Miroslav
Published: April 2024

Human milk is a biofluid with a unique composition among mammalian milks. Besides this milk’s major components, its bioactive compounds, like hormones, immune factors, and oligosaccharides, are unique and important for infant growth and development. The best form of nutrition for term and preterm infants is the mother’s own milk. However, in the absence of the mother’s own milk, donor milk should be made available. Milk banks support neonatal intensive care units by providing preterm infants with human milk that generally has reasonable nutritive value for this sensitive population. However, neither mother’s own milk nor donor milk has sufficient energy content for the growth of preterm babies, so adequate human milk supplementation is crucial for their progress. Due to the different characteristics of human breast milk, as well as ubiquitous environmental pollutants, such as microplastics, new methods are required for monitoring the quality and characteristics of human milk, which will lay a solid foundation for the further development and progress of human milk research.
Exploring Key Barriers of HACCP Certification Adoption in the Meat Industry: A Decision-Making Trial and Evaluation Laboratory Approach
Authors: Dima Adriana , Radu Elena , Dobrin Cosmin
Published: April 2024

Food safety management represents an important concern in contemporary society. The Hazard Analysis Critical Control Point (HACCP) system is a crucial tool for meat producers, preventing and controlling major food safety concerns in the process. This research investigates key barriers to HACCP implementation in the meat industry, employing the Decision-Making Trial and Evaluation Laboratory (DEMATEL) model to identify and categorize these obstacles. Using the insights of 18 experts, a cause-and-effect relationship diagram is generated through which twelve barriers are categorized in terms of their cause and effect and then analyzed. Threshold value is calculated as 0.299. The findings reveal poor management as the primary impediment, followed by challenges in training, knowledge, and dedication. Categorizing the barriers into four groups emphasizes the critical role of effective management and human resources. The study contributes valuable insights to food safety management literature, serving as a practical resource for industry practitioners. Despite limitations in relying on expert opinions and the industry-specific focus, the research lays a foundation for informed decision-making, stressing the importance of effective management in successful HACCP implementation. Future research directions include diversifying geographical representation, exploring practical solutions, and integrating emerging technologies for a better understanding of HACCP adoption challenges.