bluuebunny/crossref_metadata_2025 huggingface dataset:
Manual Acupuncture Manipulation Recognition Method via Interactive Fusion of Spatial Multiscale Motion Features
Authors: He Jiyu , Su Chong , Chen Jie , Li Jinniu , Yang Jingwen , Liu Cunzhi
Published: May 2024

Manual acupuncture manipulation (MAM) is essential in traditional Chinese medicine treatment. MAM action recognition is important for junior acupuncturists’ training and education; however, there are obvious personalized differences in hand gestures among expert acupuncturists for the same type of MAM. In addition, during the MAM operations, the magnitude and frequency of the expert acupuncturists’ hand shape and relative needle‐holding finger position changes are tiny and fast, resulting in difficulties in observing MAM action details. Thus, we propose a Spatial Multiscale Interactive Fusion MAM Recognition Network to solve the difficulties in MAM recognition. First, this paper presents an optical flow‐based hand motion contour global feature extraction method for acupuncture hand shape. Second, to explore the motion rule between the needle‐holding fingers during the MAM operations, we design a quantitative description method of the relative motion of the needle‐holding fingers: an “interactive attention module,” which achieves feature fusion and mines the correlation between different scales of MAM action features. Finally, the proposed MAM recognition method was validated by 20 acupuncturists from the Beijing University of Traditional Chinese Medicine and 10 from the Beijing Zhongguancun Hospital who participated in the MAM video signal collection. The proposed recognition method achieves the highest average validation accuracy of 95.3% and the highest test accuracy of 96.0% for four typical MAMs, proving its feasibility and effectiveness.
A capacitance reduction method of hybrid modular multilevel converter based on multi‐harmonic voltage injection
Authors: Li Hongxu , Wang Qin , Wu Qunfang , Xiao Lan , Li Jinbo , Chen Qi
Published: May 2024

In a modular multilevel converter (MMC) system, the sub‐module (SM) capacitors account for a large proportion of cost, volume and weight. Increasing modulation index (m) is an effective method to reducing the capacitance. Traditional MMC based on half‐bridge SM (HBSM) cannot boosting m while the hybrid MMC composed of HBSMs and full‐bridge sub‐modules (FBSM) can increase the m. The negative voltage is required when hybrid MMC works at the boosted m, which is only provided by the FBSMs because the HBSMs cannot output negative voltage. Therefore, appropriate control strategies are needed to achieve the normal operation of hybrid MMC under boosted m. This paper presents a control method suitable for hybrid MMC with high m based on multi‐harmonic voltage injection. The m is increased to 1.41 with the proposed multi‐harmonic voltage injection. Compared with the HBSM‐MMC, the proposed method reduces the total capacitance by more than 32%. Boosting m also reduces the RMS and peak value of the arm current by 18%. A comprehensive comparison was presented to demonstrate the cost and effect. Simulation and experiment verified the proposed method.
Measuring the gas reservoirs in 108 < M⋆ < 1011 M⊙ galaxies at 1 ≤ z ≤ 3
Authors: Mérida Rosa M. , Gómez-Guijarro Carlos , Pérez-González Pablo G. , Sánchez-Blázquez Patricia , Elbaz David , Franco Maximilien , Leroy Lucas , Magdis Georgios E. , Magnelli Benjamin , Xiao Mengyuan
Published: May 2024

Context. Understanding the gas content in galaxies, along with its consumption and replenishment, is vital to our grasp of the evolution of the Universe. Numerous studies have addressed this notion, utilizing various observational tools and analytical methods. These include examining low-transition 12CO millimeter rotational lines and exploring the far-infrared and the (sub-)millimeter emission of galaxies. With the capabilities of present-day facilities, much of this research has been centered on relatively bright galaxies.

Aims. This study is aimed at exploring the gas reservoirs of a more general type of galaxy population at 1.0 < z < 3.0 that is not restricted to bright (sub-)millimeter objects. We strive to obtain a measurement that will help to constrain our knowledge of the gas content at 1010 − 11 M⊙, with upper limits at ∼108 − 10 M⊙.

Methods. We stacked ALMA 1.1 mm data to measure the gas content of a mass-complete sample of galaxies down to ∼108.6 M⊙ at z = 1 (∼109.2 M⊙ at z = 3) extracted from the HST/CANDELS sample in GOODS-S. The selected sample is composed of 5530 predominantly blue (⟨b − i⟩∼0.12 mag, ⟨i − H⟩∼0.81 mag), star-forming main sequence (MS) objects (ΔMS = log SFR−log SFRMS ∼ −0.03 dex).

Results. At 1010 − 11 M⊙, our gas fractions (fgas = Mgas/(Mgas + M⋆)), ranging from 0.32 to 0.48 at these redshifts, are in good agreement with other studies based on mass-complete samples down to 1010 M⊙. These values are, however, lower than expected, according to other works more biased to individual detections. At 109 − 10 M⊙, we obtained 3σ upper limits for the fgas values ranging from 0.69 to 0.77. At 108 − 9 M⊙, these upper limits rise to ∼0.97. The upper limits at 109 − 10 M⊙ are on the level of the extrapolations of scaling relations based on mass-complete samples and below those based on individual detections. As such, these results suggest that the gas content of low-mass galaxies is, at most, equivalent to what has been extrapolated from the literature scaling relations based on mass-complete samples down to 1010 M⊙. Overall, the comparison of our results with the literature reflects how the inclusion of bluer, less obscured, and more MS-like objects progressively pushes the gas content down to lower values.
The GAPS programme at TNG
Authors: Montalto M. , Greco N. , Biazzo K. , Desidera S. , Andreuzzi G. , Bieryla A. , Bignamini A. , Bonomo A. S. , Briceño C. , Cabona L. , Cosentino R. , Damasso M. , Fiorenzano A. , Fong W. , Goeke B. , Hesse K. M. , Kostov V. B. , Lanza A. F. , Latham D. W. , Law N. , Mancini L. , Maggio A. , Molinaro M. , Mann A. W. , Mantovan G. , Naponiello L. , Nardiello D. , Nascimbeni V. , Pagano I. , Pedani M. , Safonov B. S. , Scandariato G. , Seager S. , Singh V. , Sozzetti A. , Strakhov I. A. , Winn J. N. , Ziegler C. , Zingales T.
Published: May 2024

Aims. We report the confirmation of a new transiting exoplanet orbiting the star TOI-5076.

Methods. We present our vetting procedure and follow-up observations which led to the confirmation of the exoplanet TOI-5076b. In particular, we employed high-precision TESS photometry, high-angular-resolution imaging from several telescopes, and high-precision radial velocities from HARPS-N.

Results. From the HARPS-N spectroscopy, we determined the spectroscopic parameters of the host star: Teff = (5070±143) K, log 𝑔 = (4.6±0.3), [Fe/H] = (+0.20±0.08), and [α/Fe] = 0.05±0.06. The transiting planet is a warm sub-Neptune with a mass mp = (16±2) M⊙, a radius rp =(3.2±0.l) R⊙ yielding a density ρp = (2.8±0.5) g cm−3. It revolves around its star approximately every 23.445 days.

Conclusions. The host star is a metal-rich, K2V dwarf, located at about 82 pc from the Sun with a radius of R⋆ = (0.78±0.01) R⊙ and a mass of M⋆ = (0.80±0.07) M⊙. It forms a common proper motion pair with an M-dwarf companion star located at a projected separation of 2178 au. The chemical analysis of the host-star and the Galactic-space velocities indicate that TOI-5076 belongs to the old population of thin-to-thick-disk transition stars. The density of TOI-5076b suggests the presence of a large fraction by volume of volatiles overlying a massive core. We found that a circular orbit solution is marginally favored with respect to an eccentric orbit solution for TOI-5076b.
Asteroid-NeRF: A deep-learning method for 3D surface reconstruction of asteroids
Authors: Chen Shihan , Wu Bo , Li Hongliang , Li Zhaojin , Liu Yi
Published: May 2024

Context. Asteroids preserve important information about the origin and evolution of the Solar System. Three-dimensional (3D) surface models of asteroids are essential for exploration missions and scientific research. Regular methods for 3D surface reconstruction of asteroids, such as stereo-photogrammetry (SPG), usually struggle to reconstruct textureless areas and can only generate sparse surface models. Stereo-photoclinometry (SPC) can reconstruct pixel-wise topographic details but its performance depends on the availability of images obtained under different illumination conditions and suffers from uncertainties related to surface reflectance and albedo.

Aims. This paper presents Asteroid-NeRF, a novel deep-learning method for 3D surface reconstruction of asteroids that is based on the state-of-the-art neural radiance field (NeRF) method.

Methods. Asteroid-NeRF uses a signed distance field (SDF) to reconstruct a 3D surface model from multi-view posed images of an asteroid. In addition, Asteroid-NeRF incorporates appearance embedding to adapt to different illumination conditions and to maintain the geometric consistency of a reconstructed surface, allowing it to deal with the different solar angles and exposure conditions commonly seen in asteroid images. Moreover, Asteroid-NeRF incorporates multi-view photometric consistency to constrain the SDF, enabling optimised reconstruction.

Results. Experimental evaluations using actual images of asteroids Itokawa and Bennu demonstrate the promising performance of Asteroid-NeRF, complementing traditional methods such as SPG and SPC. Furthermore, due to the global consistency and pixel-wise training of Asteroid-NeRF, it produces highly detailed surface reconstructions. Asteroid-NeRF offers a new and effective solution for high-resolution 3D surface reconstruction of asteroids that will aid future exploratory missions and scientific research on asteroids.
An Experimental Study on Performance of Two-Part Geopolymer Concrete Using Natural Binders and Activators
Authors: P V Gokul , S Murali Megha , M Sivan Mekha , J Zachariah Nijo , Jathin Vaz Joshua
Published: May 2024

The study investigates the characteristics of geopolymer concrete, employing sodium silicate and sodium hydroxide as activators instead of cement. In conventional construction practices, binders like fly ash, ground granulated blast furnace slag (GGBS) are commonly combined with alkali solutions. The manufacturing process of geopolymer relies on various alkaline activators. In this research, GGBS is replaced with sodium hydroxide and sodium silicate as activators. GGBS is recognized for its ability to enhance the workability and strength of geopolymer concrete, exhibiting favorable mechanical properties, resistance to chemicals, minimal shrinkage, environmental friendliness and exceptional durability. Furthermore, there are still certain drawbacks to geopolymer concrete, such as the fact that alkaline solutions are difficult to handle and apply because they are viscous, corrosive, difficult to transport, as well as challenging to store in huge quantities. A two part geopolymer concrete consists of two main components. An activator solution and a binder solution. The activator solution typically contains alkali metal hydroxides or silicates, while the binder solution contains aluminosilicate material such as fly ash or metakaolin. When mixed together, these solutions undergo a chemical reaction that forms a solid and durable geopolymer material.
Examination of Wind Impacts on RCC Frame Structures in Different Wind Zones
Authors: Saxena Abhishek , Krishna PVVSRR , Reddy Uma , Dutt Amit , Kumar Ashwani , Mohammad Q. , Maan Preeti
Published: May 2024

Reinforced refers to a structurally sound assemblage of carefully joined slabs, beams, columns, and foundation components. Through the use of this complex network, loads are systematically transferred from slabs to beams, then to columns, converge at the foundation, and finally travel to the soil beneath. This structural analysis offers a thorough investigation of load-carrying dynamics by examining multiple scenarios for the same structure while accounting for varying wind speeds. A G+9 storey building is subjected to a comparative evaluation in three different wind zones (I, II, and III) with corresponding wind speeds of 33 m/s, 39 m/s, and 44 m/s. The structural behaviour is carefully modelled and examined under the impact of dead load, live load, and wind load using sophisticated STAAD Pro software. This thorough analysis clarifies the structure’s unique reactions to different wind speeds. In order to determine the design loads of a multistorey building, this paper gives a comparative assessment of wind load. Then, using the fundamental wind speed and other local characteristics, the wind load in that zone may also be calculated. The wind speed is time-dependent and random, though. The current study uses the IS 875 code to analyse wind loads in different zones of a multistorey building. The design wind speed of that zone, with a variance, is used to estimate the wind loads.
Incorporation of Silica fume and Metakaolin to improve the Durability properties in Self-curing concrete
Authors: Sankar K. Vijay , Priyanka M. , Kumar S. Pream , Nandhini U. , Jeslin J.S. , Vigneshwari M. , Sivanavilan M.
Published: May 2024

Concrete is a composite material that has evolved into a much-needed material in the field of construction. One of the approaches to improving the durability of concrete is by using pozzolanic materials like fly ash, silica fume, blast furnace slag, and metakaolin. Using this supplementary cementitious material, the effects of cement that cause severe environmental impacts can be eradicated. In this investigation, an attempt has been made to study the strength characteristics of M20-grade concrete mixes with partial replacement of cement by metakaolin and silica fume and full replacement of fine aggregate by M-sand. We use Polyethylene glycol 6000 as a self-curing agent to eliminate conventional curing. The replacement percentage of metakaolin is 5%, 10%, 15%, and 20%, and silica fume is replaced by 10% of the weight of cement, respectively. The addition of 1.5% of polyethylene glycol 6000 is used to make concrete as a self-curing concrete. Since this project focuses on replacing the cement and fine aggregate, from the optimum percentage, the cubes will be cast and tested to study the durability properties of the concrete.
Review of Mechanical, Durability, and Thermal properties of Light weight concrete containing cenosphere
Authors: Jose Christin , Radhakrishnan Ganga , Anandan Abhinav , T A Althaf , B Sankar
Published: May 2024

Compared to conventional concrete, lightweight concrete offers a reduced unit weight, making it easier to handle and transport. Its popularity has surged globally in numerous countries and has proven beneficial for construction purposes. Lightweight concrete often exhibits better thermal insulation properties compared to traditional concrete, contributing to energy efficiency in buildings. Recently, the inclusion of cenospheres in lightweight aggregates is being is heavily researched around the world. Ceneosphere addition increases the volume of the concrete mixture because of their smaller size and hollow nature of the particle. This research paper showcases the various applications and advantages of lightweight concrete (LWC) containing cenosphere, along with highlighting the role of different supplementary cementitious materials characteristics and manufacturing methods. Furthermore, the current study examines previous researches on sustainable lightweight concretes and showcases the improvements and advancements in mechanical, durability, and thermal properties obtained when cenospheres were added.
Experimental Study on the Behavior of One Part Geopolymer Concrete Using Natural Binders and Activators
Authors: P V Gokul , Balakrishnan Devika , Prakash Ajay , S Nair Jishnu
Published: May 2024

The cement industry is one of the primary factors contributing to the process of global warming with a large carbon footprint. Approximately 8% of global CO2 emissions are attributed to cement. The development of cement substitute materials has advanced with the discovery of geopolymer concrete. The conventional geopolymers are two part mixes made up of an activator-containing liquid phase and an aluminum-silicate material-containing solid phase. Among the many benefits of geopolymers are their increased environmental friendliness, better workability, greater compressive strength, increased resistance to sulfate and acids, increased temperature resistance, and decreased drying shrinkage and creep. However, geopolymerization is a difficult procedure. Furthermore, there are still certain drawbacks to geopolymer concrete, such as the fact that alkaline solutions are difficult to handle and apply because they are viscous, corrosive, difficult to transport, as well as challenging to store in huge quantities. As a result, the creation of one-part geopolymer concrete gained more advantages over the traditional two part geopolymer. Solid aluminosilicate and solid alkali activator combine to form one part geopolymer concrete. The creation of one-part geopolymer concrete with natural binders is the primary goal of this research. It should be highlighted that GGBS based geopolymer concrete is challenging to make and has poor workability. As a result, various proportions of GGBS and silica fume are utilized as binders in this experiment. Powdered NaOH is utilized as alkaline activator. The mechanical properties are established by conducting necessary experiments for finding the best concrete mixture for this present work.The concrete mix with 80%, GGBS, 10% silica fume and 10% NaOH exhibits the expected quality of fresh properties and mechanical
characteristics.
Expanding Bioenergy: A Comparison of Waste-to-Energy Techniques
Authors: Deepika N.M. , P Vijayan Vinodh , Rajalakshmi B. , Nijhawan Ginni , Tyagi Lalit Kumar , Alabdeli Haider , Yadav Dinesh Kumar
Published: May 2024

The paper explores the ability of biomass as a renewable energy source globally and analysis of waste generation and bioenergy abilities. It highlights the significance of sustainable waste control and the performance of numerous biomass conversion technology in producing bioenergy, biofuels, and bio-chemical compounds. The study highlights worldwide initiatives and challenges confronted in maximizing biomass capability, specially inside the bioenergy sector. It emphasizes the need for improved waste management strategies, technological improvements, and political guidance to enhance the contribution of bioenergy to worldwide energy demands.
Biomass and Operational Initiatives for Sustainable Bioenergy Generation
Authors: Karthik A. , V Asha , Nijhawan Ginni , Stephan Maria , Pahwa Shilpa , Al-Jawahry Hassan M. , Khan Irfan
Published: May 2024

The global shift towards sustainable energy resources highlights the importance of biomass as a promising path for generating green, renewable energy. This study synthesizes modern research and technological improvements in biomass feedstocks, bioenergy conversion approaches, and integrated biorefinery systems. It explores the multifaceted position of biomass in addressing power safety, mitigating climate change, and fostering financial improvement, in particular in emerging economies. The paper evaluates diverse biomass resources, along with lignocellulosic materials, dairy waste, and microalgae, and discusses their conversion into biofuels and biochemicals via tactics including fermentation, anaerobic digestion, and biochemical conversion. It similarly delves into the environmental and monetary implications of biomass usage, highlighting the challenges and opportunities in enhancing efficiency, reducing fees, and making sure sustainability. By supplying a comprehensive evaluate of the modern country and future instructions of bioenergy research, this paper pursuit to make contributions to the development of low-carbon, renewable fuel options and advance the global transition towards a more sustainable and varied energy portfolio.
Sustainable Drone Detection using Deep Learning Paradigms
Authors: Panduri Bharathi , Abhilash P.K. , Madhuri T.N.P. , Bethapudi Venkata Naga Tejaswi , Almusawi Muntather
Published: May 2024

Drones are becoming more and more common, which has advantages but also concerns. They can be used to support illegal operations like drug trafficking and endanger places that are important to security. While advances in sensor technology haven't produced reliable answers in the literature, current drone detection and neutralization methods frequently require previous detection and categorization. Using radio frequency (RF) signals and a frequency signature-based deep learning model, this work promotes an environmentally friendly and multidisciplinary method of drone identification and categorization. Using commercial drones, we generated a novel drone RF dataset and thoroughly evaluated two-stage and combined detection-classification frameworks, assessing their efficacy in simultaneous multi-signal and single-signal scenarios. According to our investigation, the Deep Residual Neural Network (DRNN) framework
achieves classification performance that is equivalent to that of the YOLOV5 framework, but it offers improved detection performance in
multi-signal settings when compared to traditional Goodness-of-Fit (GoF) spectrum sensing. This study opens the door for multidisciplinary efforts to address new security concerns by showcasing the possibility of long-term, data-driven drone detection methods.
Black Carbon and Traffic-Related PM2.5 in Bangkok Area
Authors: Phanukarn Pornsuda , Ruchiraset Apaporn , Chinwetkitvanich Sopa
Published: May 2024

This study was to investigate level of black carbon (BC) in urban areas of Bangkok, Thailand. Hourly BC concentrations were measured at two stations (operated by PCD), i.e., Bangna station and Thonburi station (roadside) during dry season by using the aethalometer (Model AE-42). The averages of hourly BC concentrations observed were 5.1±2.9 and 4.3±1.9 µg/m3, respectively. The diurnal pattern of BC levels obtained from two stations exhibited two peaks of BC concentrations occurring in the morning (0500 to 0800 LST) and late evening (2100 to 2300 LST), which the late evening peaks were higher than the morning ones. The morning peaks of BC were evidently influenced by traffic condition, while the evening peaks were possibly related to traffic associated with meteorological effects. BC concentrations from roadside stations (Thonburi) were higher than those from Bangna station possibly due to less distance of sampling equipment from roads. There was some difference of BC concentrations observed between during weekday and weekends, particularly, at roadside station (Thonburi station). In addition, increase of diesel vehicles proportion, particularly in the nighttime, contributed to higher BC concentrations. The relationships among BC concentration, air pollutants (PM2.5), vehicle fleets and meteorological variables were found.
Preliminary investigation of microplastic contamination in river snails (Filopaludina martensi) in Eastern Thailand and evaluation of human exposure
Authors: Prarat Panida , Hongsawat Parnuch , Chouychai Bopit
Published: May 2024

Microplastic contamination in the aquatic environment is a growing environmental issue with implications for food safety concerns. This study investigated microplastics in river snails (Filopaludina martensi) obtained from local markets in the eastern province of Thailand. The study analyzed the abundance, shape, size, color, and polymer type of microplastics extracted from river snail tissue and estimated human intake of microplastics through river snail consumption. The results revealed that the average microplastic abundance was 88.63 ± 51.18 particles/g wet weight. The predominant microplastics were fibers and fragments smaller than 1.0 mm, with colors ranging from transparent-white. Polymer analysis indicated that river snails primarily contained polyethylene (PE), polypropylene (PP), and polystyrene (PS). Microplastics’ estimated annual intake (EAI) was significantly higher than the average in other countries. This suggests that humans may ingest microplastics through food consumption due to the biomagnification of microplastic accumulation in the food chain. Given this elevated level of human exposure to microplastics, there is an urgent need to develop policies to regulate the use, management, and disposal of plastic waste in Thailand.
Quantifying Fracture Dynamics in Clean Energy: A Novel Fractal Perspective
Authors: Ye Dayu , Liu Guannan , Feng Gao
Published: May 2024

Geothermal energy, as an emergent source of power, has consistently been a focal point of scholarly investigation both domestically and internationally, with a particular emphasis on the prediction and assessment of its extraction efficiency. In common geothermal extraction projects, the seepage behavior of water within the fractures for the geothermal reservoirs significantly impacts the efficiency of resource extraction. This study introduces an interdisciplinary fractal model for geothermal extraction. An enhanced fractal theory, tailored for geothermal reservoirs, is proposed, employing four innovative fractal parameters— fracture fractal dimension, fracture tortuosity fractal dimension, fracture roughness parameter, and maximum fracture length—to quantitatively characterize the fracture structure. This refined fractal theory is applied to geothermal reservoir extraction under the complex thermal-hydromechanical coupling. The findings indicate that the proposed structural parameters effectively characterize the micro-macro interactions during the geothermal extraction process. Significant evolution of these fractal parameters is observed throughout the extraction process. Furthermore, there is an inverse relationship between geothermal extraction efficiency and two key fractal parameters—fracture tortuosity fractal dimension and fracture roughness parameter—while the reservoir stress is directly proportional to these parameters.
Occupational eye lens dose among nuclear medicine workers in a tertiary hospital in Saudi Arabia
Authors: Nasr R.Y. , Albahiti S.K. , Khafaji M. , Shabib N.G. , Malabari R.A.
Published: May 2024

Background: Exposure to ionizing radiation remains a major concern in nuclear medicine, especially given the possible health risks posed to medical personnel. Additionally, since the occupational eye dose limit was lowered in 2011 to an equivalent dose of 20 mSv/yr, new implications have extended to roles within nuclear medicine units. The goal of this investigation was to determine the current occupational radiation eye doses for nuclear medicine employees. Methods: A 5 yr retrospective assessment was performed on staff members involved in all nuclear medicine imaging from different categories. Optically Stimulated Luminescence (OSL) badges were used to measure occupational dose. The H-lens values were calculated for each staff member during this period. Results: Significant differences were observed between individual staff members in terms of H-lens values. They were significantly higher among hot lab technicians than among NIC (p < 0.001) and NM (p < 0.0001) technicians. Conclusions: Although none of the participants exceeded the eye dose limit for ionizing radiation exposure, there was significant variation in exposure across various roles and expertise. The annual average eye dose ranged from 0.2 mSv to 2.9 mSv, which is within the advised dose limit.
Phänotypische Klassifizierung der Kardiomyopathien entsprechend den Leitlinien der ESC 2023
Authors: Olic Janet-Jacqueline , Bäßler Andrea , Maier Lars
Published: May 2024

Kardiomyopathien sind Herzmuskelerkrankungen mit struktureller und funktioneller Myokardstörung. Die ESC hat 2023 erstmals eine internationale Leitlinie zum gesamten Spektrum der Kardiomyopathien herausgebracht. Ein zentrales Element der Leitlinie ist die phänotypische Klassifizierung der Kardiomyopathien. Hierbei spielt neben morphologischen und funktionellen Merkmalen als wesentliche Neuerung auch die genaue Gewebecharakterisierung (z. B. Narbenbildung) basierend auf einer kardialen Magnetresonanztomografie (CMR) eine wesentliche Rolle. Auf dieser Grundlage erfolgt die phänotypische Einteilung in 5 Hauptformen. Zusätzlich zur dilatativen, hypertrophen und restriktiven Kardiomyopathie (DCM, HCM und RCM) wurde die nicht dilatierte linksventrikuläre Kardiomyopathie (NDLVC) neu definiert. Ferner wurde die Gruppe der arrhythmogenen rechtsventrikulären Kardiomyopathie (ARVC) aktualisiert. Die hiermit definierten Kardiomyopathie-Phänotypen sollen die Ermittlung der genauen Ätiologie vereinfachen.
Myokardiale Hypertrophie – von dem klinischen Phänotyp zur Diagnose einer hypertrophen Kardiomyopathie
Authors: Schwarting Stéphanie , Massberg Steffen
Published: May 2024

Die myokardiale Hypertrophie beschreibt einen klinischen und bildmorphologischen Phänotyp, der auf verschiedene Ätiopathogenesen zurückzuführen ist. Sie kann sich als sekundäre Anpassungsreaktion auf abnormale Druckverhältnisse manifestieren oder im Rahmen von primären Erkrankungen auftreten, die direkt die Kardiomyozyten oder das Myozytennetzwerk betreffen. Die hypertrophe Kardiomyopathie repräsentiert dabei eine eigenständige Krankheitsentität.

In der kardiologischen Praxis ist es entscheidend, die heterogenen Ursachen des hypertrophen Phänotyps zu differenzieren und unterschiedliche diagnostische Wege initiieren zu können. Hierbei ist eine umfassende Basisdiagnostik mittels Anamnese, Elektrokardiografie, Echokardiografie und weiterführende Bildgebungen von Bedeutung, um eine gezielte Differenzierung zu ermöglichen. Eine präzise Diagnose ist entscheidend für die Risikoeinschätzung und gezielte therapeutische Intervention.
CDK4/6 Inhibition – Therapy Sequences and the Quest to Find the Best Biomarkers – an Overview of Current Programs
Authors: Schneeweiss Andreas , Brucker Sara Y. , Huebner Hanna , Volmer Lea L. , Hack Carolin C. , Seitz Katharina , Ruebner Matthias , Heublein Sabine , Thewes Verena , Lüftner Diana , Lux Michael P. , Jurhasz-Böss Ingolf , Taran Florin-Andrei , Wimberger Pauline , Anetsberger Daniel , Beierlein Milena , Schmidt Marcus , Radosa Julia , Müller Volkmar , Janni Wolfgang , Rack Brigitte , Belleville Erik , Untch Michael , Thill Marc , Ditsch Nina , Aktas Bahriye , Nel Ivonne , Kolberg Hans-Christian , Engerle Tobias , Tesch Hans , Roos Christian , Budden Christina , Neubauer Hans , Hartkopf Andreas D. , Fehm Tanja N. , Fasching Peter A.
Published: May 2024

In recent years, new targeted therapies have been developed to treat patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) breast cancer. Some of these therapies have not just become the new therapy standard but also led to significantly longer overall survival rates. The cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) have become the therapeutic standard for first-line therapy. Around 70 – 80% of patients are treated with a CDK4/6i. In recent years, a number of biomarkers associated with progression, clonal selection or evolution have been reported for CDK4/6i and their endocrine combination partners. Understanding the mechanisms behind treatment efficacy and resistance is important. A better understanding could contribute to planning the most effective therapeutic sequences and utilizing basic molecular information to overcome endocrine resistance. One study with large numbers of patients which aims to elucidate these
mechanisms is the Comprehensive Analysis of sPatial, TempORal and molecular patterns of ribociclib efficacy and resistance in advanced Breast Cancer patients (CAPTOR BC) trial. This overview summarizes the latest clinical research on resistance to endocrine therapies, focusing on CDK4/6 inhibitors and discussing current study concepts.
Evidenzbasierte und patientenorientierte Indikationsstellung zur Knieendoprothese – Update der Leitlinie
Authors: Lützner Jörg , Deckert Stefanie , Lange Toni , Postler Anne Elisabeth , Aringer Martin , Berth Hendrik , Bork Hartmut , Dreinhöfer Karsten E , Günther Klaus-Peter , Heller Karl-Dieter , Hube Robert , Kirschner Stephan , Kladny Bernd , Kopkow Christian , Sabatowski Rainer , Stoeve Johannes , Wagner Richard , Lützner Cornelia
Published: May 2024

Die Implantation einer Knieendoprothese zählt mit ca. 170000 Eingriffen pro Jahr zu den am häufigsten stationär durchgeführten Operationen in Deutschland. Eine einheitliche, angemessene und patientenorientierte ärztliche Indikationsstellung ist bei einem solchen Eingriff unerlässlich. Das Update der S2k-Leitlinie „Indikation Knieendoprothese“ beinhaltet auf aktueller Evidenz basierende und im breiten Konsens abgestimmte Empfehlungen und eine Checkliste im praxistauglichen Format.

Für dieses Leitlinien-Update wurde eine systematische Literaturrecherche nach (inter-)nationalen Leitlinien und systematischen Übersichtsarbeiten zur Gonarthrose und Knieendoprothetik durchgeführt, um klinisch relevante Fragestellungen zu Diagnostik, Prädiktoren für das Outcome, Risikofaktoren und Kontraindikatoren zu beantworten.

Eine Knieendoprothese soll nur bei radiologisch nachgewiesener fortgeschrittener Gonarthrose (Kellgren-Lawrence-Grad 3 oder 4), nach vorangegangener konservativer Therapie über mindestens 3 Monate sowie bei hohem subjektivem Leidensdruck hinsichtlich der kniebezogenen Beschwerden und nach Ausschluss möglicher Kontraindikationen (Infektionen, Begleiterkrankungen, BMI ≥ 40 kg/m2) erfolgen. Modifizierbare Risikofaktoren (wie Rauchen, Diabetes mellitus, Anämie) sollen zuvor adressiert und ggf. optimiert werden. Die Ziele der Patient*innen sollen erfragt und deren Eintrittswahrscheinlichkeit gemeinsam besprochen werden. Schließlich ist die Entscheidung zur Knieendoprothese von Patient*in und Operateur*in gemeinsam zu treffen, wenn der zu erwartende Nutzen die möglichen Risiken überwiegt.

Das Update der S2k-Leitlinie wurde um die unikondyläre Knieendoprothese erweitert, die präoperative Optimierung modifizierbarer Risikofaktoren ergänzt sowie Konkretisierungen der Hauptindikationskriterien vorgenommen.
Einwirkung von Hypoxie auf die Qualität der Thoraxkompression in einer simulierten Flugzeugkabine in Reiseflughöhe
Authors: Schmitz Jan , Aeschbach Daniel , Beccard Inga , Frings Nina , Hinkelbein Jochen , Jordan Jens , Kammerer Tobias , Liebold Felix , Limper Ulrich , Post Titiaan , Schick Volker , Tank Jens , Elmenhorst Eva-Maria
Published: May 2024

Zwischen 1/15 000 und 1/50 000 Passagiere haben während eines Fluges akute medizinische Probleme, wobei Herzstillstände, die eine kardiopulmonale Wiederbelebung (CPR) erfordern, 0,3 % der medizinischen Notfälle ausmachen. Hypoxie in der Flugzeugkabine könnte die Sauerstoffversorgung und die körperliche Leistungsfähigkeit des Helfenden beeinträchtigen, deshalb wurde eine randomisierte, kontrollierte Doppelblindstudie durchgeführt, um die Hypothese zu testen, dass Hypoxie die Effektivität der CPR verringert. 24 medizinische Fachkräfte wurden in 2 verschiedene Studienarme randomisiert, die jeweils 2 Bedingungen testeten. Mixed ANOVAs mit Post-hoc-False-Discovery-Rate mit paarweisen Vergleichen zeigten, dass eine längere Hypoxieexposition, die den Bedingungen eines Langzeitflugs entspricht, die Qualität der Thoraxkompressionen beeinträchtigen kann. Zusätzlicher Sauerstoff für das medizinische Personal ist eine wirksame Gegenmaßnahme.
Einstellungen und Erwartungen von psychologischen und ärztlichen
Psychotherapeut*innen gegenüber Open Notes: Analyse qualitativer
Survey-Antworten
Authors: Meier-Diedrich Eva , Neumann Katharina , Heinze Martin , Schwarz Julian
Published: May 2024

Ziel Erforschung der Einstellungen und Erwartungen von
Psychotherapeut*innen (PT) gegenüber eines digitalen, patientenseitigen Zugangs
zu klinischen Verlaufsnotizen (engl. “Open Notes”; kurz: ON), einschließlich
potentieller Vor- und Nachteile in der psychotherapeutischen Praxis.

Methodik Im Rahmen der PEPPPSY-Studie wurde ein Online-Survey zu dem o.g.
Thema durchgeführt. Es wurden Freitextantworten (n = 107) qualitativ mittels
thematischer Analyse ausgewertet.

Ergebnisse 129 Psychologische und ärztliche PT nahmen an der Befragung
teil. PT sahen Vorteile wie Transparenz und patientenorientierte Dokumentation,
befürchten aber auch Nachteile für die therapeutische Beziehung und einen
erhöhten Workload durch die Einführung von ON. Es wurden Bedenken hinsichtlich
Datensicherheit und negativer Auswirkungen auf die Behandlung geäußert.
Empfehlungen zur Implementierung beinhalten patientenspezifische Anpassungen des
Zugangs und begleitete Einsichtnahme der ON.

Schlussfolgerung PT zeigen eine ambivalente Haltung gegenüber ON. Weitere
Forschung und Leitlinien zur Anwendung von ON in der Psychotherapie sind
nötig.
Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort
Authors: Abdelwahab Mahmoud , Voest Jessica A. de , Metz Torri D. , Hughes Brenna L. , Grobman William A. , Saade George R. , Manuck Tracy A. , Longo Monica , Simhan Hyagriv N. , Rouse Dwight J. , Mendez-Figueroa Hector , Gyamfi-Bannerman Cynthia , Bailit Jennifer L. , Costantine Maged M. , Sehdev Harish M. , Tita Alan T.N. ,   for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network, Bethesda, MD, United States
Published: May 2024

Objective This study aimed to test the hypothesis that being pregnant and delivering during the coronavirus disease 2019 (COVID-19) pandemic was associated with changes in gestational weight gain (GWG) or frequency of small- (SGA) or large-for-gestational-age (LGA) neonates.

Study Design Secondary analysis of a multicenter observational cohort comparing pregnant people who delivered during the COVID-19 pandemic (June–December 2020) to people who delivered prior to the pandemic (March–December 2019). Those with multiple gestations, fetuses with major congenital anomalies, implausible GWG values, unavailable body mass index (BMI), or who were severe acute respiratory syndrome coronavirus-2-positive were excluded. The primary outcome was frequency of optimal recommended GWG based on prepregnancy BMI. Neonatal outcomes included birth weight, ponderal index, and frequency of SGA, LGA, and small head circumference for live births. Multivariable regression analysis was used to assess associations between exposure to the pandemic and outcomes.

Results A total of 10,717 pregnant people were included in our analysis. A total of 4,225 pregnant people were exposed to the pandemic and 6,492 pregnant people delivered prior to the COVID-19 pandemic. Pregnant people exposed to the pandemic were older and more likely to have gestational diabetes. The frequency of appropriate GWG was 28.0% during the pandemic and 27.6% before the pandemic (adjusted odds ratio [aOR]: 1.02, 95% confidence interval [CI]: 0.93–1.11). Excessive GWG was more likely (54.9 vs. 53.1%; aOR: 1.08, 95% CI: 1.001–1.17), and inadequate GWG was less likely during the pandemic (17.0 vs. 19.3%; aOR: 0.86, 95% CI: 0.77–0.95). The frequency of SGA was 5.4% during the pandemic and 6.1% before the pandemic (aOR: 0.90, 95% CI: 0.76–1.06), and the frequency of LGA was 16.0% during the pandemic versus 15.0% before the pandemic (aOR: 1.06, 95% CI: 0.95–1.18). Other neonatal outcomes including birth weight percentile (62.1 [35.8–83.2] vs. 60.2 [34.4–82.2]; adjusted mean difference (aMD) = 1.50, 95% CI: −0.28 to 3.29), ponderal index (2.6 g/cm3 [2.4–2.8] in both groups; aMD = 0.01, 95% CI: 0.00–0.02), and small head circumference for livebirths (<10th percentile [8.2 vs. 8.1%; aOR: 1.03, 95% CI: 0.89–1.19], <3rd percentile [3.5 vs. 3.1%; aOR: 1.16, 95% CI: 0.93–1.44]) were similar between groups as well.

Conclusion Being pregnant and delivering during the COVID-19 pandemic was associated with a higher likelihood of excessive GWG and a lower likelihood of inadequate GWG.

Key Points
Lower Body Weightlifting Injuries Treated in United States Emergency
Departments from 2012–2021
Authors: Aceto Matthew , Cassinat Joshua , Ghattas Yasmine S. , Wright Vonda
Published: May 2024

Weightlifting has become an increasingly popular form of exercise that has been
shown to have many health benefits but can be dangerous if performed improperly.
The objective of this study was to describe the epidemiology of lower body
weightlifting injuries in the United States. The National Electronic Injury
Surveillance System database was queried from January 1, 2012, to December 31,
2021, for lower body injuries related to using weightlifting equipment.
Demographics, diagnosis, disposition, and mechanism of injury (MOI) were
analyzed. There were 7,773 lower extremity weightlifting injuries identified
from 2012–2021, giving a national estimate of 311,842 injuries. The most common
MOI was dropped weight (n=1785, 22.96%). Deadlifts were the most cited exercise
that led to lower extremity injury (n=503, 6.47%). Males were more likely than
females to be injured (76% males vs. 24% females; p<0.001), especially by
compound movements with free weights including squats (79.63% males vs. 19.96%
females, p<0.03) and deadlifts (83.89% males vs. 16.10% females, p<0.001).
Nearly all injuries were treated as outpatient but those admitted to the
hospital were significantly older than those treated as outpatients (38.0 years
vs. 31.2 years, p<0.05). Weightlifting carries a high risk of injury due to
the intensity and technique required for the different movements involved.
Spirocyclic Hybrids of Nortropane and 1,3-Oxazinan-2-one Fragments
Authors: Shivanyuk Alexander , Mandzhulo Alexandr , Vashchenko Iryna , Lukin Oleg , Shishkina Svetlana , Dolgonos Grygoriy , Gerasov Andrii , Yepishev Vitaliy , Samofalova Dariia , Fetyukhin Volodymyr
Published: May 2024

We report facile and versatile procedures for the synthesis of exo- and endo-isomeric spirocyclic hybrids of pharmacophoric (1R,5S)-8-azabicyclo[3.2.1]octane (nortropane) and 1,3-oxazinan-2-one fragments. Our approach consists of the hydrocyanation of endo- and exo-isomeric N-Cbz-protected nortropane-3-spiroepoxides, the reduction of hydroxy nitriles into amino alcohols, the synthesis of N-alkylated amino alcohols via reductive amination, the spirocyclization of the amino alcohols, N-alkylation of the unsubstituted 1,3-oxazinan-2-one fragment in the spiro compounds, and removal of the Cbz protecting groups.
Ring-Opening of Donor-Acceptor Cyclopropane Diester for the Synthesis of Oxime Esters and 2,3-Dihydroazete Ester
Authors: Banerjee Prabal , Yadav Neeraj , Verma Kritika , Das Arnab , Kaur Navpreet
Published: May 2024

A simple and efficient approach for the synthesis of privileged oxime esters by employing donor-acceptor cyclopropane diesters (DACs) as one of the potential precursors is reported. The strategy involves Lewis acid catalyzed ring-opening of DACs, resulting in an open-chain intermediate followed by the base-mediated construction of the corresponding oxime esters in a one-pot reaction. Moreover, the process also features the synthesis of diethyl 4-(4-methoxyphenyl)azete-2,2(3H)-dicarboxylate.
Eosinophilia in an Indian Patient with Helminthic Infection Unresponsive to Albendazole and Diethylcarbamazine: An Enigmatic Case of Human Fascioliasis
Authors: Ray Debadrita , P. Ganesh C. , Kumar Yogendra , Dhibar Deba Prasad , Mewara Abhishek , De Arka
Published: May 2024

Human fascioliasis is a zoonosis caused by Fasciola hepatica and Fasciola gigantica. Population migration, globalization of food trade, climate change, and drug resistance are contributing to the re-emergence of Fasciola infection in several countries with increased recognition even in nonendemic regions. Helminthic infections are prevalent in India and are a common cause of eosinophilia in Indian patients who are often empirically treated with antihelminthic agents. However, human fascioliasis is rarely reported in India and does not respond to commonly used antihelminthic agents like albendazole, mebendazole, praziquantel, and diethylcarbamazine (DEC). We report a case of a young female with abdominal pain and eosinophilia who did not respond to empirical treatment with albendazole and DEC. She was diagnosed with Fasciola hepatica on endoscopic retrograde cholangiopancreatography and was treated with nitazoxanide that led to complete resolution of symptoms and normalization of eosinophil counts.
Anomalies of the Craniocervical Junction (Chiari Malformations)
Authors: Giugno Andrea , Fichera Valeria , Zanghì Antonio , Vecchio Michele , Catalano Marco , Palmucci Stefano , Belfiore Giuseppe , Lavalle Salvatore , Polizzi Agata , Praticò Andrea D.
Published: May 2024

Arnold Chiari malformations include a combination of posterior fossa, hindbrain, and cervical occipital junction abnormalities, sometimes associated with spinal cord abnormalities such as spina bifida, syringomyelia, and syringobulbia. The most frequent form is Chiari I syndrome but two other variants, progressively more severe, have been described. Chiari malformations are the result of defective development of posterior fossa and can be due to genetic mutations, skeletal malformations, and intrautero factors. Clinical manifestations depend on the compression of the nerve structures within the foramen magnum and the spinal canal and mainly consist in headache or neck pain, gait disturbances, sensory or motor abnormalities, and autonomic signs. However, a high number of cases of Chiari I is asymptomatic and the diagnosis is occasional. Diagnosis is performed through nuclear magnetic resonance imaging of the brain and cervical tract, although other investigations may support the diagnosis. First-line treatment for candidate patients is a surgical procedure that involves decompression of the posterior cranial fossa and the craniocervical junction, as well as correction of associated malformations with techniques that depend on the severity of the case. Anyhow, some symptomatic patients benefit from conservative medical treatment with nonsteroidal anti-inflammatory drugs.
Physicians' Perspectives with the E-prescribing System in Five Teaching Hospitals
Authors: Alipour Jahanpour , Payandeh Abolfazl , Hashemi Aida , Aliabadi Ali , Karimi Afsaneh
Published: May 2024

Objectives Despite the evidence suggesting the potential of electronic prescribing (e-prescribing), this system also faces challenges that can lead to inefficiency and even failure. This study aimed to evaluate physicians' perspectives on the efficiency, effectiveness, opportunities, and challenges associated with the e-prescribing system.

Methods In 2023, a descriptive analytics cross-sectional study was carried out. Due to the finite population size, all the physicians from five studied hospitals who agreed to participate in the study were included through the census method (n = 195). Data collection was conducted using a validated questionnaire. Data were analyzed using descriptive (mean, standard deviation, and frequency) and analytical (Pearson's correlation coefficient, two-sample t-test, one-way analysis of variance (ANOVA), and linear multiple regression model) statistics.

Results The mean scores of efficiency and effectiveness were 47.47 ± 14.46 and 36.09 ± 10.67 out of 95 and 65, respectively. Removing the illegibility of the prescriptions (n = 22) was the most frequent opportunity and internet connectivity problem (n = 37) was the most frequent challenge associated with the e-prescribing system. There was a strong positive significant correlation between efficiency and effectiveness (r = 0.850, p < 0.01). Moreover, age was found to have a significant negative correlation with efficiency (B =  −7.261, p = 0.004) and effectiveness (B = − 5.784, p = 0.002).

Conclusion Physicians believe that e-prescribing enhances the efficiency and effectiveness of their work. There are many opportunity and challenges to the use of e-prescription. Assessing the needs of physicians, actively participating and training them in the stages of design and implementation, and conducting regular evaluations of the e-prescribing system are crucial to overcome the challenges. Our finding offers insightful information about how doctors see the e-prescribing system at teaching hospitals and provide a basis for managers and policy makers at the local and national levels to support the implementation of this system and plan for improvement of its shortcomings.